NUR 231 EXAM 3 QUESTIONS WITH VERIFIED ANSWERS

NUR 231 EXAM 3 QUESTIONS WITH VERIFIED ANSWERS What is the insulin to carb ratio? 1 unit to 15gm carbs What are the food classification categories? carbs, fats, proteins (fiber) What 5 things should someone with diabetes that wants to drink alcohol do? 1. Talk to MD 2. glucagon and hypoglycemia 3. Get a medical bracelet 4. Understand alcoholic intake quantity 5. Educate friends What happens to the blood sugar of someone with diabetes when they drink alcohol? moderate amounts of alcohol may cause blood sugar to rise, excess alcohol can actually decrease your blood sugar level, sometimes causing it to drop into dangerous levels, especially for people with type 1 diabetes What are some considerations with exercising with diabetes? exercise three times each week, perform resistance training twice a week if you have type 2 diabetes, exercise at the same time of day (when BG is at it's peak), use proper footwear, avoid trauma to the lower extremities (especially if you have numbness), inspect feet daily after exercise, avoid exercise in extreme heat or cold, avoid exercise during periods or poor metabolic control, stretch for 10 to 15 minutes before exercising What should you teach someone with DM about alcohol consumption? large amounts can be converted into fats which increases the risk for DKA They are at danger for hypoglycemia. Eat while drinking to maintain blood sugar Alcohol can lead to excessive weight gain, hyperlipidemia, and elevated glucose levels What are some survival skills for people with diabetes? -Know the pathophysiology of DM (basic definition of DM, normal BG levels, effect of insulin and exercise, effect of food and stress, including illness and infections, basic treatment approaches) -Know treatment modalities(administration of insulin and oral antidiabetes medications, meal planning, and monitoring of blood glucose and urine ketones) -Recognition, treatment, and prevention of acute complications (hypo/hyperglycemia) -Pragmatic information (where to buy and store insulin, syringes, and glucose monitoring supplies, when and how to contact the primary provider) What is the effect of insulin and exercise on the BG of someone with DM? decreased BG What is the effect of food and stress (including illness and infections) on the BG of someone with DM? Increased BG What are clinical manifestations of hypoglycemia? -mild cases: sweating, tremor, tachycardia, palpitation, nervousness, and hunger -moderate: inability to concentrate, headache, lightheadedness, confusion, memory lapses, numbness of the lips and tongue, slurred speech, impaired coordination, emotional changes, irrational or combative behavior, double vision, and drowsiness -severe: disoriented behavior, seizures, difficulty arousing from sleep, or loss of consiousness How to treat hypoglycemia at home? give them 15g of a fast-acting concentrated source of carbs How do we treat hypoglycemia in emergency settings? we can give them 1 mg glucagon injection after they regain consciousness they should also be given a snack What are the clinical manifestations of DKA? polyuria, polydipsia, marked fatigue, blurred vision, weakness, and headache What are sick day rules to prevent DKA? -take insulin or oral antidiabetic agents as usual -test blood glucose and urine ketones every 3 to 4 hours -report elevated glucose levels as specified or urine ketones to primary -take supp doses of reg insulin every 3 to 4 hours if needed -substitute soft foods -take liquids every half hour to an hour to prevent dehydration and to provide calories if vomiting, diarrhea, or fever persists -report nausea, vomiting, and diarrhea to your primary because extreme fluid loss can be dangerous -be aware that if you are unable to retain oral fluids, you may require hospitalization to avoid DKA and possibly coma Management for DKA rehydration is important, NS will be given rapidly for the first few hours and then it will be switched to half normal saline; they may need potassium replacement through IV; regular insulin may be added to IV solutions to reverse acidosis Clinical manifestations for HHS hypotension, profound dehydration, tachycardia, variable neurologic signs Management of HHS similar to DKA close monitoring of volume and electrolytes Replace fluid losses (carefully- a little slower than DKA; takes days to replace fluid loss) Insulin replacement therapy Nursing Interventions for HHS -maintaining fluid and electrolyte balance -increasing knowledge about diabetes management -decreasing anxiety -monitoring and managing potential complications -educating patients on self care Nursing Diagnosis for HHS potential complications