Diabetes Type 1 HESI

What is the mechanism that results in Kussmaul respirations?
To compensate for metabolic acidosis, the respirations 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 infusion containing regular insulin
In addition to monitoring Lara’s blood glucose level, what additional serum lab value should the nurse monitor carefully? (Select all that apply.)
Hemoglobin

Calcium

Potassium

BUN

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
Lara tells the nurse, “I know that diabetes is a chronic condition, so I’ve probably had this for a while. Why didn’t I experience any symptoms before now?”

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?
D) “It must be quite a shock to learn that you have diabetes.”
Lara starts to cry and says, “You have no idea how awful this is. I want to be by myself now. Please leave me alone.”

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 the priority nursing action?
Check Lara’s blood glucose.
What action should the nurse take first?
Administer IV dextrose to a diabetic client with a 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 cake 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.
Lara talks to the nurse about what to do if she gets sick. She states, “It just doesn’t make sense to take my insulin when I feel sick, knowing I won’t want to eat anything.”

How should the nurse respond?

Being sick increases your blood sugar. Taking your usual insulin dose is important.
Lara states that her grandmother became diabetic after she retired, but that her mother had gestational diabetes mellitus (GDM) when she was pregnant with Lara. Lara asks the nurse if this is related to her condition now.

How should the nurse respond?

There is no direct correlation, but family history is important in diabetes.
Lara asks the nurse why her mother does not have diabetes, since it developed while she was pregnant. 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.
Lara tells the nurse that her grandmother was very sick after her gallbladder was removed last year. She said she was in a coma and was diagnosed with hyperglycemic hyperosmolar nonketotic syndrome (HHNS). She asks the nurse to describe differences in HHNS and DKA.

How should the nurse respond?

HHNS is caused by persistent hyperglycemia, but ketosis does not occur.
Lara tells the nurse, “I hope I never get HHNS. My grandmother’s blood glucose level was almost 1,000 mg/dl. My blood glucose level was only 370 mg/dl, and I was really sick. It’s pretty amazing my grandmother didn’t die!”

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 indicates that Lara is experiencing a complication of diabetes?
Burning sensation in her toes

Protein in her urine

A sore on her foot that is having trouble healing

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