Diabetes Mellitus By Rnpedia.Com

The nurse's best response is to check for any cuts, sores, or dry cracked skin so they can be treated early to prevent infection or gangrene. This is important because diabetes can cause nerve damage and poor circulation, which can lead to decreased sensation and delayed healing. By checking the feet daily, any abnormalities can be detected early and appropriate treatment can be initiated to prevent serious complications such as infection or the need for amputation.

Beta cells are the type of cells that secrete insulin. Insulin is a hormone that regulates blood sugar levels by allowing cells to take in glucose from the bloodstream. Beta cells are found in the pancreas, specifically in the islets of Langerhans. They are responsible for producing and releasing insulin in response to high blood sugar levels. This hormone helps to lower blood sugar levels by facilitating the uptake of glucose by cells, thus maintaining glucose homeostasis in the body.

Weight gain would not be considered an acute effect of diabetes mellitus because diabetes is commonly associated with weight loss rather than weight gain. Weight loss occurs due to the body's inability to properly utilize glucose for energy, leading to the breakdown of fat and muscle tissue. Therefore, weight gain is not typically a symptom or effect of diabetes mellitus.

When blood glucose levels are well controlled, the potential for complications of diabetes is reduced.

The nurse's first action upon finding a patient with mild hypoglycemia is to give 10-15 g of CHO or orange juice. This is because hypoglycemia is a state of low blood sugar, and providing a source of carbohydrates can quickly raise the blood sugar levels. CHO stands for carbohydrates, and orange juice is a commonly used source of quick-acting carbohydrates. Calling the rapid response team or giving glucagon or insulin may be necessary in more severe cases of hypoglycemia, but the initial action for mild hypoglycemia is to provide carbohydrates.

Oral antidiabetic agents are only effective in adult clients with type 2 diabetes. Oral antidiabetic agents aren’t effective in type 1 diabetes. Pregnant and lactating women aren’t prescribed oral antidiabetic agents because the effect on the fetus is uncertain.

Kussmaul's breathing is characterized by rapid and deep breaths, often associated with a fruity or acetone-like breath smell. This type of breathing pattern is commonly seen in patients with diabetic ketoacidosis, a condition where the body produces high levels of ketones due to a lack of insulin. The fruity breath smell is caused by the presence of ketones in the breath.

Oral hypoglycemic agents may improve blood glucose levels if dietary modification and exercise are unsuccessful. Individuals with Type 2 diabetes are usually obese at diagnosis. Individuals with Type 2 diabetes rarely demonstrate ketosis, except in stress or infection. Individuals with Type 2 diabetes do not demonstrate islet cell antibodies.

Diabetes mellitus is a chronic condition that affects the body's ability to regulate blood sugar levels. It can lead to damage in various organs, including the eyes. Retinopathy is a common eye problem associated with diabetes mellitus. It occurs when the blood vessels in the retina become damaged, leading to vision problems and potential blindness if left untreated. Therefore, clients with diabetes mellitus should be regularly assessed for retinopathy to prevent further complications. Cataracts, astigmatism, and glaucoma can also occur in individuals with diabetes, but retinopathy is the most likely eye problem associated with this condition.

The nurse should refer this client to a sex counselor or other professional. Making appropriate referrals is a valid part of planning the client’s care. The nurse doesn’t normally provide sex counseling.

The patient's blood sugar level of 578, along with symptoms such as severe thirst, dehydration, confusion, rapid breathing, and fruity breath smell, indicate a state of diabetic ketoacidosis. Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body produces high levels of ketones due to a lack of insulin. This leads to high blood sugar levels, dehydration, and metabolic acidosis, resulting in symptoms like those described in the patient. Hyperosmolar hyperglycemic nonketotic coma is a separate condition characterized by extremely high blood sugar levels, but without the presence of ketones. Hypoglycemia refers to low blood sugar levels, which is not consistent with the patient's presentation. Diabetic neuropathy refers to nerve damage caused by diabetes and does not encompass the symptoms described.

The nurse should refer this client to a sex counselor or other professional. Making appropriate referrals is a valid part of planning the client’s care. The nurse doesn’t normally provide sex counseling. Therefore, providing time for privacy and providing support for the spouse or significant other are important, but not as important as referring the client to a sex counselor.

A post-operative diabetic patient who is unable to eat is likely to be suffering from hypoglycemia. Confusion and shakiness are common symptoms. An anesthesia reaction would not occur on the second post-operative day. Hyperglycemia and ketoacidosis do not cause confusion and shakiness.

To reverse hypoglycemia, the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. If necessary, this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal, causing hyperglycemia.

Insulin is a hormone secreted by the pancreas that helps regulate blood sugar levels. It works by promoting the uptake of glucose from the bloodstream into cells, thereby lowering blood sugar levels. Glucagon, on the other hand, is another hormone produced by the pancreas that has the opposite effect of insulin. It stimulates the release of glucose from the liver, raising blood sugar levels. Therefore, insulin inhibits the release of glucagon, as they have opposing actions in regulating blood sugar.

Insulin release causes decreased blood sugar levels. Insulin is a hormone produced by the pancreas that helps regulate blood sugar levels. When insulin is released, it allows glucose to enter cells, where it can be used for energy or stored for later use. This lowers the amount of glucose in the bloodstream, resulting in decreased blood sugar levels. Increased breakdown of fats and proteins are not directly caused by insulin release. The statement about glucose being phosphorylated in the kidney is unrelated to insulin release.

Glucagon is a hormone that is released by the pancreas when blood sugar levels are low. It acts on the liver to stimulate the breakdown of glycogen, a stored form of glucose, into glucose molecules. These glucose molecules are then released into the bloodstream, increasing blood sugar levels. Therefore, the statement that glucagon increases blood levels of glucose by causing the liver to breakdown glycogen is true.

In an undiagnosed diabetic, the body is unable to properly regulate blood sugar levels. This can lead to high levels of glucose in the urine, as the kidneys attempt to remove the excess sugar from the body. Additionally, the body may break down fat for energy instead of glucose, which produces ketones as a byproduct. Therefore, a urine test in an undiagnosed diabetic may show the presence of both glucose and ketones in the urine.

The client should take glipizide twice a day, 30 minutes before a meal, because food decreases its absorption. The drug doesn’t cause hyponatremia and therefore doesn’t necessitate monthly serum sodium measurement. The client must continue to monitor the blood glucose level during glipizide therapy.

Type I DM, also known as insulin-dependent diabetes mellitus, is characterized by the destruction of beta islet cells in the pancreas, leading to a lack of insulin production. This condition is usually diagnosed before the age of 20 and may be linked to autoimmunity. Since the destruction of beta islet cells results in insufficient insulin production, individuals with Type I DM require insulin injections to manage their blood sugar levels. Therefore, the statement "Does not require insulin injections" is not true about Type I DM.

This client is having a hypoglycemic episode. Because the client is conscious, the nurse should first administer a fast-acting carbohydrate, such as orange juice, hard candy, or honey. If the client has lost consciousness, the nurse should administer either I.M. or subcutaneous glucagon or an I.V. bolus of dextrose 50%. The nurse shouldn’t administer insulin to a client who’s hypoglycemic; this action will further compromise the client’s condition.

The patient's symptoms of diaphoresis, tachycardia, anxiety, hunger, and confusion are consistent with hypoglycemia, which is low blood sugar levels. Hypoglycemia can cause these symptoms due to the brain not receiving enough glucose for energy. This can be a dangerous condition and requires immediate intervention to prevent further complications.

During periods of infection or illness, patients with Type 1 diabetes may need even more insulin to compensate for increased blood glucose levels.

The glycosylated Hb test provides an objective measure of glycemic control over a 3-month period. The test helps identify trends or practices that impair glycemic control, and it doesn’t require a fasting period before blood is drawn. The nurse can’t conclude that the result occurs from poor dietary management or inadequate insulin coverage.

Poor appetite is not an indicator of a hypoglycemic condition because hypoglycemia typically causes an increase in appetite, not a decrease. Hypoglycemia is a condition characterized by low blood sugar levels, and the body responds by releasing hormones that stimulate hunger and increase the desire for food. Therefore, poor appetite would be more likely to indicate a different condition or problem.

These devices are more accurate because they are easily to used and have improved adherence in insulin regimens by young people because the medication can be administered discreetly.

Hypotension is not related to chronic diabetes mellitus because hypotension refers to low blood pressure, whereas chronic diabetes mellitus is a condition characterized by high blood sugar levels. Atherosclerosis, neuropathy, and glaucoma are all complications commonly associated with chronic diabetes mellitus.

Because glargine is in a suspension with a pH of 4, it cannot be mixed with other insulins because this would cause precipitation. When administering glargine (Lantus) insulin it is very important to read the label carefully and to avoid mistaking Lantus insulin for Lente insulin and vice versa.

Alpha cells are the type of cells that secrete glucagon. Glucagon is a hormone that is released by the pancreas and it helps to raise blood sugar levels by stimulating the liver to release stored glucose into the bloodstream. Beta cells, on the other hand, secrete insulin, which helps to lower blood sugar levels. Plasma cells are involved in the immune response, while acinar cells are responsible for producing digestive enzymes in the pancreas.

Diabetic clients must exercise at least three times a week to meet the goals of planned exercise — lowering the blood glucose level, reducing or maintaining the proper weight, increasing the serum high-density lipoprotein level, decreasing serum triglyceride levels, reducing blood pressure, and minimizing stress. Exercising once a week wouldn’t achieve these goals. Exercising more than three times a week, although beneficial, would exceed the minimum requirement.

Decreased fat metabolism is not an effect of diabetes. Diabetes is a condition where the body is unable to properly regulate blood sugar levels. It can lead to various complications such as small vessel occlusion, necrosis of extremities, and ketone body production. However, decreased fat metabolism is not directly associated with diabetes. In fact, individuals with diabetes often have impaired glucose metabolism, leading to increased fat storage and weight gain.

In the given scenario, the patient is experiencing severe hypoglycemia and is unconscious. Glucagon is the appropriate treatment in this situation as it helps to rapidly increase blood sugar levels. Glucagon stimulates the liver to convert stored glycogen into glucose, which can then be released into the bloodstream. This can quickly raise the patient's blood sugar levels and help them regain consciousness. Giving regular insulin, NPH, or orange juice would not be appropriate in this case as they do not act as rapidly as glucagon to increase blood sugar levels.

Individuals with Type 1 diabetes often have islet cell antibodies. Individuals with Type 1 diabetes are usually thin or demonstrate recent weight loss at the time of diagnosis. Individuals with Type 1 diabetes are ketosis-prone when insulin is absent. Individuals with Type 1 diabetes need insulin to preserve life.

Peripheral neuropathy can lead to lack of sensation in the lower extremities. Clients do not feel pressure and/or pain and are at high risk for skin impairment.

Type II DM, also known as adult onset diabetes, is characterized by insulin resistance and impaired insulin secretion. It is primarily caused by a combination of genetic and lifestyle factors. While it is true that some individuals with Type II DM may require insulin therapy, it is not the case for 80% of the cases. In fact, the majority of people with Type II DM can manage their condition through lifestyle modifications, oral medications, and/or injectable non-insulin medications. Insulin therapy is typically reserved for those who cannot achieve adequate blood sugar control with other treatments.

The patient's lab results indicate a high serum blood sugar level of 950, which is consistent with hyperosmolar hyperglycemic nonketotic coma (HHNK). HHNK is a severe complication of diabetes characterized by extremely high blood sugar levels, dehydration, confusion, and altered mental status. The pH of 7.4 suggests that the patient's acid-base balance is within the normal range, ruling out diabetic ketoacidosis. Hypoglycemia is characterized by low blood sugar levels, which is not seen in this case. Diabetic neuropathy refers to nerve damage caused by diabetes and does not explain the patient's symptoms of confusion and dehydration.

The onset of action of rapid-acting Humalog is within 10-15 minutes. The onset of action of short-acting regular insulin is 30 minutes-1 hour. The onset of action of intermediate acting NPH is 3-4 hours. The onset of action of long-acting Ultralente is 6-8 hours.

A functioning pancreas is necessary for sulfonylureas to be effective.

The client should be instructed always to follow the same order when drawing the different insulins into the syringe. Insulin should never be shaken because the resulting froth prevents withdrawal of an accurate dose and may damage the insulin protein molecules. Insulin also should never be frozen because the insulin protein molecules may be damaged. Intermediate-acting insulin is normally cloudy.

Glucotrol XL is given once a day with breakfast. Answer A is incorrect because the client would develop hypoglycemia while sleeping. Answers C and D are incorrect because the client would develop hypoglycemia later in the day or evening.

Renin is an enzyme that is produced and released by the kidneys. It plays a role in the regulation of blood pressure and fluid balance in the body, but it is not considered an endocrine hormone. Endocrine hormones are secreted directly into the bloodstream by specialized glands and have a wide range of effects on different organs and tissues in the body. Insulin, glucagon, and somatostatin are all examples of endocrine hormones that are involved in regulating blood sugar levels, metabolism, and other physiological processes.

The client’s diabetes is well under control. Answer A is incorrect because it will lead to elevated glycosylated hemoglobin. Answer C is incorrect because the diet and insulin dose are appropriate for the client. Answer D is incorrect because the desired range for glycosylated hemoglobin in the adult client is 2.5%–5.9%

Novalog insulin onsets very quickly, so food should be available within 10–15 minutes of taking the insulin. Answer B does not address a particular type of insulin, so it is incorrect. NPH insulin peaks in 8–12 hours, so a snack should be eaten at the expected peak time. It may not be 3 p.m. as stated in answer C. Answer D is incorrect because there is no need to save the dessert until bedtime.

Glucagon is actually released when blood glucose levels are low, not inhibited. Glucagon helps to raise blood glucose levels by stimulating the liver to release stored glucose into the bloodstream. Therefore, the given statement is false.

Projectile vomiting is not an adverse effect of oral hypoglycemics. Adverse effects of these medications may include hypoglycemia, headache, and rashes. Projectile vomiting, which refers to forceful expulsion of stomach contents, is not typically associated with the use of oral hypoglycemics.

Glucagon is a hormone that helps increase blood sugar levels. It is commonly used to treat severe hypoglycemia. While it can have side effects, such as allergic reactions, vomiting, and nausea, fever is not typically associated with the use of glucagon. Fever is an abnormal increase in body temperature and is not a known adverse effect of glucagon administration.

For this client, wet-to-dry dressings are most appropriate because they clean the foot ulcer by debriding exudate and necrotic tissue, thus promoting healing by secondary intention. Moist, transparent dressings contain exudate and provide a moist wound environment. Hydrocolloid dressings prevent the entrance of microorganisms and minimize wound discomfort. Dry sterile dressings protect the wound from mechanical trauma and promote healing.

Exercise, reduced food intake, hypothyroidism, and certain medications decrease the insulin requirements. Growth, pregnancy, greater food intake, stress, surgery, infection, illness, increased insulin antibodies, and certain medications increase the insulin requirements.

Cyclosporine is a drug that is commonly used as an immunosuppressant. It works by suppressing the immune system, which can be beneficial in cases of Type I Diabetes where the immune system mistakenly attacks the insulin-producing cells in the pancreas. By suppressing the immune response, cyclosporine may help to prevent further damage to the pancreas and preserve insulin production. Therefore, it may be given soon after the onset of Type I Diabetes to help manage the condition.

Cardiovascular disease is the number one complication of diabetes because high blood sugar levels can damage the blood vessels and lead to the development of atherosclerosis, a condition where plaque builds up in the arteries. This can result in various cardiovascular problems such as heart attacks, strokes, and peripheral artery disease. Additionally, diabetes also increases the risk of other cardiovascular risk factors like high blood pressure and high cholesterol levels, further increasing the likelihood of developing cardiovascular disease. Therefore, it is crucial for individuals with diabetes to manage their blood sugar levels and adopt a healthy lifestyle to reduce the risk of cardiovascular complications.