Diabetes Mellitus

A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patient’s labs are the following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is the most appropriate nursing intervention to perform next?

• Start the IV fluids and administer the insulin bolus and drip as ordered

• Hold the insulin and notify the doctor of the potassium level of 2.5

• Hold IV fluids and administer insulin as ordered

• Recheck the glucose level

What type of insulin do you expect the doctor to order for treatment of DKA?

• IV NPH

• IV Novolog

• IV Levemir

• IV Regular Insulin

A patient diagnosed with diabetes mellitus is being discharged home and you are teaching them about preventing DKA. What statement by the patient demonstrates they understood your teaching about this condition?

• “I will hold off taking my insulin while I’m sick.”

• “It is normal for my blood sugar to be 250-350 mg/dL while I’m sick.”

• “It is important I check my blood glucose every 3-4 hours when I’m sick and consume liquids.”

• “I should not be alarmed if ketones are present in my urine because this is expected during illness.”

Which of the following symptoms do NOT present in hyperglycemia?

• Extreme thirst

• Hunger

• Blood glucose <60mg/dL

• Glycosuria

A patient with diabetes has a morning glucose of 50. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is MOST important?

• Recheck the glucose level

• Give the patient 1/2 cup (4ozs) of fruit juice

• Call the doctor

• Keep the patient nothing by mouth

A 36 year old male is newly diagnosed with Type 2 diabetes. Which of the following treatments do you expect the patient to be started on initially?

• Diet and exercise regimen

• Metformin BID by mouth

• Regular insulin subcutaneous

• None, monitoring at this time is sufficient enough

Which of the following statements are true regarding Type 2 diabetes treatment?

• Insulin and oral diabetic medications are administered routinely in the treatment of Type 2 diabetes.

• Insulin is never taken by the Type 2 diabetic.

• Insulin may be needed in times of surgery or illness.

• Oral medications are the first line of treatment for newly diagnosed Type 2 diabetics.

Hemoglobin A1C monitors:

• the level of hemoglobin over time.

• the level of glucose over time.

• the percent of glucose present in the blood.

• the percent of glucagon in the blood.

Indicate whether the following characteristics are associated with hypoglycemia (Select all that apply)

• Slurred speech and irritability

• Nausea and vomiting

• Too much exercise

• Increased dietary intake

• Cold, clammy skin

The primary factor contributing to the development of T2D is:

• Age

• Ethnicity

• Obesity

• Sedentary lifestyle