Questions and Answers
What are the complications that diabetes mellitus can lead to?
Which of the following is not a part of the medical management of diabetic ketoacidosis?
What is a major nursing focus for patients with DKA or HHNC?
What can improper foot care in diabetic patients lead to?
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Which condition is primarily associated with microvascular lesions in diabetes mellitus?
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What is the primary treatment for patients with pheochromocytoma?
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Which of the following factors contributes to the development of both IDDM and NIDDM?
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In the case of bilateral pheochromocytoma tumors, what is a consequence after surgery?
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Which symptom is NOT typically associated with insulin-dependent diabetes mellitus (IDDM)?
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What is the mechanism by which activities like straining can affect patients with pheochromocytoma?
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Which demographic group is reported to have a higher occurrence of diabetes mellitus?
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What differentiates non-insulin-dependent diabetes mellitus (NIDDM) from insulin-dependent diabetes mellitus (IDDM)?
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Which of the following symptoms is commonly associated with both IDDM and NIDDM?
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What is the primary focus of tertiary prevention for diabetes mellitus?
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What dietary recommendation is advised for carbohydrates in managing diabetes mellitus?
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Which of the following is considered a survival skill in diabetes education?
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What should be done if a patient experiences hypoglycemia symptoms?
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What effect does exercise have in relation to diabetes management?
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Which factor should be closely monitored to determine medication needs in diabetes management?
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How should normal daily carbohydrate intake be distributed during short illness for a patient on insulin?
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Which component is NOT included among the five primary treatment modalities for diabetes mellitus?
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Study Notes
Prevention of NIDDM
- Primary prevention targets measures to prevent and treat obesity.
- Secondary prevention involves screening for undiagnosed cases, which may comprise 50% of the population.
- Tertiary prevention focuses on detecting complications and preventing their progression.
Treatment Modalities for Diabetes Mellitus
- Five main treatment modalities: diet, exercise, hypoglycemic agents, monitoring, and education.
- Dietary recommendations include:
- Carbohydrates: 55% to 60% of total caloric intake.
- Fat: 20% to 30%, with saturated fat limited to 10%.
- Protein: 20% with restrictions on cholesterol, sodium, and refined simple carbohydrates.
- Emphasis on complex, unrefined carbohydrates.
Exercise and Its Effects
- Exercise generally has a hypoglycemic effect but can raise blood glucose levels in situations where levels exceed 300 mg/dl or during intense activity.
- Promotes cardiovascular fitness, aids in weight reduction and maintenance, and decreases insulin resistance.
Nursing Management for Diabetes Mellitus
- Assessment includes gathering data on metabolic status and evaluating cardiovascular-renal health, vision, and nerve function.
- Careful examination of lower extremities is essential to prevent complications.
- Diabetes education should be individualized with a focus on gradual, ongoing learning. Initial education should cover basic survival skills.
- Immediate treatment for hypoglycemia involves administering 10 to 15 grams of simple carbohydrates at onset of symptoms.
Signs and Symptoms of Diabetes Mellitus
- Common signs of insulin-dependent diabetes mellitus (IDDM): polyuria, polydipsia, polyphagia, weight loss, weakness, and fatigue.
- NIDDM symptoms may include weight gain and signs of hyperglycemic, hyperosmolar, nonketotic coma or related complications like neuropathy.
- Regular foot care is essential: daily inspections, preserving skin integrity, injury prevention, and referral to podiatry are recommended.
Complications of Diabetes Mellitus
- Life-threatening conditions associated with uncontrolled diabetes include diabetic ketoacidosis (DKA) and hyperglycemic, hyperosmolar, nonketotic coma (HHNC).
- Common precipitating factors: infections, stressors, and non-adherence to treatment protocols.
- Treatment of DKA and HHNC involves intensive fluid replacement, low-dose insulin infusion, and potassium replacement, potentially along with phosphate and magnesium.
Risks of Uncontrolled Diabetes
- Poorly controlled diabetes is a significant predictor of microvascular (nephropathy, retinopathy), macrovascular (atherosclerotic disease), and neuropathy complications.
- Limb amputation may be required due to vascular alterations, nerve trauma, and infections in patients with poor skin integrity and insensitivity to pain.
- Effective foot care practices can significantly reduce the risk of infection and subsequent amputation.
Nursing Focuses in DKA and HHNC Management
- Monitor critical parameters: intake and output, weight, vital signs, mental status, ECG, blood glucose, urine ketones, serum electrolytes, and osmolality.
- Implementation of medical plans must be vigilant with immediate reporting of any unexpected changes in the patient's condition.
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Description
This quiz explores the various prevention strategies and treatment modalities for obesity and non-insulin-dependent diabetes mellitus (NIDDM). It covers primary, secondary, and tertiary prevention measures, including dietary recommendations and lifestyle changes. Test your knowledge on effective methods for managing and preventing diabetes.
