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A patient with a longstanding diagnosis of type 1 diabetes has a history of poor glycemic control. The nurse recognizes the need to assess the patient for signs and symptoms of peripheral neuropathy. Peripheral neuropathy constitutes a risk for what nursing diagnosis?
- A. Infection
- B. Acute pain
- C. Acute confusion
- D. Impaired urinary elimination
Correct Answer: A
Rationale: Decreased sensations of pain and temperature place patients with neuropathy at increased risk for injury and undetected foot infections. The neurologic changes associated with peripheral neuropathy do not normally result in pain, confusion, or impairments in urinary function.
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A nurse is teaching basic survival skills to a patient newly diagnosed with type 1 diabetes. What topic should the nurse address?
- A. Signs and symptoms of diabetic nephropathy
- B. Management of diabetic ketoacidosis
- C. Effects of surgery and pregnancy on blood sugar levels
- D. Recognition of hypoglycemia and hyperglycemia
Correct Answer: D
Rationale: It is imperative that newly diagnosed patients know the signs and symptoms and management of hypoand hyperglycemia. The other listed topics are valid points for education, but are not components of the patients immediate survival skills following a new diagnosis.
A patient has been living with type 2 diabetes for several years, and the nurse realizes that the patient is likely to have minimal contact with the health care system. In order to ensure that the patient maintains adequate blood sugar control over the long term, the nurse should recommend which of the following?
- A. Participation in a support group for persons with diabetes
- B. Regular consultation of websites that address diabetes management
- C. Weekly telephone check-ins with an endocrinologist
- D. Participation in clinical trials relating to antihyperglycemics
Correct Answer: A
Rationale: Participation in support groups is encouraged for patients who have had diabetes for many years as well as for those who are newly diagnosed. This is more interactive and instructive than simply consulting websites. Weekly telephone contact with an endocrinologist is not realistic in most cases. Participation in research trials may or may not be beneficial and appropriate, depending on patients circumstances.
A patient with a history of type I diabetes has just been admitted to the critical care unit (CCU) for diabetic ketoacidosis. The CCU nurse should prioritize what assessment during the patients initial phase of treatment?
- A. Monitoring the patient for dysrhythmias
- B. Maintaining and monitoring the patients fluid balance
- C. Assessing the patients level of consciousness
- D. Assessing the patient for signs and symptoms of venous thromboembolism
Correct Answer: B
Rationale: In addition to treating hyperglycemia, management of DKA is aimed at correcting dehydration, electrolyte loss, and acidosis before correcting the hyperglycemia with insulin. The nurse should monitor the patient for dysrhythmias, decreased LOC and VTE, but restoration and maintenance of fluid balance is the highest priority.
A nurse is caring for a patient with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the patients ability to prepare and self-administer insulin?
- A. Ask the patient to describe the process in detail.
- B. Observe the patient drawing up and administering the insulin.
- C. Provide a health education session reviewing the main points of insulin delivery.
- D. Review the patients first hemoglobin A1C result after discharge.
Correct Answer: B
Rationale: Nurses should assess the patients ability to perform diabetes related self-care as soon as possible during the hospitalization or office visit to determine whether the patient requires further diabetes teaching. While consulting a home care nurse is beneficial, an initial assessment should be performed during the hospitalization or office visit. Nurses should directly observe the patient performing the skills such as insulin preparation and infection, blood glucose monitoring, and foot care. Simply questioning the patient about these skills without actually observing performance of the skill is not sufficient. Further education does not guarantee learning.
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.