Nursing Diabetes Insulin Therapy

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Questions and Answers

What indicates the client with newly diagnosed Type 1 diabetes needs more teaching about insulin therapy?

The client drinks orange juice when experiencing a headache or nervousness.

The client receives a glucagon injection at home if they pass out.

The client checks their blood glucose with a glucometer at least once a day.

The client does not worry about diet while taking insulin daily. (correct)

What laboratory test result would the nurse review to obtain information on the patient's past glucose control?

Potassium level

Urinalysis

Glycosylated hemoglobin level (correct)

Fasting glucose level

What should the nurse prioritize when administering insulin lispro to a client diagnosed with diabetes?

Administering the dose according to the regular insulin sliding scale.

Assessing the client for signs of hyperosmolar, hyperglycemic, non-ketotic syndrome.

Ensuring the client is wearing a medical alert bracelet. (correct)

Ensuring the client eats the food on the meal tray.

Which assessment data indicates a client with Type 1 diabetes is adhering to their medical treatment regimen?

Hb A1c is 5.8%. (B) Signup and view all the answers

What indicates the client understands the teaching concerning insulin storage?

The client keeps unopened vials of insulin in the refrigerator. (D) Signup and view all the answers

What is a priority intervention for the nurse caring for a client with newly diagnosed Type 1 diabetes?

Teaching the client about insulin therapy. (A) Signup and view all the answers

What should the nurse assess in a client with Type 1 diabetes who is taking insulin lispro?

The client's risk for hyperosmolar, hyperglycemic, non-ketotic syndrome. (D) Signup and view all the answers

What is the primary goal of teaching a client with Type 1 diabetes about insulin therapy?

To ensure the client's adherence to their insulin therapy regimen. (C) Signup and view all the answers

What is the priority action for the nurse to take if the patient with Type 2 diabetes complains of blurred vision and irritability?

Check the patient's blood glucose level (B) Signup and view all the answers

Which of the following insulins can be administered IV as an 'insulin drip'?

Regular insulin (B) Signup and view all the answers

What is the primary reason for the patient to eat when or shortly after taking Humalog insulin?

To prevent hypoglycemia (A) Signup and view all the answers

What does a glycosylated hemoglobin (A1c) level indicate?

Glycemic control over the past 2-3 months (A) Signup and view all the answers

Which medication is most likely to cause a vaginal yeast infection as a side effect?

Empagliflozin (C) Signup and view all the answers

Why should the patient with diabetes avoid drinking alcohol?

It can cause an Antabuse-like reaction (D) Signup and view all the answers

What is the primary advantage of carbohydrate counting in the diet of a patient with diabetes?

It helps to improve glycemic control (B) Signup and view all the answers

What is the duration of action for insulin glargine?

Approximately 24 hours (B) Signup and view all the answers

Why should the patient with diabetes store unopened insulin vials in the refrigerator?

To maintain the insulin's strength and potency (C) Signup and view all the answers

What is the primary reason for the patient to take Glyburide?

To improve pancreatic beta cell function (B) Signup and view all the answers

What type of insulin has a more rapid onset, peak, and duration of action than short-acting regular insulin?

Rapid acting insulin (C) Signup and view all the answers

What is the goal of lowering hemoglobin A1C?

To reduce microvascular and neuropathic complications (B) Signup and view all the answers

What is essential for the patient to understand before being discharged?

How to recognize and treat signs and symptoms of hypoglycemia and hyperglycemia (C) Signup and view all the answers

Why is it important to eat a mid-afternoon snack when taking NPH insulin?

To prevent hypoglycemia (C) Signup and view all the answers

What is the correct order of drawing up insulin into a syringe?

Regular insulin first, then cloudy NPH insulin (D) Signup and view all the answers

What is the duration of action of glargine insulin?

20 to 24 hours (D) Signup and view all the answers

What is the mechanism of action of metformin?

Reduces glucose production by the liver and enhances insulin sensitivity (B) Signup and view all the answers

Why is repaglinide known as the 'Humalog of oral hypoglycemic drugs'?

It has a very fast onset of action (B) Signup and view all the answers

When should glipizide be administered in relation to meals?

30 minutes before a meal (D) Signup and view all the answers

What should be done first when hypoglycemia is suspected?

Check the patient's blood glucose level (B) Signup and view all the answers

Which of the following is a rapid-acting insulin with an onset of action of less than 15 minutes?

Insulin aspart (D) Signup and view all the answers

What information is essential to include in patient teaching before discharge from the hospital for a patient with newly diagnosed Type 1 diabetes?

Insulin administration, hypoglycemia prevention, symptoms, and treatment (A) Signup and view all the answers

Which information should be included in a teaching plan for patients taking oral hypoglycemic drugs?

Limit your alcohol consumption and report symptoms of anorexia and fatigue (B) Signup and view all the answers

When should the nurse provide instructions to the patient about prefilled insulin syringes?

Within 1-2 days of prefilled insulin syringes use (A) Signup and view all the answers

What should the nurse tell the patient with diabetes to best explain how Metformin works?

It reduces glucose production by the liver and enhances insulin sensitivity (A) Signup and view all the answers

Which of the following is a long-acting insulin that mimics natural, basal insulin with no peak action and a duration of 24 hours?

Insulin glargine (A) Signup and view all the answers

What is the primary goal of teaching a patient about insulin glargine?

To provide a consistent basal level of insulin (C) Signup and view all the answers

Which of the following is a characteristic of glipizide?

It has a rapid onset and short duration of action (B) Signup and view all the answers

When is the patient at highest risk of hypoglycemia following an 8:00 AM dose of NPH insulin?

2:00 PM (C) Signup and view all the answers

What should the nurse prioritize when teaching a patient about insulin administration?

Rotate sites at least once or twice a week (B) Signup and view all the answers

Study Notes

Insulin Therapy

Insulin therapy requires adherence to a specific diet, carbohydrate counting is recommended by the American Diabetic Association.
Unopened insulin vials should be stored in the refrigerator to maintain their strength and potency.

Laboratory Tests

Glycosylated hemoglobin (HbA1c) level detects glucose bound to red blood cells, indicating glycemic control over 2-3 months.
Fasting glucose level indicates current glucose control.

Insulin Administration

Rapid-acting insulin (e.g., lispro, aspart, glulisine) should be administered immediately before a meal.
Long-acting insulin (e.g., glargine, detemir) has a slower onset and longer duration of action.
Regular insulin can be administered IV as an "insulin drip".

Diabetes Management

A patient with Type 2 diabetes should adhere to a diabetic diet and exercise regularly to control blood glucose levels.
A patient with Type 1 diabetes should understand how to use a portable blood glucose monitor, recognize and treat signs and symptoms of hypoglycemia and hyperglycemia, and understand insulin administration.

Hypoglycemia

NPH insulin peaks around 2-3 pm, so patients should eat a mid-afternoon snack to prevent hypoglycemia.
Hypoglycemia prevention, symptoms, and treatment should be taught to patients with diabetes.

Oral Hypoglycemic Drugs

Oral hypoglycemic drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes.
Limiting alcohol consumption, reporting symptoms of anorexia and fatigue, and notifying a healthcare provider if blood glucose levels rise above the target level are important for patients taking oral hypoglycemic drugs.

Insulin Types

Insulin glargine is a long-acting insulin with no peak, lasting 24 hours.
Insulin aspart is a rapid-acting insulin.
NPH insulin is an intermediate-acting insulin.

Medications

Metformin reduces glucose production by the liver and enhances insulin sensitivity.
Glipizide should be taken 30 minutes before meals to stimulate insulin secretion.
Repaglinide is a rapid-acting oral hypoglycemic drug that allows patients to take the drug with meals and skip a dose when skipping a meal.
Empagliflozin is an SGLT-2 inhibitor that increases the risk of urinary and genital complications, especially genital mycotic infections.

Nursing Interventions

When a patient with diabetes complains of blurred vision and irritability, the nurse should first check the patient's blood glucose level.
The nurse should teach patients about insulin administration, hypoglycemia prevention, symptoms, and treatment, and provide instructions on how to use a portable blood glucose monitor.

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Description

A quiz on nursing diabetes care, focusing on insulin therapy and patient education. Questions cover topics such as glucagon injections, blood glucose monitoring, and dietary considerations.