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?

    <p>Hb A1c is 5.8%.</p> Signup and view all the answers

    What indicates the client understands the teaching concerning insulin storage?

    <p>The client keeps unopened vials of insulin in the refrigerator.</p> Signup and view all the answers

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

    <p>Teaching the client about insulin therapy.</p> Signup and view all the answers

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

    <p>The client's risk for hyperosmolar, hyperglycemic, non-ketotic syndrome.</p> Signup and view all the answers

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

    <p>To ensure the client's adherence to their insulin therapy regimen.</p> 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?

    <p>Check the patient's blood glucose level</p> Signup and view all the answers

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

    <p>Regular insulin</p> Signup and view all the answers

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

    <p>To prevent hypoglycemia</p> Signup and view all the answers

    What does a glycosylated hemoglobin (A1c) level indicate?

    <p>Glycemic control over the past 2-3 months</p> Signup and view all the answers

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

    <p>Empagliflozin</p> Signup and view all the answers

    Why should the patient with diabetes avoid drinking alcohol?

    <p>It can cause an Antabuse-like reaction</p> Signup and view all the answers

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

    <p>It helps to improve glycemic control</p> Signup and view all the answers

    What is the duration of action for insulin glargine?

    <p>Approximately 24 hours</p> Signup and view all the answers

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

    <p>To maintain the insulin's strength and potency</p> Signup and view all the answers

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

    <p>To improve pancreatic beta cell function</p> 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?

    <p>Rapid acting insulin</p> Signup and view all the answers

    What is the goal of lowering hemoglobin A1C?

    <p>To reduce microvascular and neuropathic complications</p> Signup and view all the answers

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

    <p>How to recognize and treat signs and symptoms of hypoglycemia and hyperglycemia</p> Signup and view all the answers

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

    <p>To prevent hypoglycemia</p> Signup and view all the answers

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

    <p>Regular insulin first, then cloudy NPH insulin</p> Signup and view all the answers

    What is the duration of action of glargine insulin?

    <p>20 to 24 hours</p> Signup and view all the answers

    What is the mechanism of action of metformin?

    <p>Reduces glucose production by the liver and enhances insulin sensitivity</p> Signup and view all the answers

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

    <p>It has a very fast onset of action</p> Signup and view all the answers

    When should glipizide be administered in relation to meals?

    <p>30 minutes before a meal</p> Signup and view all the answers

    What should be done first when hypoglycemia is suspected?

    <p>Check the patient's blood glucose level</p> 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?

    <p>Insulin aspart</p> 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?

    <p>Insulin administration, hypoglycemia prevention, symptoms, and treatment</p> Signup and view all the answers

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

    <p>Limit your alcohol consumption and report symptoms of anorexia and fatigue</p> Signup and view all the answers

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

    <p>Within 1-2 days of prefilled insulin syringes use</p> Signup and view all the answers

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

    <p>It reduces glucose production by the liver and enhances insulin sensitivity</p> 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?

    <p>Insulin glargine</p> Signup and view all the answers

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

    <p>To provide a consistent basal level of insulin</p> Signup and view all the answers

    Which of the following is a characteristic of glipizide?

    <p>It has a rapid onset and short duration of action</p> Signup and view all the answers

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

    <p>2:00 PM</p> Signup and view all the answers

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

    <p>Rotate sites at least once or twice a week</p> 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.

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