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MSN 277 Exam 1 STUDY GUIDE WITH COMPLETE QUESTIONS AND CORRECT ANSWERS RATED A+
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MSN 277 Exam 1 STUDY GUIDE WITH COMPLETE QUESTIONS AND CORRECT ANSWERS RATED A+
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MSN 277 Exam 1 STUDY GUIDE WITHCOMPLETE QUESTIONS AND CORRECT
ANSWERS RATED A+
Behaviors that convey nursing presence Correct Answer Trust
Openness
Small talk
Empathetic attention
Patient education
Coordination of care
Direct/Indirect care
Patho of type 1 diabetes Correct Answer -Autoimmune
destruction of beta cells
-DEC insulin production
-glucose from food can't be stored in liver
Patho of Type 2 diabetes Correct Answer Insufficient amount of
insulin production/ poor utilization of insulin
S/S of Type 1 DM Correct Answer Polydipsia
Polyphagia
Polyuria
S/S of Type 2 DM Correct Answer -3 Ps
-Fatigue
-recurrent infection
-delayed wound healing
-visual changes
Diagnostic Tests for DM Correct Answer -HgbA1C >6.5%
-Fasting plasma glucose >126mg/dl
-2 hour plasma glucose >200mg/dl
,-randome glucose test >200mg/dl
Risk factors for type 1 DM Correct Answer genetic predisposition
Risk factors for type II DM Correct Answer obesity
fam history
Ethnicity (AA, Asian, NA)
Complications with Type 1 DM Correct Answer Acute: DKA &
Hypoglycemia
Chronic: Macrovascular disease, Microvascular disease
(retinopathy, neuropathy, nephrothopy, dermopathy)
Complications for type 2 DM Correct Answer ACUTE:
Hyperosmolar Hyperglycemic Syndrome (HHS)
CHRONIC: same as type 1 DM
Patho of DKA Correct Answer -insulin supply=insufficient
-glucose unable to be used for energy...body breaks down fats
into FFAs and ketones
-ketones = metabolic acidosis
S/S of DKA Correct Answer **Kussmaul Respirations (blowing off
CO2)
fruity breath, weakness/fatigue, polydipsia, orthostatic
hypotension, poor skin turgor
Diagnostic testing for DKA Correct Answer -blood glucose
>300mg/dl
-arterial blood pH <7.3
-serum bicarbonate level <15mEq
-Ketones in blood/urine
,Risk factors for DKA Correct Answer -Type I DM
-illness
-infection
-inadequate insulin dosage
-undiagnosed type I DM
-poor self management
Being available in a situation with the wholeness of one's
individual being
BEING WITH and DOING FOR the patient
Doing for=physical assessment, observation, direct patient care
Being with=caring for emotional, spiritual, behavioral needs
Correct Answer Nursing Presence
Interventions for DKA Correct Answer -replace fluids (IV)
-airway management
-stabilize BP and UO
-insulin therapy
-monitor vitals
-potassium replacement
Pharm for DKA Correct Answer -IV infusion 0.9% NaCl (after
BG=250, add 5% dextrose to IV)
-continuous regular insulin drip @ 0.1 U/kg/hr
Patho of HHS Correct Answer patient able to make enough
insulin to prevent DKA... but not enough to prevent hyperglycemia
-INC glucose in blood = severe fluid volume deficit
-leads to electrolyte imbalance, dehydration, hypovolemia `
, S/S of HHS Correct Answer -dehydration (poor turgor,
tachycardia, hypotension)
-seizures
-coma
-death
Diagnostic for HHS Correct Answer -Blood glucose >600mg/dl
-INC serum osmolality
-no ketones in blood/urine
Risk factors for HHS Correct Answer age >60 yrs
-uncontrolled type II DM
Interventions for HHS Correct Answer -Greater fluid requirement
than DKA (IV)
-electrolyte infusions
-vital assessment
-cardiac monitoring
-monitor I/O
Pharm for HHS Correct Answer -IV infusion of insulin & 0.9% or
0.45% NaCl
Patho of Hypoglycemia Correct Answer Type I & II DM
-too much insulin in proportion to glucose in body
-low blood glucose cause neurological defects to occur
S/S hypoglycemia Correct Answer -confusion/irritability
-diaphoresis
-tremors
-hunger
-weakness
-sever= coma, seizures, death
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