NURS 370 Exam 3 Study Questions with Verified Answers

NURS 370 Exam 3 Study Questions with Verified Answers 1. Short Acting Insulin - ANSWER (Regular) -Onset: 30-60 minutes -Peak: 2-3 hours -Duration: 4-6 hours 2. Intermediate Acting Insulin - ANSWER (NPH) -Onset: 2-4 hours -Peak: 6-8 hours -Duration: 12-16 hours 3. Long Acting Insulin - ANSWER (Glargine, Detemir, Degludec) -Onset: 2 hours -Peak: none -Duration: 24 hours 4. Hypoglycemia (conscious treatment) - ANSWER (15 g of carbs) -½ cup of juice -2 or 3 glucose tablets -A tube of glucose gel -Followed by something like a half sandwich or cheese and crackers (complex carb with protein) so they don't spike high and crash back down 5. Hypoglycemia (unconscious treatment) - ANSWER -IV dextrose 50% -Glucagon 6. Hypoglycemia (prevention) - ANSWER -Always carry a form of fast-acting sugar -Increase food prior to exercise -A meal or snack every 4 to 5 hour -Check blood sugar regularly 7. Hypoglycemia (s/s) - ANSWER (cold & clammy) -Inability to concentrate -Headache -Lightheadedness -Confusion -Memory lapses -Numbness of the lips & tongue -Slurred speech -Impaired coordination -Emotional changes -Irrational or combative behavior -Double vision -Drowsiness 8. Sick Days (diabetes) - ANSWER -Take insulin or oral antidiabetic agents as usual -Test blood glucose & test urine ketones every 3-4 hours -Attempt to consume frequent, small portions of carbohydrates -In general, blood sugar levels will rise but should be reported if they are greater than 300 mg/dL. 9. Diabetic Macrovascular (complications) - ANSWER (macroangiopathy) -Blood vessel walls thicken, sclerose, and become occluded by plaque that adheres to the vessel walls -Leads to coronary artery disease, cerebrovascular disease, and peripheral vascular disease -Focus of management is aggressive modification and reduction of risk factors 10.Diabetic Retinopathy (complications) - ANSWER -Painless so often not caught early without regular eye examinations -Glucose control, control of HTN, & smoking cessation can help to slow the progression -Laser photocoagulation can be effective at preventing vision loss 11.Diabetic Nephropathy (complications) - ANSWER -Renal disease secondary to microvascular changes in the kidney occurs in 20-40% of patients with diabetes -Leading cause of end stage renal disease -Characterized by albuminuria, HTN, & progressive renal insufficiency -Some patients will progress to dialysis or kidney transplant -Management of glucose & HTN are key as well as early treatment of UTI and avoidance of nephrotoxic drugs -For pts who have developed albuminuria an ACE inhibitor or ARB should be prescribed to lower BP & reduce albuminuria 12.Diabetic Neuropathy (complications) - ANSWER Damage to nerves from elevated blood glucose 13.Peripheral Neuropathy (complications) - ANSWER Paresthesias & aching or burning sensation usually at night, decrease in proprioception & decreased pain & temperature sensation 14.Autonomic Neuropathy (complications) - ANSWER Cardiac resting tachycardia, exercise intolerance, orthostatic hypotension, painless MI, GI bloating, nausea, vomiting, decreased gastric motility & delayed absorption affecting blood sugar, & urogenital causing urinary retention & difficulty with sexual functioning 15.Diabetes (criteria for diagnosis) - ANSWER -A1c of 6.5% or greater -Random glucose ≥ 200 mg/dL -Fasting glucose ≥ 126 mg/dL -2 hour postload glucose ≥ 200 mg/dL during an oral glucose tolerance test 16.Hgb A1c - ANSWER -Reflects average blood glucose levels over a period of approximately 2 to 3 months and is used to evaluate the long term effectiveness of the patients regimen -A1C greater than 6.5 indicates diabetes 17.Diabetes (discharge teaching) - ANSWER -Nutrition -Exercise -Foot care -Eye care -Impact of stress: some patients may need insulin during periods of illness or stress -Properly inject insulin -Measure blood sugar -Eat before exercise -Signs & symptoms of hypoglycemia & hyperglycemia