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Questions and Answers
Which patient meets the diagnostic criteria for diabetes mellitus?
Which patient meets the diagnostic criteria for diabetes mellitus?
- A 48-year-old woman with a hemoglobin A1C of 8.4% (correct)
- A 78-year-old man with a 2-hour glucose tolerance plasma glucose of 184 mg/dL
- A 68-year-old woman with a random plasma glucose of 190 mg/dL
- A 58-year-old man with a fasting blood glucose of 111 mg/dL
Which statement by the patient requires an intervention by the nurse regarding insulin administration?
Which statement by the patient requires an intervention by the nurse regarding insulin administration?
- I will discard any insulin bottle that is cloudy in appearance. (correct)
- I may keep my insulin at room temperature (75°F) for up to a month.
- The best injection site for insulin administration is in my abdomen.
- I can wash the site with soap and water before insulin administration.
Which statement made by the patient indicates that teaching about a healthy eating plan was successful?
Which statement made by the patient indicates that teaching about a healthy eating plan was successful?
- I may have a hypoglycemic reaction if I drink alcohol on an empty stomach. (correct)
- If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet.
- I plan to lose 25 pounds this year by following a high-protein diet.
- I should include more fiber in my diet than a person who does not have diabetes.
Which patient with type 1 diabetes mellitus would be at the highest risk for developing hypoglycemic unawareness?
Which patient with type 1 diabetes mellitus would be at the highest risk for developing hypoglycemic unawareness?
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Which statement made by the patient indicates that teaching about preventing diabetic nephropathy has been successful?
Which statement made by the patient indicates that teaching about preventing diabetic nephropathy has been successful?
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Study Notes
Diabetes Diagnosis Criteria
- Diagnosis of diabetes mellitus requires a hemoglobin A1C ≥ 6.5%, fasting plasma glucose ≥ 126 mg/dL, or 2-hour plasma glucose ≥ 200 mg/dL during an oral glucose tolerance test.
- Classic symptoms of hyperglycemia or a random plasma glucose ≥ 200 mg/dL also confirm diabetes.
Insulin Administration Education
- Cloudiness in insulin bottles may indicate intermediate-acting or premixed insulin; such bottles should not be discarded.
- Best injection site is the abdomen; routine hygiene suffices.
- Insulin can be stored at room temperature (up to 75°F) for one month unless temperatures exceed 86°F or drop below freezing.
- It is recommended to rotate injection sites within the same anatomical area.
Healthy Eating for Diabetes Management
- Drinking alcohol on an empty stomach can lead to hypoglycemic reactions.
- High-fiber diets are beneficial; recommendations suggest 14 g of fiber per 1000 kcal.
- Insulin pumps offer flexibility in food choices but do not negate the need to limit saturated fat intake.
Hypoglycemic Unawareness Risk
- Older adults and those on β-adrenergic blockers, like propranolol, are at increased risk for hypoglycemic unawareness, lacking early symptoms of hypoglycemia.
- This condition can lead to severe consequences like incoherence or unconsciousness due to the failure of counterregulatory hormones.
Preventing Diabetic Nephropathy
- Controlling blood pressure through a low-salt diet helps reduce the risk of diabetic nephropathy.
- Regular yearly dilated eye exams by an ophthalmologist are crucial for monitoring diabetic complications.
- Managing blood glucose levels is important; however, maintaining blood sugar above 180 mg/dL is not a safe strategy to prevent hypoglycemia.
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