NCLEX Practice Quiz For Diabetes Mellitus

Diabetes mellitus is associated with several chronic complications, including retinopathy, neuropathy, and coronary artery disease. Retinopathy refers to damage to the blood vessels in the retina, leading to vision problems or blindness. Neuropathy involves nerve damage, often resulting in pain, tingling, or numbness, particularly in the hands and feet. Coronary artery disease is a condition where the blood vessels supplying the heart are damaged, increasing the risk of heart attacks. These complications arise due to prolonged high blood glucose levels, which can damage blood vessels and nerves throughout the body. Proper management of blood sugar levels and regular monitoring are essential to prevent or delay these complications.

In Diabetic Ketoacidosis (DKA), especially when secondary to infection, the nurse might observe Kussmaul’s respirations and a fruity odor on the breath. Kussmaul’s respirations are deep and labored breathing patterns that occur as the body tries to compensate for metabolic acidosis by expelling more carbon dioxide. The fruity odor on the breath is due to the presence of acetone, a type of ketone produced during fat metabolism. These symptoms are indicative of severe DKA, where the body is breaking down fat for energy in the absence of sufficient insulin, leading to the accumulation of ketones. Prompt recognition and treatment of these symptoms are crucial to prevent further complications.

Insulin forces potassium out of the plasma and into the cells. This action helps to lower blood potassium levels and is particularly significant in the management of conditions like diabetic ketoacidosis (DKA), where hyperglycemia and insulin deficiency can lead to high plasma potassium levels. When insulin is administered, it facilitates the uptake of glucose into cells, and simultaneously, potassium is transported into the cells. This dual action helps in correcting hyperglycemia and reducing hyperkalemia (high blood potassium levels). Monitoring potassium levels is crucial during insulin therapy to avoid potential complications such as hypokalemia, which can cause muscle weakness, arrhythmias, and other serious health issues.

For a client with diabetes mellitus who has recently undergone an above-knee amputation, the nurse's primary responsibility when preparing the client for dinner is to check the client’s serum glucose level. Monitoring blood glucose levels is crucial in managing diabetes, especially after surgery, because stress, changes in diet, and immobility can affect glucose levels. Ensuring that the client’s glucose is within a safe range helps prevent complications such as hypoglycemia or hyperglycemia. Although assisting the client out of bed, positioning them correctly, and ensuring the residual limb is elevated are also important, monitoring blood glucose directly impacts the client’s immediate safety and overall metabolic stability.

The most common cause of Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) is undiagnosed and untreated diabetes mellitus. HHNS is a serious condition characterized by extremely high blood glucose levels, severe dehydration, and altered mental status. It typically occurs in individuals with type 2 diabetes who have not been diagnosed or are not managing their condition properly. Without adequate insulin, glucose cannot enter the cells and remains in the bloodstream, leading to hyperglycemia. The body responds by increasing urine output to eliminate excess glucose, resulting in severe dehydration and electrolyte imbalances. Early diagnosis and effective management of diabetes are essential to prevent HHNS and its potentially life-threatening complications.

If a client taking glyburide (DiaBeta) for diabetes mellitus vomits one hour after taking the medication, the nurse should monitor blood glucose closely and look for signs of hypoglycemia. Glyburide is an oral hypoglycemic agent that stimulates the pancreas to release insulin, thereby lowering blood glucose levels. Vomiting can affect the absorption of the medication, increasing the risk of hypoglycemia (low blood sugar). Symptoms of hypoglycemia include sweating, trembling, dizziness, and confusion. Re-administrating glyburide or giving insulin without knowing the current blood glucose level could exacerbate the situation. Therefore, close monitoring is essential to ensure the client's safety and to take appropriate corrective actions if hypoglycemia occurs.

 Clients with type 1 diabetes may require more insulin during periods of infection. Infections can cause stress on the body, leading to the release of stress hormones such as cortisol and adrenaline, which increase blood glucose levels. As a result, the body's need for insulin rises to manage these elevated glucose levels effectively. Adjusting insulin dosage to account for this increase helps to prevent hyperglycemia and the potential development of Diabetic Ketoacidosis (DKA). Monitoring blood glucose levels more frequently during illness is also essential to make appropriate insulin adjustments and maintain good glycemic control.

The nurse should explain that regulated food intake is fundamental to controlling diabetes mellitus (DM). For individuals with DM, maintaining stable blood glucose levels is crucial. Eating small, frequent meals can help prevent significant fluctuations in blood sugar levels, which can occur with larger meals. Consistent meal patterns, portion control, and balanced nutrition are key components of diabetes management. This approach helps in achieving better glycemic control, avoiding spikes and drops in blood glucose levels. Educating the client on the importance of monitoring carbohydrate intake, even when snacking, is essential for effective diabetes management and overall health.