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Dka Quizlet Questions

Diabetes Mellitus Complications (hhns And Dka) Nclex

Diabetes Mellitus Complications (hhns And Dka) Nclex

HHS is typically seen in patients with type 2 diabetes and infection, such as pneumonia. The main presenting sign is a glucose level above 600 mg/dL. Enough evidence of dehydration already exists that orthostatic vital sign assessments are not a priority, and they are often inaccurate in the elderly due to poor vascular tone. Patients with HHS do not have elevated ketone levels, which is a key distinction between HHS and DKA. Temperature will eventually be taken but is often blunted in the elderly and diabetics. An infectious diagnosis has already been made. The glucose level for appropriate fluid and insulin treatment is the priority. The patient with HHS presented with a glucose level of 800 mg/dL and is started on IV fluids and insulin. What action do you anticipate when the patient's glucose reaches 250 mg/dL? A. Administer an intravenous (IV) solution with 5% dextrose. B. Administer sodium polystyrene sulfate (Kayexalate). C. Slow the IV infusion rate to 40 mL/hour. D. Assess cardiac monitoring for peaked T waves. A. Administer an intravenous (IV) solution with 5% dextrose. When blood glucose levels fall to approximately 250 mg/dL, IV fluids containing glucose are administered to prevent hypoglycemia. Kayexalate (for cation exchange) is used in the treatment of hyperkalemia, which causes peaked T waves on cardiac monitoring. In HHS hypokalemia may result from insulin moving the potassium intracellularly. Fluid replacement remains a priority, but it is given with dextrose. The infusion rate of 40 mL/hour keeps the vein open, but it is not the appropriate replacement rate. What is a typical finding of hyperosmolar hyperglycemic syndrome (HHS)? A. Occurs in type 1 diabetes as the presenting symptom B. Slow onset resulting in a blood glucose level greater than 600 mg/ Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

What are the types of diabetes insipidus? Central Diabetes Insipidus The most common form of serious diabetes insipidus, central diabetes insipidus, results from damage to the pituitary gland, which disrupts the normal storage and release of ADH. Damage to the pituitary gland can be caused by different diseases as well as by head injuries, neurosurgery, or genetic disorders. To treat the ADH deficiency that results from any kind of damage to the hypothalamus or pituitary, a synthetic hormone called desmopressin can be taken by an injection, a nasal spray, or a pill. While taking desmopressin, a person should drink fluids only when thirsty and not at other times. The drug prevents water excretion, and water can build up now that the kidneys are making less urine and are less responsive to changes in body fluids. Nephrogenic Diabetes Insipidus Nephrogenic diabetes insipidus results when the kidneys are unable to respond to ADH. The kidneys' ability to respond to ADH can be impaired by drugs-like lithium, for example-and by chronic disorders including polycystic kidney disease, sickle cell disease, kidney failure, partial blockage of the ureters, and inherited genetic disorders. Sometimes the cause of nephrogenic diabetes insipidus is never discovered. Desmopressin will not work for this form of diabetes insipidus. Instead, a person with nephrogenic diabetes insipidus may be given hydrochlorothiazide (HCTZ) or indomethacin. HCTZ is sometimes combined with another drug called amiloride. The combination of HCTZ and amiloride is sold under the brand name Moduretic. Again, with this combination of drugs, one should drink fluids only when thirsty and not at other times. Dipsogenic Diabetes insipidus Dipsogenic diabetes insipidus is caused by a defect in or damage to the thirst Continue reading >>

Test: Bstrandable Nclex Endocrine Review | Quizlet

Test: Bstrandable Nclex Endocrine Review | Quizlet

"(SELECT ALL THAT APPLY) A 45-year-old female client is admitted to the hospital with Cushing's syndrome. Which nursing interventions are appropriate for this client? "After undergoing a subtotal thyroidectomy, a client develops hypothyroidism. The physician prescribes levothyroxine (Synthroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent? An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump: "a. Gives small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal. b. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals. c. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream. d. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels" A program of weight loss and exercise is recommended for a patient with impaired fasting glucose (IFG). When teaching the patient about the reason for these lifestyle changes, the nurse will tell the patient that a. the high insulin levels associated with this syndrome damage the lining of blood vessels, leading to vascular disease. b. although the fasting plasma glucose levels do not currently indicate diabetes, the glycosylated hemoglobin will be elevated. c. the liver is producing excessive glucose, which will eventually exhaust the ability of the pancreas to produce insulin, and exercise will normalize glucose production. d. the onset of diabetes and the associated cardiovascular Continue reading >>

Endocrine/diabetes Nclex Questions

Endocrine/diabetes Nclex Questions

4.intravenous infusion of sodium bicarbonate Primary goal achievement of HHNS is to rehydrate the client to restore fluid volume and to correct electrolyte deficiency. 572. An external insulin pump is prescribed for a client with DM and the client asks the nurse about the functioning of the pump. The nurse bases the response on which info about the pump? 1.is timed to release programmed doses of short-duration or NPH insulin into the bloodstream at specific intervals 2.continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels 3.is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases insulin into the bloodstream 4.gives a small continues dose of short-duration insulin subcutaneously, and the client can self administer a bolus with an additional dose from the pump before each meal And insulin pump provides a small continuous dose of short - duration (rapid or short acting) insulin subcutaneously throughout the day and night, and the client can self-administered a bolus with an additional dose from the pump before each meal as needed. short - duration insulin is used in an insulin pump. And external pump is not attach surgically to the pancreas. 573. The client with a diagnosis of DKA is being treated in the ED. Which findings would the nurse expect to know as confirming this diagnosis? Select all that apply. In DKA, the arterial pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, The blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. The client would be experiencing polyuria, and Kussmaul's respirations would be present. A comatose state may occur if DKA is not treated, but coma would not confirm the di Continue reading >>

Adult Health - Endocrine

Adult Health - Endocrine

Home > Preview A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar state (HHS) is made. The nurse would immediately prepare to initiate which anticipated health care provider's prescription? 1. Endotracheal intubation 2. 100 units of NPH insulin 3. Intravenous infusion of normal saline 4. Intravenous infusion of sodium bicarbonate An external insulin pump is prescribed for a client with diabetes mellitus and the client asks the nurse about the functioning of the pump. The nurse bases the response on which information about the pump? 1. Is timed to release programmed doses of short-duration or NPH insulin into the bloodstream at specific intervals 2. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels 3. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream 4. Gives a small continuous dose of short-duration insulin subcutaneously, and the client can self-administer a bolus with an additional dose from the pump before each meal 4. Gives a small continuous dose of short-duration insulin subcutaneously, and the client can self-administer a bolus with an additional dose from the pump before each meal A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings would the nurse expect to note as confirming this diagnosis? Select all that apply. 1. Increase in pH 2. Comatose state 3. Deep, rapid breathing 4. Decreased urine output 5. Elevated blood glucose level 6. Low plasma bicarbonate level 3. Deep, rapid breathing 5. Elevated blood glucose level 6. Low plasma bicarbonate level The nurse teaches a cl Continue reading >>

Airway Obstruction And Asthma

Airway Obstruction And Asthma

An elderly client with pneumonia may appear with which of the following symptoms first? 2. Which of the following pathophysiological mechanisms that occurs in the lung parenchyma allows pneumonia to develop? 3. A 7-year-old client is brought to the E.R. Hes tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and a nonproductive cough. He recently had a cold. From his history, the client may have which of the following? Chronic obstructive pulmonary disease (COPD) 4. Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder? 5. Which of the following types of asthma involves an acute asthma attack brought on by an upper respiratory infection? 6. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following classes of medication right away? 7. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should be taken first? 8. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this information, he most likely has which of the following conditions? Adult respiratory distress syndrome (ARDS) 9. The term blue bloater refers to which of the following conditions? Adult respiratory distress syndrome (ARDS) 10. The term pink puffer refers to the client with which of the following conditions? 11. A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. Hes tachypneic, with a prolonged expiratory p 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 Practice Questions

Diabetes Practice Questions

1. The risk factors for type 1 diabetes include all of the following except: a. Diet b. Genetic c. Autoimmune d. Environmental 2. Type 2 diabetes accounts for approximately what percentage of all cases of diabetes in adults? a. 55%-60% b. 35%-40% c. 90-95% d. 25-30% 3. Risk factors for type 2 diabetes include all of the following except: a. Advanced age b. Obesity c. Smoking d. Physical inactivity 4. What percentage of women with gestational diabetes is diagnosed with type 2 diabetes following pregnancy? a. 25%-30% b. 5%-10% c. <5% d. 20%-25% 5. Untreated diabetes may result in all of the following except: a. Blindness b. Cardiovascular disease c. Kidney disease d. Tinnitus 6. Prediabetes is associated with all of the following except: a. Increased risk of developing type 2 diabetes b. Impaired glucose tolerance c. Increased risk of heart disease and stroke d. Increased risk of developing type 1 diabetes 7. Diabetics are at increased risk of heart disease if they also: a. Smoke b. Have high HDL cholesterol levels c. Take aspirin d. Consume a high-fiber diet 8. Blood sugar is well controlled when Hemoglobin A1C is: a. Below 7% b. Between 12%-15% c. Less than 180 mg/dL d. Between 90 and 130 mg/dL 9. Excessive thirst and volume of very dilute urine may be symptoms of: a. Urinary tract infection b. Diabetes insipidus c. Viral gastroenteritis d. Hypoglycemia 10. Among female children and adolescents, the first sign of type 1 diabetes may be: a. Rapid weight gain b. Constipation c. Genital candidiasis d. Insomnia 11. Untreated hyperglycemia may lead to all of the following complications except: a. Hyperosmolar syndrome b Vitiligo c. Diabetic ketoacidosis d. Coma 12. Hyperinsulinemia may be caused by all of the following except: a. An insulinoma b. Nesidioblastosis c. Insulin Continue reading >>

Diabetes Practice Questions

Diabetes Practice Questions

Which of the following is the appropriate initial action by the nurse when preparing insulin administration? A. Injecting air into the regular insulin B. Withdrawing the cloudy insulin first before the clear insulin C. Injecting air into the cloudy insulin but withdrawing the clear insulin first D. Withdrawing the clear insulin and cloudy insulin in separate syringes C - This action ensures prevention of contamination of the rapid-acting insulin. In case of emergency (DKA), rapid effect of the clear insulin is maintained. Injecting air into the cloudy insulin will promote easy aspiration of the medication, once the syringe already contains the clear insulin. The client with insulin-dependent diabetes mellitus (IDDM) has been brought to the emergency room. What should the nurse watch for if blood pH is 7.28? B - Ketoacidosis is characterized by low blood pH. Type 1 diabetic clients are prone to ketoacidosis. Which of the following laboratory test best indicate compliance of the diabetic client and insulin therapy? C - Glycosylated hemoglobin (HbA1c) is the best indicator of diabetic control. If reflects blood glucose level for the past 3 to 4 months The diabetic client is having ketoacidosis. Which of the following is the appropriate initial nursing action? B - Ketoacidosis is characterized by severe hyperglycemia. The emergency management of ketoacidosis is regular insulin IV The client has been diagnosed to have IDDM. Which order should you question? A - Propranolol, a beta-adrenergic blocker causes hypoglycemia. It is contraindicated among diabetes clients. The nurse is planning care for a client with hyperthyroidism. Which of the following nursing interventions are appropriate? SELECT ALL THAT APPLY A. Instill isotonic eye drops as necessary B. Provide several, smal Continue reading >>

Diabetes Mellitus Nclex Practice Quiz #1 (40 Questions)

Diabetes Mellitus Nclex Practice Quiz #1 (40 Questions)

This exam is all about Diabetes Mellitus! The purpose of this exam is to provide nurses and future nurses an overview of the disease, including its management, impact, and complications. Accomplish this 40-item NCLEX style examination and guarantee a good performance on your NCLEX. Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending. ~ Carl Bard Topics Included topics in this practice quiz are: Guidelines Follow the guidelines below to make the most out of this exam: Read each question carefully and choose the best answer. You are given one minute per question. Spend your time wisely! Answers and rationales are given below. Be sure to read them. If you need more clarifications, please direct them to the comments section. Questions See Also You may also like these quizzes: 3,500+ NCLEX-RN Practice Questions for Free – Tons of practice questions for various topics in the NCLEX-RN! Study Guides Cardiovascular System Respiratory System Nervous System Digestive and Gastrointestinal System Endocrine System Urinary System Homeostasis: Fluids and Electrolytes Cancer and Oncology Nursing Burns and Burn Injury Management Emergency Nursing Miscellaneous Recommended Books and Resources Selected NCLEX-RN review books: MUST HAVE: Saunders Comprehensive Review for the NCLEX-RN® Examination, 7th Edition – A must have book if you're taking the NCLEX-RN. You need to have this. Saunders Strategies for Success for the NCLEX – An invaluable guide that will help you master what matters most in passing nursing school and the NCLEX. Mosby's Comprehensive Review of Nursing for NCLEX-RN – This book has helped nurses pass the NCLEX exam for over 60 years. Practice with over 600 alternative item question formats. Prioritization, Dele Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

List Clinicopathologic features that might be present with DKA? Elevation in liver enzymes (hepatic lipidosis, pancreatitis) Hyperlipidemia Hyperlipasemia Hyperamylasemia Metabolic Acidosis Serum Hyperosmolality Azotemia (usually pre-renal) Hemeturia, pyuria, bactiuria (always submit cysto for culture an dsensitivity) Ketonuria Continue reading >>

Lewis Med Surg -diabetes Nclex Review Practice Questions

Lewis Med Surg -diabetes Nclex Review Practice Questions

B. Increased high-density lipoproteins (HDL) C. Decreased low-density lipoproteins (LDL) D. Decreased very-low-density lipoproteins (VLDL) Macrovascular complications of diabetes include changes to large- and medium-sized blood vessels. They include cerebrovascular, cardiovascular, and peripheral vascular disease. Increased triglyceride levels are associated with these macrovascular changes. Increased HDL, decreased LDL, and decreased VLDL are positive in relation to atherosclerosis development. A patient is admitted with diabetes mellitus, malnutrition, and cellulitis. The patient's potassium level is 5.6 mEq/L. The nurse understands that what could be contributing factors for this laboratory result (select all that apply)? A. The level may be increased as a result of dehydration that accompanies hyperglycemia. B. The patient may be excreting extra sodium and retaining potassium because of malnutrition. C. The level is consistent with renal insufficiency that can develop with renal nephropathy. D. The level may be raised as a result of metabolic ketoacidosis caused by hyperglycemia. E. This level demonstrates adequate treatment of the cellulitis and effective serum glucose control. The additional stress of cellulitis may lead to an increase in the patient's serum glucose levels. Dehydration may cause hemoconcentration, resulting in elevated serum readings. Kidneys may have difficulty excreting potassium if renal insufficiency exists. Finally, the nurse must consider the potential for metabolic ketoacidosis since potassium will leave the cell when hydrogen enters in an attempt to compensate for a low pH. Malnutrition does not cause sodium excretion accompanied by potassium retention. Thus it is not a contributing factor to this patient's potassium level. The elevated p Continue reading >>

Multiple Choice Quiz

Multiple Choice Quiz

(See related pages) Please answer all questions 1 Cerebrospinal fluid, fluid within the eyes, joints, and body cavities, and fluid secretions of exocrine glands are all classified specifically as ______________ fluid. 2 What are the two major factors that regulate the movement of water and electrolytes from one fluid compartment to the next? B) osmoreceptors in the hypothalamus detect the increase in osmotic pressure of body fluids and signal the posterior pituitary to release ADH C) chemoreceptors in the renal tubule sense the increased viscosity of renal filtrate and signal the hypothalamus which, in turn, signals the posterior pituitary D) the juxtaglomerular apparatus senses the greater osmotic pressure in the blood and triggers the release of ADH 4 How does alcohol function as a diuretic? B) Alcohol receptors in the liver sense its presence and trigger a biochemical pathway that increases urine output to rid the body of alcohol. D) Alcohol prevents the distal convoluted tubule from reabsorbing water from the filtrate. 5 A so-called "salt craving" is primarily the result of _________________. 6 _______________ ions account for nearly 90% of the positively charged ions found in extracellular fluid. 7 The hormone aldosterone regulates the concentrations of _____________ and ______________ in the body. 8 Edema can be caused by all of these factors except ________________. 9 The imbalance known as ____________ can be caused by certain diuretic medications. 10 Which of the following does not occur as a result of a shift in the acid- base balance of the body? 12 The three most important buffer systems in body fluids include the bicarbonate buffer system, the ______________ buffer system, and the protein buffer system. 13 How is it possible for the rate and depth of breath Continue reading >>

Diabetes Nclex Questions

Diabetes Nclex Questions

Rationale: The patient's impaired fasting glucose indicates prediabetes and the patient should be counseled about lifestyle changes to prevent the development of type 2 diabetes. The patient with prediabetes does not require insulin or the oral hypoglycemics for glucose control and does not need to self-monitor blood glucose. During a diabetes screening program, a patient tells the nurse, "My mother died of complications of type 2 diabetes. Can I inherit diabetes?" The nurse explains that a. as long as the patient maintains normal weight and exercises, type 2 diabetes can be prevented. b. the patient is at a higher than normal risk for type 2 diabetes and should have periodic blood glucose level testing. c. there is a greater risk for children developing type 2 diabetes when the father has type 2 diabetes. d. although there is a tendency for children of people with type 2 diabetes to develop diabetes, the risk is higher for those with type 1 diabetes. Rationale: Offspring of people with type 2 diabetes are at higher risk for developing type 2 diabetes. The risk can be decreased, but not prevented, by maintenance of normal weight and exercising. The risk for children of a person with type 1 diabetes to develop diabetes is higher when it is the father who has the disease. Offspring of people with type 2 diabetes are more likely to develop diabetes than offspring of those with type 1 diabetes. A program of weight loss and exercise is recommended for a patient with impaired fasting glucose (IFG). When teaching the patient about the reason for these lifestyle changes, the nurse will tell the patient that a. the high insulin levels associated with this syndrome damage the lining of blood vessels, leading to vascular disease. b. although the fasting plasma glucose levels do n Continue reading >>

Nclex Practice Questions Diabetes

Nclex Practice Questions Diabetes

An older adult patient is in the hospital being treated for sepsis related to a urinary tract infection. The patient has started to have an altered sense of awareness, profound dehydration, and hypotension. What does the nurse suspect the patient is experiencing? a. systemic inflammatory response syndrome The nurse is preparing to administer IV fluids for a patient with ketoacidosis who has a history of hypertension and congestive heart failure. What order for fluids would the nurse anticipate infusing for this patient? A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan? a. making sure that the patient is aware that quantity of food s will be limited b. ensuring that the patient understands that some favorite foods may not be allowed on the meal plan and substitutes will need to be found c. determining whether the patient is on insulin or taking oral anti diabetic medication d. reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns. d. reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns The nurse is educating the patient with diabetes about the importance of increasing dietary fiber. What should the nurse explain is the rationale for the increase? (select all that apply) b. decrease the need for exogenous insulin d. may reduce postprandial glucose levels The nurse is educating a patient about the benefits of fruit versus fruit juice in the diabetic diet. The patient states, " What difference does it make if you drink the juice or eat the fruit? It is all the same." What is the best response by the nurse? a. "Eating the frui Continue reading >>

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