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Exam 3 Nursing
DM questions
| Question | Answer |
|---|---|
| DM - The nurse is caring for a client who has normal glucose levels at bedtime, hypoglycemia at 2am and hyperglycemia in the morning. What is this client likely experiencing? | The Somogyi effect is when blood sugar drops too low in the morning causing rebound hyperglycemia in the morning. The hypoglycemia at 2am is highly indicative. The Dawn phenomenon is similar but would not have the hypoglycemia at 2am. |
| Dm- The nurse is caring for a patient whose blood glucose level is 55mg/dL. What is the likely nursing response? | The client has low hypoglycemia. This is generally treated with a small snack |
| DM - What insulin type can be given by IV? Select all that apply: | The only insulin that can be given by IV is regular insulin |
| Dm - A client with type II diabetes is being educated about what to do if he catches the flu or a cold. What is something he should be informed of? | The body's natural reaction to illness is to release glucose. As such, diabetics can expect to face increased hyperglycemia in addition to their illness |
| Dm - In educating a client about Type II Diabetes, what would be a proper explanation for poor wound healing? | High blood glucose damages capillaries which prevent proper healing |
| Dm - When does regular insulin generally have peak action after application? | The exact details depend on various factors, but 2-3 hours for peak action of regular insulin is an accepted range. |
| DM- In educating a client with diabetes, what response would reveal need for further education? | The recommended self-care routine is to wash feet on a daily basis without soaking and carefully cleaning |
| A client with diabetes and coronary heart disease is being evaluated for treatment. In light of the heart condition, which medication option is more likely to be an issue? | Cardiac safety of diabetes meds is a very complex subject. That said, pioglitazone is known to possibly have issues. |
| What is NOT true of hyperglycemic hyperosmolar nonketotic syndrome (HHNS) compared to diabetic ketoacidosis (DKA)? | In HHNS, you tend to avoid the decrease in pH and ketosis (hence nonketotic) that often occurs in diabetic ketoacidosis. Remember that the two are very similar otherwise |
| Insulin lipodystrophy should be treated in part by | Alternating insulin injection sites helps avoid lipodystrophy, which is a lump or dent in the skin that can be caused by using the same site for injections. |
| DM- The client with a fruity odor to their breath is a concern as this is a symptom of what? | Diabetic ketoacidosis (complication of hyperglycemia) |
| DM- Food is broken down into ______ (simple sugar) | Glucose |
| DM- For glucose to enter into the cell you need __________ | Insulin |
| DM - Insulin is a hormone produced and secreted by the _______ cells from the islets of Langerhans | Beta |
| DM- Insulin helps glucose enter ______ and ______ tissue | Muscles & adipose |
| DM- Insulin promotes conversion of __________ to glycogen for storage in the _________ | Glucose Liver |
| DM- Glucagon is secreted by the ________cells of the islets of Langerhans and stimulates the release of _____by the liver. | Alpha cells glucose |
| DM- Decrease in insulin and elevated blood glucose = ____________ | Hyperglycemia |
| DM- Increase in insulin and low blood glucose = _________________ | Hypoglycemia |
| DM- Alcohol my increase the risk for _____________ in people treated with insulin or ___________ | Hypoglycemia sulfonylureas |
| DM- Type I you are ________ dependent. You produce no _______ | Insulin insulin |
| DM- Type I you are more likely to become ___________ because you do not produce any _____ | Hyperglycemic insulin |
| DM What is glycosuria ______________ | Sugar in your urine |
| DM Glycosuria is associated with Type I or Type 2 _________ | Type 1 |
| DM What is the management of type I DM (hint 3 items) _____ ________ _________ | Insulin, diet, exercise |
| DM What is polysipsia? What is polyuria ? | Thirsty lots urination lots |
| DM Ketones in your urine are associated with acidosis or alkalosis? | Acidosis |
| DM What are ketones? | Fat that is stored up for engery, which leads to production of acid, the by product is ketones. |
| DM This type of diabetes has a gradual onset what is it? | Type II |
| DM What is the management of type II | Oral hypoglycemia or insulin, diet, exercise |
| DM With type II do you produce insulin? | Some is usually produced – that the difference between type I and type II |
| DM What causes type II | Obese, age, hx of DM in family, HTN |
| DM Exercise can lead to what _____________ | Hypoglycemia |
| DM Exercise _________ than _____________ | Regular sporadic |
| DM Treatment for DM is ________________ | Individualized per patient |
| DM Eat __________ before during and after ________ | Carbohydrates, exercise |
| DM ________ phenomenon occurs during the night | Somogyi |
| DM Somogyi has a rapid ______ in blood glucose but manifests as _______glucose in the morning. | Decrease increase |
| DM _______ phenomenon occurs during the morning | Dawn |
| DM During Dawn phenomenon the early morning glucose is elevated by the release of ______ hormone | Growth |
| DM What is the management for dawn phenomenon? ___________ | Give evening insulin later in the evening |
| DM Refrigerated vials to prevent loss of _________ up to _____ month | Potency 1 |
| DM Vials in use can be kept at _____ temp to decrease local _______ at the _________ site | Room irritation injection |
| DM Prefilled syringes are considered stable for up to _______ wks when stored in the _______ | 3 weeks refrigerator |
| DM When using oral hypoglycemic agents you need to have some production of _________ | Insulin |
| DM _________ increase islets of Langerhans to excrete insulin – give with food | Sulfonylurea |
| DM _________ (Glucotrol) take 30 ____ before ________ | Glipizde mins eating |
| DM _________ (diabinese) can produce ______, _________, N/V, palpitaitons, _________ | Chlorpropamide flushing, sweating, hyperventilation |
| DM _________ (Glucophage) works by making existing _______ more effective. Will not cause _______ | Metformin insulin hypoglycemia |
| DM Name 3 Rapid acting Insulin’s: ________, __________, ______________ | Name 3 Rapid acting Insulin’s: ________, __________, ______________ |
| DM Name 1 short acting insulin? When is it used? | Regular (Novolin –R, Humulin R) sliding scale |
| DM 2 Intermediate Acting | 1) NPH Humlin –N 2) NPH |
| DM Name 1 long acting | Lantus (_______) |
| DM Name 3 acute complications of DM | 1) Hypoglycemia 2) Hyperglycemia 3) Diabetic Ketoacidosis |
| DM What are the symptoms of Diabetic Ketoacidosis | 1. Hyperglycemia - which are what? 2. N/V, abdominal pain (acidosis), headache, weakness, fatigue, blurred vision 3. Hyperpnea – which what? Kussmaul’s breathing Fruity order breath Decreased LOC |
| DM With Diabetic ketoacidosis your urine with test positive with what to things? | Glucose and ketones |
| DM What are the Chronic Complications of diabetes (6 of them) | 1) infectcions 2) peripheral vascular disease 3) vascular changes 4) diabetic neuropathies 5) retinopathy 6) Chornic renal failure |
| DM What are the preventions for retinopathy (4 of them) | 1) refrain from straining to have a BM 2) use stoolf softner or laxative 3) avoid postures that lower the head 4) avoid lifting weight above the head |
| DM What is the management for chronic renal failure (3 things) | 1. controlling HTN and blood glucose level is the key to delaying renal damage 2) good hydration 3) use the bathroom “by the clock” to reduce stagnant residual urine |
| DM These symptoms are Type 1 or Type 2? Hyperglycemia, ketosis, polyuria, glucosuria, polydispsia, polyphagia, weightloss, fatigue, malaise | Type I |
| DM These symptoms are Type 1 or Type 2? and are they Hypo or Hyper Blurred vision, fatigue, parathesias, skin infections | Type 2 Hyperglycemia |
| DM what time of the day does dawn effect take place? | 4am -8am |
| DM what type of DM does dawn effect, effect? | Type 1 and Type 2 |
| DM what hormone causes dawn effect? | growth |
| DM What is somogyi phenomenon? | Nocturnal hypoglycemia with rebound morning hyperglycemia |
| DM Hyperosmolar Hyperglycemic State (HHS) occurs with what type? | Type 2 with blood glucose above 600 |
Created by:
pbeach