LPN NCLEX-PN DIABETES

LPN NCLEX-PN DIABETES

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Brit Clinical manifestations associated with a diagnosis of type 1 DM :

Hypoglycemia

The lowest fasting plasma glucose level suggestive of a diagnosis of DM is:

126mg/dl Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every: 2-3 weeks A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is: Diaphoresis Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation : Palpation for increased pulse volume in the arteries of the lower extremities The nurse expects that a type 1 diabetic may receive ____ of his or her morning dose of insulin preoperatively:

50-60%

A bedtime snack is provided the patient. This is based on the knowledge that intermediate-acting insulin are effective for an approximate

duration of:

16-20 hours

Patient refuses his bedtime snack. This should alert the nurse to assess for:

Signs of hypoglycemia earlier than expected.A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is: 6-14 hours after administration An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the

response on the information that the pump:

Gives small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal.A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis?Elevated blood glucose level and a low plasma bicarbonate A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to

decrease the client's anxiety would be to:

Convey empathy, trust, and respect toward the client.A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The priority nursing diagnosis would be: High risk for deficient fluid volume A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to: Administer regular insulin intravenously A nurse performs a physical assessment on a client with type 2 DM. Findings include a fasting blood glucose of 120mg/dl, temperature of 101, pulse of 88, respirations of 22, and a bp of 140/84. Which finding would be of most concern of the nurse?Temperature A client with type 1 DM calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicated an inadequate understanding of the peak action of NPH insulin and exercise?"The best time for me to exercise is every afternoon." NPH NPH is intermediate acting insulin. The onset of action is 1-2 hours, it peaks in 6-14 hours, and it's duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.

Insulin Pump Provides a small continuous dose of regular insulin subcutaneously throughout the day and night, and the client can self-administer a bolus with additional dosage from the pump before each meal as needed. Regular insulin is used in an insulin pump. An external pump is not attached surgically to the pancreas.Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection?More insulin A client is in DKA, secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?Kussmaul's respirations and a fruity odor on the breath Which of the following causes of HHNS is most common?Undiagnosed, untreated diabetes mellitus Insulin forces which of the following electrolytes out of the plasma and into the cells?Potassium Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?IV bolus, followed by continuous infusion.Rotating injection sites when administering insulin prevents which of the following complications?Insulin lipodystrophy Which of the following chronic complications is associated with diabetes?Retinopathy, neuropathy, and coronary artery disease Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?Monitor blood glucose closely, and look for signs of hypoglycemia.A client with DM has an above-knee amputation because of severe peripheral vascular disease, Two days following surgery, when preparing the

client for dinner, it is the nurse's primary responsibility to:

Check the client's serum glucose level A client with DM states, "I cannot eat big meals; I prefer to snack throughout the day." The nurse should carefully explain that the: Regulated food intake is basic to control

The insulin that has the most rapid onset of action would be:

Lispro The physician orders 36 units of NPH and 12 units of regular insulin. The nurse plans to administer these drugs in 1 syringe. Identify the steps in this procedure by listing them in priority order.

• Inject air equal to NPH dose into NPH vial
• Invert regular insulin bottle and withdraw regular insulin dose
• Inject air equal to regular dose into regular dose
• Invert NPH vial and withdraw NPH dose.

A client with type 1 DM has a fingerstick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should: Administer the insulin as ordered The nurse knows that glucagon may be given in the treatment of hypoglycemia because it: Increases blood glucose levels

A client's blood gases reflect diabetic acidosis. The nurse should expect:

Decreased HCO3 Which adaptations should the nurse caring for a client with diabetic ketoacidosis expect the client to exhibit? Select all that apply: Low PCO2 and Retinopathy Has an immediate onset, a peak of 30-90 minutes, and duration of 2-4 hours.Lispro Retinopathy Neuropathy Produces fatty masses at the injection sites, causing unpredictable absorption of insulin injected into these sites.Insulin Lipodystrophy Regular insulin (Humulin R) A short-acting insulin and is administered via IV with an initial dose of 0.3 units/kg, followed by 0.2 units/kg 1 hour later, followed by 0.2 units/kg every 2 hours until blood glucose becomes <13.9 mmol/L (<250 mg/dL). At this point, insulin dose should be decreased by half, to 0.1 units/kg every 2 hours, until the resolution of DKA.