Skylar Hansen (DM, pediatric)Skyler Hansen Age: 18 years Diagnosis: Diabetes|NUR 172_Skyler Hansen Vsim/ Verified Answers.

Skylar Hansen (DM, pediatric) The nurse understands that the pathophys of type 1 DM is characterized by which of the following? Ans: destruction of pancreatic beta cells these cells are responsible for secretion of insulin. Type 2 DM is the result of impaired insulin production or insulin resistance which may be r/t necrosis of the pancreatic alpha cells The nurse would expect that a pt experiencing moderate hypoglycemia would exhibit which of the following sets of s/s? Ans: HA, light headedness, slurred speech s/s grouped into 2 categories: adrenergic sx and CNS sx. In moderate hypoglycemia, the drop in blood glucose affects brain, resulting in HA, lightheadedness, and slurred speech, as well as other sx that may include loss of consciousness, hunger, tachycardia, and sweating The nurse knows that which of the following is a normal fasting serum glucose level for a pt of 18 y/o? Ans: 90 mg/dL normal fasting serum glucose range for ages 2-18 is 60-100 mg/dL glycosylated hemoglobin (HgbA1c) represents average blood glucose levels over a period of approximately 2-3 mos. Which of the following would the nurse know to be a normal level range indicating good maintenance of blood glucose over time? Ans: 4-6% (indicates consistently near-normal blood glucose concentrations) For an unconscious pt who is experiencing hypoglycemia in a health care facility, the nurse would make what emergency management intervention? Ans: 25 to 50 mL of dextrose 50% in water In hospitals and EDs, for pts who are unconscious or cannot swallow, 25-50 mL of D50W may be administered IV T/F: insulin regimen typically involve a combination of short-acting and long-acting insulin Ans: T normally functioning pancreas secretes insulin throughout the day in response to blood glucose levels. Using a combination of short- and long-lasting insulin mimics this normal pattern The nurse would educate the patient that which of the following factors increase risk of developing type 2 DM? Ans: family hx HTN obesity race/ethnicity, age, previously impaired fasting glucose or impaired glucose tolerance, HDL </= 35, and/or triglyceride >/= 250, and hx of gestational diabetes are all risk factors the nurse understands that diabetes can lead to which of the following long-term complications? Ans: CV disease blindness renal disease peripheral neuropathy atherosclerotic changes leading to CV disease develops at an earlier age in pts w/ diabetes. Most pts w/ diabetes have some degree of retinopathy after 20 yrs, which can lead to blindness. Nephropathy, or kidney disease secondary to microvascular changes in the kidneys, is a common complication that develops over 10-15 yrs. Peripheral neuropathy increases w/ age of pt and duration of diabetes. DKA is an acute, short-term complication from inadequate insulin. Which of following is the rationale for the nurse administering dextrose 50% in water (D50W) intravenously rather than another concentrated source of carbohydrates for a pt with type 1 DM? Ans: pt cannot swallow pt is unconscious once Skyler regains consciousness after receiving D50W to treat an acute hypoglycemic episode, which of the following is the most appropriate intervention by the nurse to prevent another decrease in blood glucose? Ans: provide a snack of cheese and crackers after dextrose, a snack with starch and protein should be given to pt on awakening to prevent recurrence of hypoglycemia and to replenish liver stores of glucose the nurse recognizes that which factors may have contributed to skyler's low blood glucose in this case? Ans: too little food too much physical activity another medication that may have been given in this case would have been glucagon. what does the nurse understand would be the correct dosage for this medication? Ans: 1 mg IV, IM, or subQ T/F: glucagon works by promoting conversion of hepatic glycogen to glucose Ans: T glucagon is a hormone produced by the alpha cells of pancreas that stimulates liver to breakdownglycogen, the stored glucose while in the hospital, skyler receives a short-acting and intermediate-acting insulin. the nurse knows that, when preparing the 2 insulins, which insulin should be drawn into the syringe first? Ans: short-acting when providing the pt education for skyler, it is important for the nurse to emphasize the peak effect times for insulin. The expected peak for regular insulin is which of the following? Ans: 2-3 hrs after injecting subQ intermediate insulin has peak of 4-15 hrs after injection long acting has peak of 10-30 hrs after injection the nurse realizes additional pt education is required when skyler makes which of the following statements? Ans: "i will make sure to eat one snack per day" which of the following does the nurse recognize as the major, acute complications of diabetes? Ans: DKA hypoglycemia hyperglycemic hyperosmolar syndrome the nurse assesses the IV site prior to administering 50 mL of D50W IV to the pt w/ hypoglycemia per protocol. the nurse identifies rednes and swelling at IV site. which action should the nurse take? Ans: insert another IV to administer the d50W d50W is hypertonic solution and very irritating to veins