question

Characterized by partial or complete metabolic deficiency of insulin

answer

Diabetes mellitus

question

Diabetes mellitus is a contributing factor for the development of what

answer

Cardiovascular disease hypertension renal failure blindness and stroke

question

Toxins and viruses can predispose an individual 2 diabetes by destroying the beta cells which type of diabetes

answer

Type 1

question

Obesity, physical inactivity, high triglycerides, and hypertension may lead to the development of insulin resistance diabetes what type

answer

Type 2

question

Blood glucose level is less than 60

answer

Hypoglycemia

question

Autonomic nervous system responses rapid onset

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Hunger, lightheadedness, and shakiness headache anxiety and irritability pale, cool skin diaphoresis irritability normal or shallow respirations tachycardia and palpitations

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Impaired cerebral function gradual onset

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Strange or unusual feelings decreasing level of consciousness difficulty in thinking and inability to concentrate change an emotional behavior slurred speech headache and blurred vision seizures leading to coma

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Blood glucose levels usually greater than 250

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Hyperglycemia

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Assessment findings of hyperglycemia

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thirst polyuria oliguria nausea vomiting abdominal pain skin that is warm dry and flushed with poor tugor mucous membranes confusion weakness with lethargy weak pulse diminish reflexes rapid deep respirations with acetone fruity odor due to ketones

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Diagnostic criteria for diabetes

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An 8 hour fasting blood glucose level of 126 or more a random blood glucose of 200 or more with classic signs of diabetes and oral glucose tolerance test of 200 or more in a two hour sample

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What is the expected reference range for glycosylated hemoglobin

answer

4% to 6% but an acceptable target for children who have diabetes may be 6.5% to 8% with a total target goal of less than 7%

question

Signs and symptoms of hypoglycemia

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Shakiness diaphoresis anxiety nervousness chills headache confusion labile difficulty focusing hunger dizziness heart palpitations

question

Rapid acting insulin

answer

Insulin lispro Humalog

question

Onset of Humalog

answer

Less than 15

question

peak of Humalog

answer

0.5 to 1 hour

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Duration of Humalog

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Three to four hours

question

Short acting insulin

answer

Regular insulin Humulin R

question

Onset of short acting insulin

answer

0.5 to 1 hr

question

Peak of short acting insulin

answer

2 - 4 hours

question

Duration of short acting insulin

answer

5 - 7 hours

question

Intermediate acting insulin

answer

NPH insulin Humulin N

question

Onset of intermediate acting insulin

answer

1 - 2 hour

question

Peak of intermediate acting insulin

answer

4 - 12 hours

question

Duration of intermediate acting insulin

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18 - 24 hours

question

Long acting insulin

answer

Insulin glargine lantus

question

Onset of long acting insulin

answer

Three to four hours

question

Peak of long acting insulin

answer

There is none

question

Duration of long acting insulin

answer

10.4 - 24 hours

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Nursing considerations in education on insulin

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Do not mix insulin glargine with any other insulins Inject at a 90 degree angle when mixing rapid and short draw up short acting insulin first

question

Acute life-threatening condition characterized by hyperglycemia resulting in the breakdown of body fat for energy and accumulation of ketones in the blood and urine the onset is rapid and mortality rate is high

answer

Diabetic ketoacidosis

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Causes of diabetic ketoacidosis

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Insufficient insulin acute stress poor management of acute illness

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Nursing actions for diabetic ketoacidosis

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provide rapid isotonic fluid is 0.9% sodium chloride follow with a hypotonic fluid 0.5% sodium chloride excessive subjective and objective data ketones in blood and urine fruity scented breath mental confusion dyspnea nausea and vomiting dehydration weight loss electrolyte imbalances if left untreated patient can go into a coma when glucose levels approach 250 a glucose IV fluids to minimize the risk of cerebral edema monitor glucose monitor serum potassium levels administer sodium bicarbonate administer oxygen

question

Long-term complications with diabetes mellitus

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Neuropathy retinopathy nephropathy cardiovascular disease altered thyroid function limited mobility of small joints

question

a nurse is reviewing sick day management with a parent of a child who has type 1 diabetes. Which of the following should the nurse include in the teaching? Select all that apply a. Monitor blood glucose levels every 3 hours b. discontinue taking insulin feeling better c. drink 8 oz of fruit juice every hour d. test urine for ketones e. call the health care provider if blood glucose is greater than 240

answer

Monitor blood glucose levels every 3 hours test urine for ketones call the health and care provider in blood glucose is greater than 240

question

a nurse is teaching a child with type 1 diabetes mellitus about self care. Which of the following statements by the child indicates understanding of the teaching? a. i should skip breakfast when i am not hungry B. i should increase my insulin with exercise C. I should drink a glass of milk when I'm feeling irritable D. i should draw up the NPH insulin into the syringe before regular insulin

answer

I should drink a glass of milk when I'm feeling irritable

question

a nurse is caring for a child with type 1 diabetes. Which of the following is a clinical manifestation of diabetic ketoacidosis? Select all that apply A. blood glucose 58 B. weight gain c. Dehydration D. mental confusion E. fruity breath

answer

Dehydration mental confusion fruity breath

question

A nurse is teaching an adolescent who has diabetes about foot care. Which of the following should be included and the teaching? A. inspect feet once a week B. cut your toe nail in rounded formatoin C. You can use cornstarch on your feet D. you can use over the counter callus removers

answer

You can use cornstarch on your feet

question

A nurse is teaching an adolescent with diabetes about clinical manifestations of hypoglycemia. Which of the following should be included in teaching? Select all that apply A. increased urination B. hunger C. signs of dehydration D. irritability E. sweating and pallor F. kussmaul respirations

answer

Hunger irritability sweating and pallor

ATI chapter 33 diabetes mellitus pediatrics – Flashcards

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