Exam 3 Guided Reading - Answer Key
Unit 6: Chapter 20 - Metabolic Disorders
Source: Ebersole & Hess' Gerontological Nursing & Healthy Aging, 6th ed. Page numbers below are the printed
textbook pages.
1. The onset of type 2 diabetes in later life is ______ with ______
recognizable cues.
The onset is usually insidious, with few, if any, recognizable cues.
Textbook page 283 - main text (Recognizing and Analyzing Cues).
2. The diagnosis is often discovered after there is already ______ or an
acute event occurs.
It is often discovered after there is already end-organ damage (such as
blindness) or an acute event (such as a stroke) occurs.
Textbook page 283 - main text; examples supported by Box 20.3.
3. Early signs and symptoms of diabetes include:
Classic cues include thirst and excessive urination. In older adults, early cues
may instead be dehydration, confusion, or delirium. Urinary glucose may
also cause incontinence rather than obvious urinary frequency.
Textbook page 283 - main text.
4. What are the risk factors for diabetes mellitus (modifiable and
nonmodifiable)?
Nonmodifiable: high-risk population; age over 45; first-degree relative (parent,
sibling, or child) with diabetes; previous gestational diabetes or delivery of a
baby weighing more than 9 lb; history of cardiovascular disease; and taking
atypical antipsychotics or glucocorticoids.
Modifiable: blood pressure greater than 140/90 mm Hg; prediabetes;
overweight or obesity (BMI greater than 25 kg/m²); undesirable lipid levels (HDL
below 35 mg/dL or triglycerides above 250 mg/dL); and inactivity.
Textbook page 284 - Box 20.6, Risk Factors for Diabetes Mellitus.
5. What blood glucose level is classified as hypoglycemia?
A blood glucose level below 60 mg/dL.
Textbook page 283 - main text.
6. Which is more common in older adults: hypoglycemia or hyperglycemia?
Hypoglycemia is more common in older adults with diabetes.
Textbook page 283 - main text; contributing factors are listed in Box 20.5.
Exam 3 Guided Reading - Unit 6, Chapter 20 Page 1
, 7. What are the signs of hypoglycemia?
Early cues include tachycardia, palpitations, diaphoresis, tremors, pallor,
and anxiety. Later cues include headache, dizziness, fatigue, irritability,
confusion, hunger, visual changes, seizures, and coma.
Textbook page 283 - main text.
8. What is the immediate treatment for hypoglycemia?
Give the patient glucose, either orally or intravenously.
Textbook page 283 - main text.
9. What prevention strategies do we teach patients to prevent
hypoglycemia?
Teach the patient to avoid skipping meals, understand how food and activity
affect glucose, monitor blood glucose as instructed, and perform an extra
glucose check whenever feeling clammy or cold, sweaty, shaky, or
confused. The patient and daily caregivers should know the warning cues for
low glucose and what action to take. When insulin is used, exercise should be
regular rather than erratic, with glucose checked before and after exercise to
help prevent hypoglycemia.
Textbook page 285 - main text and Box 20.7; exercise detail continues on page 286.
10. What are complications of hyperglycemia?
Complications include decreased visual acuity/blindness, paresthesia,
neuropathy, heart disease, stroke, and periodontal disease. Severe
hyperglycemia can progress to hyperosmolar nonketotic coma, dehydration,
confusion, delirium, and death.
Textbook page 283 - Box 20.3, Signs of End-Organ Damage in DM, and main text.
Exam 3 Guided Reading - Unit 6, Chapter 20 Page 2
Unit 6: Chapter 20 - Metabolic Disorders
Source: Ebersole & Hess' Gerontological Nursing & Healthy Aging, 6th ed. Page numbers below are the printed
textbook pages.
1. The onset of type 2 diabetes in later life is ______ with ______
recognizable cues.
The onset is usually insidious, with few, if any, recognizable cues.
Textbook page 283 - main text (Recognizing and Analyzing Cues).
2. The diagnosis is often discovered after there is already ______ or an
acute event occurs.
It is often discovered after there is already end-organ damage (such as
blindness) or an acute event (such as a stroke) occurs.
Textbook page 283 - main text; examples supported by Box 20.3.
3. Early signs and symptoms of diabetes include:
Classic cues include thirst and excessive urination. In older adults, early cues
may instead be dehydration, confusion, or delirium. Urinary glucose may
also cause incontinence rather than obvious urinary frequency.
Textbook page 283 - main text.
4. What are the risk factors for diabetes mellitus (modifiable and
nonmodifiable)?
Nonmodifiable: high-risk population; age over 45; first-degree relative (parent,
sibling, or child) with diabetes; previous gestational diabetes or delivery of a
baby weighing more than 9 lb; history of cardiovascular disease; and taking
atypical antipsychotics or glucocorticoids.
Modifiable: blood pressure greater than 140/90 mm Hg; prediabetes;
overweight or obesity (BMI greater than 25 kg/m²); undesirable lipid levels (HDL
below 35 mg/dL or triglycerides above 250 mg/dL); and inactivity.
Textbook page 284 - Box 20.6, Risk Factors for Diabetes Mellitus.
5. What blood glucose level is classified as hypoglycemia?
A blood glucose level below 60 mg/dL.
Textbook page 283 - main text.
6. Which is more common in older adults: hypoglycemia or hyperglycemia?
Hypoglycemia is more common in older adults with diabetes.
Textbook page 283 - main text; contributing factors are listed in Box 20.5.
Exam 3 Guided Reading - Unit 6, Chapter 20 Page 1
, 7. What are the signs of hypoglycemia?
Early cues include tachycardia, palpitations, diaphoresis, tremors, pallor,
and anxiety. Later cues include headache, dizziness, fatigue, irritability,
confusion, hunger, visual changes, seizures, and coma.
Textbook page 283 - main text.
8. What is the immediate treatment for hypoglycemia?
Give the patient glucose, either orally or intravenously.
Textbook page 283 - main text.
9. What prevention strategies do we teach patients to prevent
hypoglycemia?
Teach the patient to avoid skipping meals, understand how food and activity
affect glucose, monitor blood glucose as instructed, and perform an extra
glucose check whenever feeling clammy or cold, sweaty, shaky, or
confused. The patient and daily caregivers should know the warning cues for
low glucose and what action to take. When insulin is used, exercise should be
regular rather than erratic, with glucose checked before and after exercise to
help prevent hypoglycemia.
Textbook page 285 - main text and Box 20.7; exercise detail continues on page 286.
10. What are complications of hyperglycemia?
Complications include decreased visual acuity/blindness, paresthesia,
neuropathy, heart disease, stroke, and periodontal disease. Severe
hyperglycemia can progress to hyperosmolar nonketotic coma, dehydration,
confusion, delirium, and death.
Textbook page 283 - Box 20.3, Signs of End-Organ Damage in DM, and main text.
Exam 3 Guided Reading - Unit 6, Chapter 20 Page 2
