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The Most Important Long-term Strategy For The Treatment Of Type 2 Diabetes Mellitus Is To Quizlet

Nutrition Chapter 4 Quiz

Nutrition Chapter 4 Quiz

John Fibernugget wants to increase his fiber intake. Which of the following would be the safest way for him do this? A) Eating enriched grains such as Rice Krispies and Saltines C) Reading the labels of grain products and buying those labeled "wheat flour" D) Eating more fruits and vegetables and not removing the edible peels D) Eating more fruits and vegetables and not removing the edible peels Which of the following foods would have the most fiber? B) English muffins made with enriched flour Which of the following breakfasts would be highest in carbohydrate? A) Grapefruit half, 2 fried eggs, 3 bacon slices, 1 slice of toast with butter, coffee B) 8 ounces orange juice, 2 cups Cream of Wheat with 2 tablespoons sugar, English muffin with jelly, 1 cup whole milk C) 8 ounces orange juice, 2 bran muffins, 8 ounces nonfat yogurt, coffee D) 1 cup whole milk, 2 ounces sausage, 2 fried eggs, 1 slice of toast with butter B) 8 ounces orange juice, 2 cups Cream of Wheat with 2 tablespoons sugar, English muffin with jelly, 1 cup whole milk Medical conditions related to metabolic syndrome are A) Type 1 diabetes, coronary artery disease, and cancer. B) Type 1 diabetes, coronary artery disease, and stroke. C) Type 2 diabetes, coronary artery disease, and stroke. D) Type 2 diabetes, coronary artery disease, and cancer. C) Type 2 diabetes, coronary artery disease, and stroke. All of the following are characteristic of Type 2 diabetes mellitus except B) caused by insensitivity of fat and muscle cells to insulin. All of the following are characteristic of Type 2 diabetes mellitus except B) caused by insensitivity of fat and muscle cells to insulin. The most important dietary approach for the treatment of Type 2 diabetes mellitus is to C) maintain a constant ratio of carbohydrate to prot Continue reading >>

N300 Exam 2: Diabetes Mellitus

N300 Exam 2: Diabetes Mellitus

1. Type 1 diabetes usually occurs in young clients who are underweight. In this disease, there is no production of insulin from the beta cells in the pancreas. People with Type 1 diabetes are insulin-dependent with a rapid onset of symp- toms, including polyuria, polydipsia, and polyphagia. **2. Type 2 diabetes is a disorder that usually occurs around the age of 40, but it is now being detected in children and young adults as a result of obesity and sedentary life- styles. Wounds that do not heal are a hall- mark sign of Type 2 diabetes. This client weighs 248.6 pounds and is short. 3. Gestational diabetes is diabetes that occurs during pregnancy. 4. Acanthosis nigricans (AN), dark pigmentation and skin creases in the neck, is a sign of hyper- insulinemia. The pancreas is secreting excess amounts of insulin as a result of excessive caloric intake. It is identified in young children and is a precursor to the development of Type 2 diabetes. TEST-TAKING HINT: The test taker must be aware of kilogram and pounds; the stem is asking about a disease process and acantho- sis nigricans is a clinical manifestation of a disease, not a disease itself. Therefore, the test taker should not select this as a correct answer. The client diagnosed with Type 1 diabetes has a glycosylated hemoglobin (A1c) of 8.1%. Which interpretation should the nurse make based on this result? 2. This result is within acceptable levels. 3. This result is above recommended levels. 1. The acceptable level for an A1c for a client with diabetes is between 6% and 7%, which corresponds to a 120-140 mg/dL average blood glucose level. 2. This result is not within acceptable levels for the client with diabetes, which is 6% to 7%. **3. This result parallels a serum blood glucose level of approximately 180 to 200 mg Continue reading >>

3962 Diabetes Mellitus

3962 Diabetes Mellitus

The usual recommendation for treatment of hypoglycemia is for 10 to 15 g of a fast-acting, simple carbohydrate orally, such as three or four commercially prepared glucose tablets; 4 to 6 oz of fruit juice or regular soda; 6 to 10 Life Savers or other hard candies; or 2 to 3 tsp of sugar or honey. It is unnecessary to add sugar to juice, even it if is labeled as unsweetened juice, because the fruit sugar in juice contains enough simple carbohydrate to raise the blood glucose level and additional sugar may result in a sharp rise in blood sugar that will last for several hours. You are caring for a newly diagnosed type 2 diabetic. The patient is 67 years old and has been found to have what long-term complication of diabetes mellitus? Long-term complications are seen in both type 1 and type 2 diabetes but usually do not occur within the first 5 to 10 years after diagnosis. However, evidence of these complications may be present at the time of diagnosis of type 2 diabetes, because patients may have had undiagnosed diabetes for many years. Renal (microvascular) disease is more prevalent in patients with type 1 diabetes, and cardiovascular (macrovascular) complications are more prevalent in older patients with type 2 diabetes. Research studies have shown that type 2 diabetes can be prevented or delayed in people at high risk for the disease through weight reduction and exercise. The diabetic Nurse Educator is teaching a class for newly diagnosed diabetics and their families. In this class the Nurse Educator is teaching about "sick day rules." What guideline applies to periods of illness ("sick day rules") in a diabetic patient? 2. Do not eliminate insulin when nauseated and vomiting. 3. Report elevated glucose levels greater than 150 mg/dL. 2. Do not eliminate insulin when na Continue reading >>

Pharm Chapter 57 Drugs For Diabetes Mellitus

Pharm Chapter 57 Drugs For Diabetes Mellitus

Sort Complications of Diabetes Short-term Hyperglycemia and hypoglycemia Long-term Macrovascular damage *Heart Disease *Hypertension *Stroke *Hyperglycemia *Altered lipid metabolism The nurse has just administered the morning dose of a patient's lispro (Humalog) insulin. Just after the injection, the dietary department calls to inform the patient care unit that breakfast trays will be 45 minutes late. What will the nurse do next? Inform the patient of the delay. Check the patient's blood glucose levels. Call the dietary department to send a tray immediately. Give the patient food, such as cereal and skim milk, and juice.(Correct) Rationale: Lispro insulin's onset of action is 15 minutes. It is essential that a diabetic patient eat a meal after injection. Otherwise profound hypoglycemia may result. A patient with type 1 diabetes is admitted to the medical unit with an acute exacerbation of chronic obstructive pulmonary disease (COPD). He is placed on IVPB antibiotics, nebulizer treatments with albuterol, and an IV corticosteroid, and he is also taking a proton pump inhibitor for gastrointestinal esophageal reflux disease (GERD). He takes a dose of glargine insulin every evening. That evening the nurse notes that his blood glucose level is 170 mg/dL. The next morning, his fasting glucose level is 202 mg/dL. What is the most likely cause of his elevated glucose levels? The albuterol The antibiotics The proton pump inhibitor The corticosteroid(Correct: Rationale: Corticosteriods antagonize the hypoglycemic effects of insulin, resulting in elevated blood glucose levels After the 0700 report, the day shift nurse notices that a patient has a 0730 dose of insulin due and goes to the automated dispensing machine to retrieve the insulin. The nurse sees that the night shift nurse Continue reading >>

Medsurg Exam #2 Diabetes

Medsurg Exam #2 Diabetes

A college student is newly diagnosed with type 1 diabetes. The patient now has a headache, changes in vision, and is anxious, but does not have the portable blood glucose monitor with him or her. Which action should the campus nurse advise the patient to take? Take an extra dose of rapid-acting insulin "I will take a brisk 30-minute walk five days per week and do resistance training three times a week." The nurse is teaching a patient with type 2 diabetes about exercise as a method to control blood glucose levels. The nurse knows the patient understands when the patient elicits which exercise plan? "I want to go fishing for 30 minutes each day. I will drink fluids and wear sunscreen." "I will go running each day when my blood sugar is too high to bring it back to normal." "I will plan to keep my job as a teacher because I get a lot of exercise every school day." "I will take a brisk 30-minute walk five days per week and do resistance training three times a week." "To toughen my skin so I do not get pressure sores, I should rub my feet down with rubbing alcohol after my bath." The nurse is reviewing diabetic self-care management with a patient newly diagnosed with diabetes. The patient is in need of further education when stating to the nurse: "To toughen my skin so I do not get pressure sores, I should rub my feet down with rubbing alcohol after my bath." "I have scheduled an eye examination with an ophthalmologist for next week. I will need to have an annual eye exam." "I am going to check my feet for pressure areas every morning before I take a bath." The infection increases the glucose level, resulting in a need for more insulin A type 2 (non-insulin-dependent) diabetic patient who takes oral hypoglycemics is admitted to the hospital with a urinary tract infection ( Continue reading >>

Diabetes Mellitus, Type 2

Diabetes Mellitus, Type 2

Sort Overview Resulting from a combination of resistance to insulin action and impairment in insulin secretion, producing hyperglycemia and related complications to many systems of the body, including microvascular (retinal andrenal), macrovascular (coronary and peripheral vascular), and neuropathic manifestations One of the leading causes of morbidity and mortality in the United States, and a contributing factor leading to blindness, renal failure, and lower limb amputations Long-term medical treatment required to manage as well as limit the development of complications Remaining ability to secrete some endogenous insulin so that the patient isn't dependent upon insulin administration, although it may still be needed in treatment Previously called adult-onset diabetes, but diagnosed in children as young as age 2 Overview-Pathophysiology Characterized by a combination of peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells, the results are a progressive loss of beta cell function and mass. Insulin resistance elevates levels of free fatty acids in plasma, leading to decreased glucose transport into muscle cells, elevated hepatic glucose production, and increased breakdown of fat. Abnormal glucose tolerance occurs and postprandial blood glucose levels increase; hepatic gluconeogenesis suppression fails and fasting hyperglycemia develops. Cellular damage occurs in the capillary endothelial cells of the retina, mesangial cells in the renal glomerulus, and the neurons and Schwann cells in peripheral nerves due to the inability of cells to regulate the uptake of glucose. Insulin resistance, combined with the presence of lipid and thrombotic abnormalities and atherosclerotic risk factors, determines cardiovascular risk; increased cardiovascul Continue reading >>

Nutrition Chapter 15 Diabetes

Nutrition Chapter 15 Diabetes

If someone using intensive insulin therapy with multiple injections daily wanted to celebrate his or her birthday and enjoy a slice of birthday cake, he or she would use an extra dose of intermediate- or long-acting insulin. use an extra dose of short- or rapid-acting insulin. If a patient with diabetes mellitus checks blood glucose level before going for a 2-mile run and it is 90 mg/dL, he or she should administer extra short- or rapid-acting insulin. administer extra intermediate- or long-acting insulin. eat carbohydrate-containing food before exercising. go for the run and recheck blood glucose levels afterwards. To prevent hypoglycemia after exercise, patients with type 1 diabetes should increase their intake of protein-based foods. increase their intake of carbohydrate-based foods. The best strategy for a patient with type 2 diabetes to use to maintain good metabolic control is to avoid all sources of simple carbohydrates. avoid eating during the evening or at night. space their meals evenly throughout the day. eat one large meal and two small meals each day. Glycosylated hemoglobin level is used to indicate the effect of meals on blood glucose level. day-to-day variations in blood glucose level. iron deficiency anemia in patients with diabetes. overall blood glucose control over several weeks. A young man with type 1 diabetes runs 3 miles, falls asleep on the sofa, and forgets to eat his next meal. He is likely to experience If a patient with diabetes complains that he or she is experiencing diarrhea on a regular basis, the nurse should ask about the amount of sleep that the patient gets each night. the patient's use of laxative medications. Patients with diabetes are most likely to maintain good glycemic control successfully if their prescribed meal plan is base Continue reading >>

Diabetes Mellitus And Metabolic Syndrome

Diabetes Mellitus And Metabolic Syndrome

the beta cells of the pancreas release the hormone insulin. Insulin helps move glucose from the blood and into body cells, thus lowering blood glucose levels. Low blood glucose levels; In this case, to restore balance, the pancreas releases the hormone glucagon. Glucagon stimulates the liver to release glucose into the blood. What additional hormones help elevate blood glucose levels? epinephrine, cortisol, and growth hormone What are the types types of diabetes and what are both characterized by? characterized by high levels of blood glucose, which we now know is called hyperglycemia. In type 1 diabetes, there is a lack of insulin. Most commonly, this is caused by autoimmune destruction of the beta cells of the pancreas. Remember, insulin moves glucose out of the blood and into the cells. In type 2 diabetes, the pancreas can produce insulin, but the cells have become resistant to accepting it. The body responds by producing even more insulin, but the insulin remains unable to carry out its work. Blood glucose levels stay elevated. obesity and lack of physical activity. Fat cells are particularly resistant to insulin. Remember: it is a disease of hyperglycemia, so diagnosis is based on blood glucose testing. There are three common methods: fasting blood glucose level, oral glucose tolerance test, and glycated hemoglobin test, also called the HbA1c test. The HbA1c test can assess blood glucose control over the preceding three months. Diabetes has serious potential complications Managing blood glucose levels is key in treatment. With type 1 diabetes, insulin is always needed. Medical management of type 2 diabetes often requires a stepwise approach. The first step is lifestyle modifications, followed by monotherapy of an oral antidiabetic agent. If these are not effective Continue reading >>

Pharm Quiz 10 Flashcards | Quizlet

Pharm Quiz 10 Flashcards | Quizlet

Acetaminophen (Tylenol) does not cause gastric distress as do aspirin, ibuprofen, naproxen sodium, and glucocorticoids. This medication would be the least likely to cause additive effects, because the patient on steroids is already at risk for gastric distress. When assessing for potential side effects of fludrocortisone (Florinef), what is a priority for the nurse to monitor? Serum sodium levels for potential hyponatremia Intake and output for potential fluid volume deficit Fludrocortisone (Florinef) has mineralocorticoid properties, resulting in sodium and fluid retention along with potassium excretion. The other assessments are not priorities for this medication administration What plan is best for the patient beginning prednisone therapy? Administer the medication early evening to coincide with the natural secretion pattern of the adrenal cortex. Plan to keep a strict, unchanging schedule to prevent adverse reactions. Take the medication with food to diminish the risk of gastric irritation. Take the medication only every other day to decrease the risk of adrenal hyperplasia. Take the medication with food to diminish the risk of gastric irritation. Glucocorticoids can cause gastric distress and should be administered with food. The normal circadian secretion of the adrenal cortex is early morning to wake the person up, not early evening. These medications should be tapered off slowly to prevent adrenal crisis. The patient takes the medication daily. The nurse is caring for a patient who has just started taking levothyroxine (Synthroid). What assessment finding is a priority for the nurse to address? Irritability is a symptom of hyperthyroidism. This could be a sign that the medication dose is too high. A lowered heart rate, weight gain, and intolerance to cold could Continue reading >>

Chapter 19 Nutrition For Diabetes Mellitus

Chapter 19 Nutrition For Diabetes Mellitus

4. The three main symptoms of untreated type 1 diabetes mellitus are b. neuropathy, nephropathy, and retinopathy. c. confusion, loss of coordination, and headaches. d. fatigue, loss of appetite, and frequent infections. 5. The cause of type 1 diabetes mellitus is c. inability of cells to respond to insulin in the bloodstream. d. inability of the pancreas to keep up with the body's demands for insulin. 6. The two strongest risk factors for type 2 diabetes are b. recurrent viral infections and stress. d. preference for sweet foods and sedentary lifestyle. 7. In individuals with type 2 diabetes, insulin production is generally 12. The main difference between the different types of exogenous insulin is c. the type of solvent used to carry the insulin. d. the length of time they take to act in the body. 13. Sulfonylureas and meglitinides decrease blood glucose levels by b. slowing the rate of absorption of glucose. c. providing an exogenous source of insulin. 14. Patients with diabetes mellitus should exercise at times when their blood glucose level is _____ mg/dL. 15. To prevent hypoglycemia after exercise, patients with type 1 diabetes should c. increase their intake of protein-based foods. d. increase their intake of carbohydrate-based foods. 16. Patients with type 2 diabetes are most likely to maintain good metabolic control if they a. avoid all sources of simple carbohydrates. b. avoid eating during the evening or at night. c. space their meals evenly throughout the day. d. eat one large meal and two small meals each day. 17. Glycosylated hemoglobin level is used to indicate a. the effect of meals on blood glucose level. b. day-to-day variations in blood glucose level. c. iron deficiency anemia in patients with diabetes. d. overall blood glucose control over several we Continue reading >>

Diabetes Mellitus Flashcards | Quizlet

Diabetes Mellitus Flashcards | Quizlet

Rationale: Type 2 diabetes is a disorder usually occurring around the age of 40, but it is now being detected in children and young adults as a result of obesity and sedentary lifestyles. Nonhealing wounds are a hallmark sign of type 2 diabetes. The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1C) of 8.1%. Which interpretation should the nurse make based on this result? 2. This result is within acceptable levels. 3. This result is above recommended levels. 3. This result is above recommended levels. Rationale: This result parallels a serum blood glucose level of approximately 180 to 200 mg/dL. An A1C is a blood test reflecting average blood glucose levels over a period of three months; clients with elevated blood glucose levels are at risk for developing long-term complications. The nurse administered 28 units of Humulin N, an intermediate-acting insulin to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement? 1. Ensure the client eats the bedtime snack. 2. Determine how much food the client ate at lunch. 4. Offer the client protein after administering insulin. 1. Ensure the client eats the bedtime snack. Rationale: Humulin N peaks in 6 to 8 hours, making the client at risk for hypoglycemia around midnight, which is why the client should receive a bedtime snack. This snack with prevent nighttime hypoglycemia. The client diagnosed with type 1 diabetes is receiving Humalog, a rapid-acting insulin, by sliding scale. The order reads blood glucose level: <150, zero units; 151 to 200, three units; 201 to 250, six units; >251, contact HCP. The unlicensed assistive personnel (UAP) reports to the nurse the client's glucometer reading is 189. How much insulin should the nurse administer to the client? Rationale: Continue reading >>

Chapter 19: Nutrition For Diabetes Mellitus

Chapter 19: Nutrition For Diabetes Mellitus

1. A person is diagnosed as having diabetes mellitus if his or her fasting blood glucose level on two occasions is greater than _____ mg/dL. a. 90 b. 120 c. 126 d. 156 ANS: C Diabetes mellitus is diagnosed as fasting blood glucose level >126 mg/dL on two occasions. DIF: Cognitive Level: Knowledge REF: Page 401 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 2. Long-term complications of diabetes mellitus include a. arthritis, rheumatism, and osteoporosis. b. retinopathy, nephropathy, and neuropathy. c. impaired immunity and opportunistic infections. d. dermatitis, nephrotic syndrome, and detached retina. ANS: B Long-term complications of diabetes mellitus include retinopathy, nephropathy, and neuropathy. Diabetes mellitus can increase risk and severity of infection indirectly due to poor circulation and high blood glucose levels, but immunity is not impaired. Arthritis, rheumatism, osteoporosis, dermatitis, nephritic syndrome, and detached retina are not associated with diabetes. DIF: Cognitive Level: Knowledge REF: Pages 401-402 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 3. The type of diabetes therapy that seems to be most effective in decreasing and delaying the complications of diabetes is a. psychotherapy. b. intensive therapy. c. combined therapy. d. conventional therapy. ANS: B Intensive therapy is most effective in decreasing and delaying the complications of diabetes because it allows better control of blood glucose levels. Psychotherapy may help patients cope with psychological concerns about their disease, but will not delay complications. Conventional therapy may help prevent complications if blood glucose levels are well controlled, but this is less likely than with intensive therapy. Combined the Continue reading >>

Diabetes

Diabetes

Sort 1. A 54-year-old patient admitted with type 2 diabetes asks the nurse what "type 2" means. What is the most appropriate response by the nurse? A. "With type 2 diabetes, the body of the pancreas becomes inflamed." B. "With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased." C."With type 2 diabetes, the patient is totally dependent on an outside source of insulin." D. "With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas." B."With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased." Rationale: In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced, and/or the cells of the body become resistant to insulin. The pancreas becomes inflamed with pancreatitis. The patient is totally dependent on exogenous insulin and may have had autoantibodies destroy the β-cells in the pancreas with type 1 diabetes mellitus. 2. The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain information on the patient's past glucose control? A. Prealbumin level B. Urine ketone level C. Fasting glucose level D. Glycosylated hemoglobin level D. Glycosylated hemoglobin level Rationale. A glycosylated hemoglobin level detects the amount of glucose that is bound to red blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the RBCs and remains there for the life of the blood cell, which is approximately 120 days. Thus the test can give an indication of glycemic control over approximately 2 to 3 months. The prealbumin level is used to establish nutritional status and is unrelated to past glucose control. The urine ketone level will only show that hyperglycemia or starvation is pr Continue reading >>

Diabetes Mellitus (lifespan)

Diabetes Mellitus (lifespan)

Which descriptors are typical of type 2 diabetes mellitus? (select all that apply) -Cells have decreased ability to respond to insulin -Most patients diagnosed are obese adults It is necessary for glucose transport across cell membranes Why is glucose vital to the body's cells? A patient with diabetes presents to the emergency department (ED) with a blood sugar of 640 mg/dL and reports being constantly thirsty and having to urinate "all of the time." How does the nurse document this subjective finding? Which cultures tend to have a higher incidence of DM? (select all that apply) Which individual is at greatest risk for developing type 2 DM? According to the Amercian Diabetes Association (ADA), which laboratory finding is most indicative of DM? 2-hour glucose tolerance blood glucose=210 mg/dL Untreated hyperglycemia results in which condition? In a patient with hyperglycemia, the respiratory center is triggered in an attempt to excrete more carbon dioxide and acid, thus causing a rapid and deep respiratory pattern. What is the term for this respiratory pattern? Which electrolyte is most affected by hyperglycemia? Which complications of DM are considered emergencies? (select all that apply) In determining if a patient is hypoglycemic, the nurse looks for which characteristics in addition to checking the patient's blood glucose? (select all that apply) Which factors differentiate DKA from HHS? (select all that apply) A patient is admitted with a blood glucose level of 900 mg/dL. IV fluids and insulin are administered. Two hours after treatment is initiated, the blood glucose level is 400 mg/dL. Which implication is the patient most at risk for developing? What type of insulin is used in the emergency treatment of DKA and hyperglycemic-hyperosmolar nonketotic syndrome (HHN Continue reading >>

Chapter 51 Flashcards | Quizlet

Chapter 51 Flashcards | Quizlet

Exercise lowers blood glucose, increases levels of HDLs, and decreases total cholesterol and triglyceride levels. Low fat intake and low levels of stimulation do not reduce a patient's need for insulin. Adequate sleep is beneficial in reducing stress, but does not have an effect that is pronounced as that of exercise. A medical nurse is caring for a patient with type 1 diabetes. The patient's medication administration record includes the administration of regular insulin three times daily. Knowing that the patient's lunch tray will arrive at 11:45, when should the nurse administer the patient's insulin? Sulfonylureas exert their primary action by directly stimulating the pancreas to secrete insulin and therefore require a functioning pancreas to be effective. Biguanides inhibit the production of glucose by the liver and are in used in type 2 diabetes to control blood glucose levels. Thiazolidinediones enhance insulin action at the receptor site without increasing insulin secretion from the beta cells of the pancreas. Alpha glucosidase inhibitors work by delaying the absorption of glucose in the intestinal system, resulting in a lower postprandial blood glucose level. A diabetes nurse educator is teaching a group of patients with type 1 diabetes about "sick day rules." What guideline applies to periods of illness in a diabetic patient? A) Do not eliminate insulin when nauseated and vomiting. B) Report elevated glucose levels greater than 150 mg/dL. C) Eat three substantial meals a day, if possible. D) Reduce food intake and insulin doses in times of illness. The most important issue to teach patients with diabetes who become ill is not to eliminate insulin doses when nausea and vomiting occur. Rather, they should take their usual insulin or oral hypoglycemic agent dose, Continue reading >>

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