Case Study Diabetes Type 1

What is the mechanism that results in Kussmaul respiration?
To compensate for metabolic acidosis, the respiration are deep and rapid
To achieve the goal of restoring Lara’s fluid volume, the nurse would expect to implement which intervention?
Maintain an infusion of normal saline solution
To restore Lara’s blood glucose to a normal level, what should the nurse prepare to administer?
An IV solution containing regular insulin
In addition to monitoring Lara’s blood glucose level, what additional lab values should the nurse monitor carefully
Calcium
Hemoglobin
Blood Urea Nitrogen (BUN)
Potassium
The nurse’s decision about what to tell these callers should be based on what primary consideration
Lara’s right to privacy regarding her health information
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Which response is best for the charge nurse to provide
The lab values can be copied as long as there is no identifying client data
The nurse identifies that Lara has experienced classic symptoms of diabetes, which are
Polyuria, Polyphagia, and polydipsia
How should the nurse respond
The symptoms have an abrupt onset that is often brought on by a viral illness, like the flu
What is the best initial response by the nurse
It must be quite a shock to learn that you have diabetes
What is the best response by the nurse
I’ll leave you alone for now, but I will stop back by in 30 minutes
Which statement made by Lara indicates that she correctly understands self-administration of insulin
The amount of short-acting insulin I take every day is based on my blood sugar readings
What action should the nurse implement
Encourage Lara to inject the insulin with the needle in place, as inserted
What is priority nursing action
Check Lara’s blood glucose
What action should the nurse take first
Administer IV dextrose to a diabetic client with blood glucose level of 25 mg/dl
What action should the nurse take first
Ask the unit clerk to find out when the trays will be available
What is the best response by the nurse
Alcohol does contain a lot of empty calories, but it is also likely to cause your blood glucose to decrease
What is the best response by the nurse
Advise Lara that extra insulin should not generally be taken before exercise
What is the best nursing action
Ask the roommate if Lara has emergency supplies such as Glucagon or icing available
Once Lara is more alert, what instructions should the nurse provide the roommate
Give Lara some crackers and milk while waiting for the emergency transport
What technique should the nurse use to assess for this occurrence
Monitor blood glucose levels during the night and before breakfast
Which statement by Lara reflects understanding of glycosylated Hgb
“At least I won’t have this done again for 3 months. I will really work at following my diet between now and then”
How should the nurse respond
She needs a second test performed before a diagnosis is made
How should the nurse respond
Being sick increases your blood sugar. Taking your usual insulin dose is important
How should the nurse respond
There is no direct correlation, but family history is important in diabetes
What is the best response
Women with gestational diabetes are at high risk for developing diabetes after pregnancy, but not all will get the disease
How should the nurse respond
HHNS is caused by persistent hyperglycemia, but ketosis does not occur
What intervention should the nurse implement
Tell Lara that HHNS is less likely to occur in Type 1 diabetes than in Type 2 diabetes
Which lab value indicates that Lara is working to reduce her risk for cardiovascular disease
Low-density lipoprotein (LDL) cholesterol of 80 mg/dl
Which finding(s) indicate that Lara is experiencing complications of diabetes
Protein in urine

Burning sensation in her toes

A sore on her foot that is having trouble healing

What response should the nurse make
You’re absolutely right, and your health care team will be there to help you
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