Diabetes Nursing Quiz: Nsg 353 Diabetes Mellitus

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 for diabetic patients because they are at a higher risk of developing foot complications due to poor blood circulation and nerve damage. Regular foot checks can help identify any issues early on and prevent them from worsening, potentially leading to the need for leg amputation.

Kussmaul's is the correct answer because it is a condition characterized by rapid, deep, and labored breathing, also known as hyperpnea. The fruity breath smell is a characteristic symptom of diabetic ketoacidosis (DKA), a complication of diabetes that can cause Kussmaul's breathing. This condition occurs when there is a buildup of ketones in the blood, leading to an acidic environment.

The patient's high blood sugar level, low pH, and fruity breath smell indicate the presence of diabetic ketoacidosis. This condition occurs when there is a severe lack of insulin in the body, causing the body to break down fat for energy instead of glucose. This leads to the production of ketones, which can cause the fruity breath smell. The patient's symptoms of severe thirst, dehydration, confusion, and rapid breathing are also consistent with diabetic ketoacidosis.

When a patient is experiencing mild hypoglycemia, the nurse's first action should be to give 10-15 g of CHO (carbohydrate) or orange juice. This is because CHO is quickly absorbed by the body and can rapidly raise blood glucose levels. Insulin would not be appropriate in this situation as it would further lower blood glucose levels. Calling the rapid response team is not necessary for mild hypoglycemia and giving glucagon is typically reserved for severe hypoglycemia when the patient is unconscious or unable to swallow.

In an undiagnosed diabetic, the body is unable to properly regulate blood sugar levels. As a result, excess glucose is present in the bloodstream and can be detected in the urine. Additionally, the body may break down fat for energy instead of glucose, leading to the production of ketones. Ketones can also be detected in the urine of an undiagnosed diabetic. Therefore, a urine test in an undiagnosed diabetic may show the presence of both glucose and ketones in the urine.

The patient is showing signs of hypoglycemia, which is a condition characterized by low blood sugar levels. The symptoms mentioned, such as diaphoresis (excessive sweating), tachycardia (rapid heart rate), anxiety, hunger, and confusion, are all common signs of hypoglycemia. This occurs when there is an imbalance between the amount of insulin in the body and the amount of glucose available for energy. Hypoglycemia can be dangerous if not treated promptly, as it can lead to seizures or loss of consciousness.

A patient with a diagnosis of diabetic ketoacidosis (DKA) typically presents with elevated blood glucose levels and a low plasma bicarbonate level. This is because DKA is characterized by a lack of insulin, leading to increased blood glucose levels. In response, the body breaks down fat for energy, resulting in the production of ketones and a decrease in bicarbonate levels. This combination of high blood glucose and low bicarbonate levels confirms the diagnosis of DKA.

The patient's lab work shows a high serum blood sugar level (950) and a high serum osmolarity (460), which are both indicative of hyperosmolar hyperglycemic nonketotic coma (HHNK). Additionally, the patient is confused and dehydrated, which are common symptoms of HHNK. Diabetic ketoacidosis (DKA) is characterized by low pH, high blood sugar, and ketones in the blood, which are not present in this case. Hypoglycemia is characterized by low blood sugar, which is not seen in this patient. Diabetic neuropathy is a long-term complication of diabetes and is not related to the acute symptoms described in this case.

In a patient with severe hypoglycemia who is unconscious, giving 1 mg of glucagon would be the first priority. Glucagon is a hormone that raises blood sugar levels by stimulating the liver to release stored glucose. It can be given intramuscularly or intravenously in emergency situations. This would help to quickly raise the patient's blood sugar levels and potentially reverse the unconsciousness. Giving regular insulin or NPH by IV would further lower the blood sugar levels, which is not appropriate in this situation. Giving 10-15 g of CHO or orange juice may not be effective in an unconscious patient as they may not be able to swallow or absorb it properly.

Cardiovascular disease is the number one complication of diabetes because high blood sugar levels can damage the blood vessels and lead to the build-up of plaque, increasing the risk of heart attacks, strokes, and other cardiovascular problems. Diabetes also often coexists with other risk factors for cardiovascular disease, such as high blood pressure, high cholesterol levels, and obesity, further increasing the likelihood of developing cardiovascular complications. Therefore, it is crucial for individuals with diabetes to manage their blood sugar levels and address other risk factors to prevent or minimize the risk of cardiovascular disease.

When admitting a patient diagnosed with type 2 diabetes mellitus, the nurse can expect certain symptoms during an assessment. Hypoglycemia is not one of these expected symptoms. Hypoglycemia refers to low blood sugar levels, which is more commonly associated with type 1 diabetes. In type 2 diabetes, the body usually produces insulin, but it may not use it effectively. Therefore, symptoms such as ketonuria (presence of ketones in urine), frequent bruising (due to poor blood clotting), and dry mouth (due to increased thirst and dehydration) may be expected, but not hypoglycemia.

Intermediate-acting insulins, such as NPH insulin, have a duration of action of 14-18 hours. This means that they start working within 1-2 hours after injection and continue to lower blood sugar levels for 14-18 hours. This duration makes them suitable for providing a bedtime snack to the patient, as it will help maintain stable blood sugar levels throughout the night.

Macrovascular complications of uncontrolled diabetes refer to the long-term damage that can occur to the large blood vessels in the body. Hyperlipidemia, or high levels of fats in the blood, is a common complication of uncontrolled diabetes. This can lead to the development of atherosclerosis, where plaque builds up in the arteries and restricts blood flow. Ischemic heart disease, which refers to reduced blood flow to the heart, is another macrovascular complication that can occur. This can lead to chest pain, heart attacks, and other heart-related issues. Therefore, the correct answer includes both hyperlipidemia and ischemic heart disease.

The microvascular complications of uncontrolled diabetes include delayed gastric emptying, glomerular injury, bleeding of retinal capillaries, and impotence. Delayed gastric emptying refers to a condition where the stomach takes longer than usual to empty its contents, leading to symptoms like bloating and nausea. Glomerular injury refers to damage to the small blood vessels in the kidneys, which can result in kidney dysfunction. Bleeding of retinal capillaries can cause vision problems and potentially lead to blindness. Impotence refers to the inability to achieve or maintain an erection, which can be a result of damage to the blood vessels and nerves in the penis.

The potential complications of diabetes include amputations (BKA) due to poor circulation and nerve damage, retinopathy which can lead to vision loss, cardio neuropathy which affects the heart and blood vessels, and arteriosclerosis which is the hardening and narrowing of the arteries. These complications can arise as a result of long-term uncontrolled blood sugar levels and can significantly impact a person's health and quality of life.