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Week 9 BSN 366 Diabetes Questions With Complete Solutions
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Week 9 BSN 366 Diabetes Questions With Complete Solutions
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Week 9 BSN 366 Diabetes Questions With CompleteSolutions
Collaborative Care of Diabetes
Question 1 of 3
Which laboratory finding warrants a repeat test to confirm a
diagnosis of diabetes?
Hemoglobin A1c (HgbA1c) of 6.0%
Fasting plasma glucose level of 90 mg/dL
Random blood glucose value of 250 mg/dL
Oral glucose tolerance test with 2-hour glucose level of 150
mg/dL Correct Answer Random blood glucose value of 250
mg/dL
A random plasma glucose value ≥200 mg/dL may indicate
diabetes, but if the patient has no symptoms, the test must be
repeated to confirm the diagnosis and rule out a false-positive
result.
DKA
-Administer intravenous (IV) fluids to treat dehydration.
-Perform blood glucose monitoring to determine effectiveness of
treatment.
-Administer sodium bicarbonate if pH is <7.0 to treat acidosis.
-Administer regular insulin intravenously to lower blood glucose
level.
-Perform telemetry monitoring when hyper- or hypokalemia is
present.
-Monitor intake and output to check fluid balance and kidney
function.
-Monitor electrolytes to identify electrolyte excesses or deficits.
-Monitor urine for ketones to determine fat breakdown.
,-Contact the health care provider if any abnormalities are
detected. Correct Answer HHS
-Administer IV fluids at higher rates to treat dehydration.
-Administer IV fluids with regular insulin to treat
hyperglycemia.
-Perform telemetry monitoring when hyper- or hypokalemia is
present.
-Monitor intake and output to check fluid balance and kidney
function.
-Monitor blood glucose hourly to determine effectiveness of
treatment.
-Contact the health care provider if any abnormalities are
detected.
Hypoglycemia occurs if insulin dosing is excessive or the
patient is not balancing insulin administration with caloric
intake.
Lipodystrophy occurs if the patient repeatedly administers the
insulin in the same area. To prevent this, the nurse will instruct
the patient to rotate injection sites. This allows for improved,
more predictable insulin absorption.
Allergic reactions can occur, manifested by local itching and a
rash or even full anaphylaxis. Correct Answer The Somogyi
effect is an overcompensation by the body in response to
extremely low blood sugar levels occurring during the night,
resulting in early morning hyperglycemia. The body releases
stored glucagon in reaction to the untreated nighttime
hypoglycemia. This is typically managed by instituting a
bedtime snack and/or by decreasing the evening insulin dose.
, The dawn phenomenon is also early morning hyperglycemia
caused by the release of cortisol and growth hormone during the
early morning hours. It tends to happen to younger patients
during periods of growth. This is typically managed by
increasing the evening insulin dose.
Nursing Management of Diabetes:
Hypoglycemia occurs when there is too much insulin and not
enough glucose.
Follow the Rule of 15.
-Administer a fast-acting carbohydrate source (15 g).
-Recheck the blood glucose level in 15 minutes.
-If the blood glucose level is still <70 mg/dL, administer another
15 g of carbohydrates.
-When the blood glucose level is >70 mg/dL, follow up within
15 minutes with a long-acting carbohydrate.
-Recheck the blood glucose level in 1 hour. Correct Answer
Hyperglycemia occurs when there is not enough insulin to
facilitate entry of glucose into the cells.
-Notify the health care provider if the blood glucose level is
>300 mg/dL.
-If the result is from a bedside capillary glucose test, have the
laboratory determine a blood glucose level for confirmation of
the bedside test result.
-Administer insulin as prescribed.
Overview
Many GLAs are on the market to manage blood glucose levels
in patients with diabetes. These include insulin, OAs, and
noninsulin injectables. GLAs to treat diabetes need to be
scheduled around meals, bedtime, or a patient's work hours.
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