Diabetes Management Q&A PDF

1. Mention 4 types of DM? ○ Type I Diabetes Mellitus (Insulin-Dependent Diabetes Mellitus) ○ Type II Diabetes Mellitus (Non-Insulin-Dependent Diabetes Mellitus) ○ Gestational Diabetes Mellitus (GDM) ○ Borderline Diabetes (Impaired fasting glucose and impaired glucose...

1. Mention 4 types of DM? ○ Type I Diabetes Mellitus (Insulin-Dependent Diabetes Mellitus) ○ Type II Diabetes Mellitus (Non-Insulin-Dependent Diabetes Mellitus) ○ Gestational Diabetes Mellitus (GDM) ○ Borderline Diabetes (Impaired fasting glucose and impaired glucose tolerance) 2. What are the non-modifiable risk factors of Type 1 DM? ○ Genetic susceptibility ○ Autoimmune factors ○ Family history of Type 1 DM ○ Age (often develops in childhood or adolescence) 3. What are the modifiable risk factors of Type 2 DM? ○ Lack of physical activity ○ Poor diet ○ Excessive weight ○ Sedentary lifestyle 4. What are the clinical manifestations of DM? ○ Polyuria (excessive urination) ○ Polydipsia (excessive thirst) ○ Polyphagia (excessive hunger) ○ Weight loss ○ Extreme fatigue ○ Blurred vision ○ Poor wound healing ○ Recurrent infections 5. The onset of action of NPH insulin is: ○ 1 to 2 hours. 6. The onset of action of Humulin R insulin is: ○ 30 minutes. 7. Mention 4 sites of insulin injection: ○ Abdomen ○ Thigh ○ Upper arm ○ Buttocks 8. What are the most complications that may happen for a patient on insulin therapy? ○ Local or systemic allergic reactions ○ Insulin lipodystrophy (lipoatrophy or lipohypertrophy) ○ Insulin resistance ○ Morning hyperglycemia (e.g., dawn phenomenon, Somogyi effect) 9. Mention 4 nursing interventions for a patient on insulin therapy: ○ Rotate injection sites to prevent lipodystrophy. ○ Monitor blood glucose levels regularly. ○ Educate the patient about recognizing signs of hypoglycemia. ○ Ensure the patient understands the correct administration technique. 10. Deep, rapid breathing is an abnormal pattern of respiration which is described as: ○ Kussmaul respiration. 11. Mention 3 causes for a patient developing hypoglycemia: ○ Too much insulin or oral agents ○ Too little food ○ Excessive physical activity 12. Mention 4 nursing interventions for a patient developing hypoglycemia: ○ Administer 15-20 grams of fast-acting carbohydrates (e.g., 2-3 teaspoons of sugar, 6-10 hard candies). ○ Monitor the patient's blood glucose level every 15 minutes. ○ If the patient is unconscious, administer glucagon or D50W intravenously. ○ Provide a snack containing protein and starch once symptoms resolve. 13. Mention 4 clinical manifestations that indicate the patient developed Diabetic Ketoacidosis (DKA): ○ Hyperglycemia ○ Dehydration ○ Acidosis ○ Kussmaul respirations (deep, rapid breathing) 14. Mention 4 nursing interventions for a patient with DKA: ○ Monitor fluid and electrolyte status. ○ Administer intravenous fluids and insulin as per protocol. ○ Monitor vital signs and blood glucose levels frequently. ○ Assess urine output to ensure adequate renal function. 15. What are the macrovascular complications of DM? ○ Coronary artery disease ○ Cerebrovascular disease ○ Peripheral arterial disease 16. What are the preventive measures of macrovascular diseases? ○ Control of blood glucose levels ○ Diet and exercise to manage obesity and hypertension ○ Use of medications to manage hypertension and hyperlipidemia ○ Smoking cessation 17. What are the microvascular complications of DM?  ○ Diabetic retinopathy ○ Diabetic nephropathy ○ Diabetic neuropathy 18. Compare between hypoglycemia, DKA, HHNS? Feature Hypoglycemia DKA HHNS Onset Sudden, over Slow, over days Slow, over days minutes Heart rate Tachycardia Tachycardia Tachycardia Blood pressure Normal Low Low Respiration Normal or shallow Kussmaul Normal Breath odor None Sweet and fruity None Mental status Bizarre behavior, Coma (very late) Confusion confusion Insulin level High Low Low Blood glucose level Very low High Very high 19. Design a discharge plan instruction for a patient with DM: ○ Diet: Follow a well-balanced diet tailored to your needs; monitor carbohydrate intake. ○ Exercise: Incorporate regular physical activity into your routine. ○ Monitoring: Regularly check blood glucose levels as advised and keep a logbook. ○ Education: Understand the signs of hypo/hyperglycemia and how to manage them. ○ Follow-Up: Schedule regular follow-up appointments with your healthcare provider. ○ Medications: Adhere to prescribed medication regimens and understand their purpose. 20. Design a nursing care plan for a patient with DM including 2 actual nursing diagnoses and 1 potential diagnosis with 3 nursing interventions for each nursing diagnosis according to priority: Nursing Diagnosis 1: Risk for fluid volume deficit related to polyuria and dehydration. Interventions:  a) Monitor vital signs and fluid intake/output regularly. b) Encourage oral fluid intake as appropriate. c) Assess skin turgor and mucous membranes for signs of dehydration. Nursing Diagnosis 2: Imbalanced nutrition related to imbalance of insulin, food, and physical activity. Interventions: a) Collaborate with a dietitian to create a personalized meal plan. b) Educate the patient about carbohydrate counting and portion control. c) Monitor blood glucose levels before and after meals to evaluate dietary management. Potential Nursing Diagnosis: Potential for self-care deficit related to physical impairments or social factors. Interventions: a) Assess the patient's ability to manage self-care activities (e.g., insulin administration). b) Provide resources for diabetes education and self-management. c) Collaborate with social services if there are barriers to self-care (e.g., financial issues).