Lewis Medical Surgical --Chapter 53
Diabetes
. A affected person with diabetes rides a bicycle to and from paintings each day. Which website
could the
nurse train the affected person to use to manage the morning insulin?
A. Thigh
b. Buttock
c. Abdomen
d. Upper arm - ANS-ANS: C
Patients ought to gain knowledge of no longer to administer insulin into a domain in an effort to
be exercised vigorously
because workout will boom the rate of absorption. The thigh, buttock, and arm are all
exercised by riding a bicycle
A 26-12 months-old girl who has kind 1 diabetes develops a sore throat and runny nostril after
caring for her unwell infant. The affected person calls the health center for recommendation
approximately her signs and symptoms and reports a glucose stage of 210 mg/dL regardless of
taking her standard glargine (Lantus) and lispro (Humalog)
insulin. Which action could the nurse endorse the patient to take?
A. Use only the lispro insulin till the signs and symptoms are resolved.
B. Limit intake of calories until the glucose is less than a hundred and twenty mg/dL.
C. Monitor blood glucose each four hours and phone the hospital if it rises.
D. Decrease carbohydrates till glycosylated hemoglobin is less than 7%. - ANS-ANS: C
Infection and different stressors boom glucose degrees and the affected person will want to
check glucose
often, treat elevations correctly with lispro insulin, and speak to the health care issuer
if glucose tiers stay increased. Discontinuing the glargine will contribute to
hyperglycemia and might lead to diabetic ketoacidosis (DKA). Decreasing carbohydrate or
caloric consumption isn't suitable because the patient will need greater calories while unwell.
Glycosylated hemoglobin checking out isn't always used to evaluate short-term alterations in
glucose.
A 27-12 months-antique affected person admitted with diabetic ketoacidosis (DKA) has a serum
glucose degree of
732 mg/dL and serum potassium stage of 3.1 mEq/L. Which action prescribed by using the
health
care issuer might the nurse put into effect first?
A. Place the patient on a cardiac screen.
B. Administer IV potassium dietary supplements.
C. Ask the affected person about home insulin doses.
, D. Start an insulin infusion at zero.1 units/kg/hr. - ANS-ANS: A
Hypokalemia can result in potentially deadly dysrhythmias along with ventricular tachycardia
and
ventricular traumatic inflammation, which could be detected with electrocardiogram (ECG)
tracking.
Because potassium must be infused over as a minimum 1 hour, the nurse might initiate cardiac
tracking before infusion of potassium. Insulin could now not be administered without cardiac
tracking because insulin infusion will further decrease potassium levels. Discussion of
domestic insulin and feasible causes can wait until the affected person is stabilized.
A 28-12 months-old male affected person with type 1 diabetes reviews how he manages his
exercising and
glucose manage. Which conduct suggests a need for the nurse to implement additional
teaching?
A. The patient constantly carries hard sweets while engaging in workout.
B. The affected person goes for a lively stroll while his glucose is 2 hundred mg/dL.
C. The patient has a peanut butter sandwich earlier than going for a bicycle experience.
D. The affected person increases daily exercising when ketones are present in the urine. -
ANS-ANS: D
When the affected person is ketotic, exercise increase the glucose degree; people with type 1
diabetes
should learn to keep away from workout while ketosis is present. Other suggestions include
(1) before workout, if glucose a hundred mg/dL, devour a fifteen-g carbohydrate snack. After 15
to 30 min,
recheck glucose ranges. (2) Delay exercising if <a hundred mg/dL. Patients using capsules that
vicinity them
at threat for hypoglycemia have to constantly bring a fast-appearing source of carbohydrate,
inclusive of
glucose capsules or hard goodies, whilst exercise. (three) Before exercise, if glucose 250 mg/dL
in someone with type 1 DM and ketones are present, put off energetic hobby until ketones are
long past. Drink fluids.
A 30-12 months-old affected person has a new diagnosis of kind 2 diabetes. When would the
nurse advocate the patient agenda a dilated eye examination?
A. Every 2 years
b. Every 6 months
c. As soon as available
d. At the age of 39 years - ANS-ANS: C
Because many patients have a few diabetic retinopathy while they may be first diagnosed with
type 2 diabetes, a dilated eye examination is recommended at the time of diagnosis and
yearly thereafter.
A lady affected person is scheduled for an oral glucose tolerance check. Which information from
the
affected person's fitness history is important for the nurse to speak to the fitness care provider
concerning decoding the result of this check?
A. The affected person makes use of oral contraceptives.
Diabetes
. A affected person with diabetes rides a bicycle to and from paintings each day. Which website
could the
nurse train the affected person to use to manage the morning insulin?
A. Thigh
b. Buttock
c. Abdomen
d. Upper arm - ANS-ANS: C
Patients ought to gain knowledge of no longer to administer insulin into a domain in an effort to
be exercised vigorously
because workout will boom the rate of absorption. The thigh, buttock, and arm are all
exercised by riding a bicycle
A 26-12 months-old girl who has kind 1 diabetes develops a sore throat and runny nostril after
caring for her unwell infant. The affected person calls the health center for recommendation
approximately her signs and symptoms and reports a glucose stage of 210 mg/dL regardless of
taking her standard glargine (Lantus) and lispro (Humalog)
insulin. Which action could the nurse endorse the patient to take?
A. Use only the lispro insulin till the signs and symptoms are resolved.
B. Limit intake of calories until the glucose is less than a hundred and twenty mg/dL.
C. Monitor blood glucose each four hours and phone the hospital if it rises.
D. Decrease carbohydrates till glycosylated hemoglobin is less than 7%. - ANS-ANS: C
Infection and different stressors boom glucose degrees and the affected person will want to
check glucose
often, treat elevations correctly with lispro insulin, and speak to the health care issuer
if glucose tiers stay increased. Discontinuing the glargine will contribute to
hyperglycemia and might lead to diabetic ketoacidosis (DKA). Decreasing carbohydrate or
caloric consumption isn't suitable because the patient will need greater calories while unwell.
Glycosylated hemoglobin checking out isn't always used to evaluate short-term alterations in
glucose.
A 27-12 months-antique affected person admitted with diabetic ketoacidosis (DKA) has a serum
glucose degree of
732 mg/dL and serum potassium stage of 3.1 mEq/L. Which action prescribed by using the
health
care issuer might the nurse put into effect first?
A. Place the patient on a cardiac screen.
B. Administer IV potassium dietary supplements.
C. Ask the affected person about home insulin doses.
, D. Start an insulin infusion at zero.1 units/kg/hr. - ANS-ANS: A
Hypokalemia can result in potentially deadly dysrhythmias along with ventricular tachycardia
and
ventricular traumatic inflammation, which could be detected with electrocardiogram (ECG)
tracking.
Because potassium must be infused over as a minimum 1 hour, the nurse might initiate cardiac
tracking before infusion of potassium. Insulin could now not be administered without cardiac
tracking because insulin infusion will further decrease potassium levels. Discussion of
domestic insulin and feasible causes can wait until the affected person is stabilized.
A 28-12 months-old male affected person with type 1 diabetes reviews how he manages his
exercising and
glucose manage. Which conduct suggests a need for the nurse to implement additional
teaching?
A. The patient constantly carries hard sweets while engaging in workout.
B. The affected person goes for a lively stroll while his glucose is 2 hundred mg/dL.
C. The patient has a peanut butter sandwich earlier than going for a bicycle experience.
D. The affected person increases daily exercising when ketones are present in the urine. -
ANS-ANS: D
When the affected person is ketotic, exercise increase the glucose degree; people with type 1
diabetes
should learn to keep away from workout while ketosis is present. Other suggestions include
(1) before workout, if glucose a hundred mg/dL, devour a fifteen-g carbohydrate snack. After 15
to 30 min,
recheck glucose ranges. (2) Delay exercising if <a hundred mg/dL. Patients using capsules that
vicinity them
at threat for hypoglycemia have to constantly bring a fast-appearing source of carbohydrate,
inclusive of
glucose capsules or hard goodies, whilst exercise. (three) Before exercise, if glucose 250 mg/dL
in someone with type 1 DM and ketones are present, put off energetic hobby until ketones are
long past. Drink fluids.
A 30-12 months-old affected person has a new diagnosis of kind 2 diabetes. When would the
nurse advocate the patient agenda a dilated eye examination?
A. Every 2 years
b. Every 6 months
c. As soon as available
d. At the age of 39 years - ANS-ANS: C
Because many patients have a few diabetic retinopathy while they may be first diagnosed with
type 2 diabetes, a dilated eye examination is recommended at the time of diagnosis and
yearly thereafter.
A lady affected person is scheduled for an oral glucose tolerance check. Which information from
the
affected person's fitness history is important for the nurse to speak to the fitness care provider
concerning decoding the result of this check?
A. The affected person makes use of oral contraceptives.
