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