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A patient has been brought to the emergency department by paramedics after being found unconscious. The patients Medic Alert bracelet indicates that the patient has type 1 diabetes and the patients blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention?
- A. IV administration of 50% dextrose in water
- B. Subcutaneous administration of 10 units of Humalog
- C. Subcutaneous administration of 12 to 15 units of regular insulin
- D. IV bolus of 5% dextrose in 0.45% NaCl
Correct Answer: A
Rationale: In hospitals and emergency departments, for patients who are unconscious or cannot swallow, 25 to 50 mL of 50% dextrose in water (D50W) may be administered IV for the treatment of hypoglycemia. Five percent dextrose would be inadequate and insulin would exacerbate the patients condition.
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A physician has explained to a patient that he has developed diabetic neuropathy in his right foot. Later that day, the patient asks the nurse what causes diabetic neuropathy. What would be the nurses best response?
- A. Research has shown that diabetic neuropathy is caused by fluctuations in blood sugar that have gone on for years.
- B. The cause is not known for sure but it is thought to have something to do with ketoacidosis.
- C. The cause is not known for sure but it is thought to involve elevated blood glucose levels over a period of years.
- D. Research has shown that diabetic neuropathy is caused by a combination of elevated glucose levels and elevated ketone levels.
Correct Answer: C
Rationale: The etiology of neuropathy may involve elevated blood glucose levels over a period of years. High blood sugars (rather than fluctuations or variations in blood sugars) are thought to be responsible. Ketones and ketoacidosis are not direct causes of neuropathies.
A school nurse is teaching a group of high school students about risk factors for diabetes. Which of the following actions has the greatest potential to reduce an individuals risk for developing diabetes?
- A. Have blood glucose levels checked annually.
- B. Stop using tobacco in any form.
- C. Undergo eye examinations regularly.
- D. Lose weight, if obese.
Correct Answer: D
Rationale: Obesity is a major modifiable risk factor for diabetes. Smoking is not a direct risk factor for the disease. Eye examinations are necessary for persons who have been diagnosed with diabetes, but they do not screen for the disease or prevent it. Similarly, blood glucose checks do not prevent the diabetes.
A 15-year-old child is brought to the emergency department with symptoms of hyperglycemia and is subsequently diagnosed with diabetes. Based on the fact that the childs pancreatic beta cells are being destroyed, the patient would be diagnosed with what type of diabetes?
- A. Type 1 diabetes
- B. Type 2 diabetes
- C. Noninsulin-dependent diabetes
- D. Prediabetes
Correct Answer: A
Rationale: Beta cell destruction is the hallmark of type 1 diabetes. Noninsulin-dependent diabetes is synonymous with type 2 diabetes, which involves insulin resistance and impaired insulin secretion, but not beta cell destruction. Prediabetes is characterized by normal glucose metabolism, but a previous history of hyperglycemia, often during illness or pregnancy.
A medical nurse is caring for a patient with type 1 diabetes. The patients medication administration record includes the administration of regular insulin three times daily. Knowing that the patients lunch tray will arrive at 11:45, when should the nurse administer the patients insulin?
- A. 10:45
- B. 11:15
- C. 11:45
- D. 11:50
Correct Answer: B
Rationale: Regular insulin is usually administered 20-30 min before a meal. Earlier administration creates a risk for hypoglycemia; later administration creates a risk for hyperglycemia.
A diabetic nurse is working for the summer at a camp for adolescents with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote?
- A. Always carry a form of fast-acting sugar.
- B. Perform exercise prior to eating whenever possible.
- C. Eat a meal or snack every 8 hours.
- D. Check blood sugar at least every 24 hours.
Correct Answer: A
Rationale: The following teaching points should be included in information provided to the patient on how to prevent hypoglycemia: Always carry a form of fast-acting sugar, increase food prior to exercise, eat a meal or snack every 4 to 5 hours, and check blood sugar regularly.