Questions and Answers
What is the blood glucose level for hypoglycemia?
Which of the following is NOT a symptom of hypoglycemia?
What are some rapid onset symptoms of hypoglycemia?
Hunger, lightheadedness, shakiness, headache, anxiety, irritability, pale cool skin, diaphoresis, normal or shallow respirations, tachycardia and palpitations.
Hypoglycemia can lead to impaired cerebral function characterized by ______ onset.
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What is the blood glucose level for hyperglycemia?
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Confusion is a symptom of hyperglycemia.
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What are some symptoms of hyperglycemia?
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What is diabetes mellitus a contributing factor for?
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Which of the following is NOT a risk factor for diabetes mellitus?
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What are the signs and symptoms of hypoglycemia?
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What is the fasting blood glucose level that signifies diabetes?
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During an oral glucose tolerance test, the client must be NPO for ______ hours before the test.
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What is the expected reference range for glycosylated hemoglobin (HbA1c)?
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How often should a diabetic measure their glucose?
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What should a child with diabetes do when sick?
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Which statement about diabetic ketoacidosis (DKA) is accurate?
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Which of the following symptoms is NOT associated with hypoglycemia?
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What should a nurse teach about foot care for a child with diabetes?
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The trade name for rapid-acting insulin is ______.
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What should a nurse discourage in diabetic foot care?
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Which statement indicates understanding of managing diabetes during illness?
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What action should be taken if a child exhibits signs of hypoglycemia?
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What is the purpose of checking urine for ketones?
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Study Notes
Diabetes Mellitus Overview
- Contributes to serious health complications including cardiovascular disease, hypertension, renal failure, blindness, and stroke as individuals age.
Risk Factors
- Genetics, exposure to toxins and viruses, obesity, physical inactivity, high triglycerides, and hypertension are key contributors.
Symptoms and Signs (S&S)
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Hypoglycemia (Blood glucose < 60 mg/dL)
- Rapid onset symptoms: hunger, lightheadedness, shakiness, headache, anxiety, irritability, cold skin, sweatiness, increased heart rate.
- Gradual onset: strange feelings, confusion, difficulty concentrating, slurred speech, seizures, potential coma.
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Hyperglycemia (Blood glucose > 250 mg/dL)
- Symptoms include thirst, frequent urination, nausea, abdominal pain, warm/dry/flush skin, confusion, lethargy, weak pulse, rapid deep breathing with fruity odor.
Diagnostic Criteria
- Fasting blood glucose ≥ 126 mg/dL
- Random blood glucose ≥ 200 mg/dL with classic diabetes symptoms
- Oral glucose tolerance test ≥ 200 mg/dL at the 2-hour mark
Blood Glucose Testing
- Fasting Blood Glucose: Requires 8 hours of fasting; antidiabetic medications should not be taken prior.
- Oral Glucose Tolerance Test: Requires 8 hours of fasting; involves testing blood glucose at intervals after glucose intake over 2 hours.
Glycosylated Hemoglobin (HbA1c)
- Normal reference range: 4%-6%
- Acceptable range for diabetic children: 6.5%-8%
Self-Monitoring Blood Glucose (SMBG)
- Recommended testing: before meals and at bedtime.
- Maintain a detailed log that includes glucose levels, insulin doses, food intake, and physical activity.
Nursing Care
- Monitor vital signs, blood glucose levels, diet, activity, and skin integrity.
- Daily foot care is crucial to prevent infections.
- Educate on proper wound care and regular eye and dental check-ups.
- Ensure meals are timed with insulin activity to prevent hypoglycemia or hyperglycemia.
Insulin Medications
- Rapid-acting: Insulin lispro (Humalog) - Onset < 15 min, peak 0.5-1 hr, duration 3-4 hr.
- Short-acting: Regular insulin (Humulin R) - Onset 0.5-1 hr, peak 2-4 hr, duration 5-7 hr.
- Intermediate-acting: NPH insulin (Humulin N) - Onset 1-2 hr, peak 4-12 hr, duration 18-24 hr.
- Long-acting: Insulin glargine (Lantus) - Onset 3-4 hr, no peak, duration 10.4-24 hr.
Managing Diabetic Ketoacidosis (DKA)
- DKA characterized by severe hyperglycemia (> 300 mg/dL) and rapid onset; requires intensive care unit admission and monitoring for fluid and electrolyte imbalances.
- Treatment includes rapid fluid replacement, insulin administration, and monitoring potassium levels.
Sick Day Management for Diabetic Children
- Monitor blood glucose every 3 hours.
- Continue taking insulin; ensure adequate fluid intake.
- Test urine for ketones and contact healthcare provider if blood glucose exceeds 240 mg/dL.
Common Misconceptions
- Do not skip meals; maintain a regular eating schedule to avoid hypoglycemia.
- Increase insulin requirements are not necessarily indicated with exercise as insulin needs may decrease.
Foot Care Guidelines for Diabetic Patients
- Inspect feet daily, cut toenails straight across, use cornstarch for moisture, and avoid commercial remedies for callus removal.
Long-Term Complications of Diabetes
- Can lead to nephropathy, retinopathy, neuropathy, cardiovascular disease, altered thyroid function, and reduced mobility in small joints.
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Description
This quiz focuses on Diabetes Mellitus, covering its health complications, risk factors, symptoms of hypoglycemia and hyperglycemia, and diagnostic criteria. Test your knowledge on the critical aspects of diabetes that impact health and well-being.
