NUR 231 EXAM 3 QUESTIONS WITH VERIFIED
ANSWERS GRADED A+
What is the insulin to carb ratio?
1 unit to 15gm carbs
What are the food classification categories?
carbs, fats, proteins (fiber)
What 5 things should someone with diabetes that wants to drink alcohol do?
1. Talk to MD
2. glucagon and hypoglycemia
3. Get a medical bracelet
4. Understand alcoholic intake quantity
5. Educate friends
What happens to the blood sugar of someone with diabetes when they drink alcohol?
moderate amounts of alcohol may cause blood sugar to rise, excess alcohol can actually decrease
your blood sugar level, sometimes causing it to drop into dangerous levels, especially for people with
type 1 diabetes
What are some considerations with exercising with diabetes?
exercise three times each week, perform resistance training twice a week if you have type 2 diabetes,
exercise at the same time of day (when BG is at it's peak), use proper footwear, avoid trauma to the
lower extremities (especially if you have numbness), inspect feet daily after exercise, avoid exercise in
extreme heat or cold, avoid exercise during periods or poor metabolic control, stretch for 10 to 15
minutes before exercising
What should you teach someone with DM about alcohol consumption?
large amounts can be converted into fats which increases the risk for DKA
They are at danger for hypoglycemia.
Eat while drinking to maintain blood sugar
Alcohol can lead to excessive weight gain, hyperlipidemia, and elevated glucose levels
What are some survival skills for people with diabetes?
-Know the pathophysiology of DM (basic definition of DM, normal BG levels, effect of insulin and
exercise, effect of food and stress, including illness and infections, basic treatment approaches)
-Know treatment modalities(administration of insulin and oral antidiabetes medications, meal
planning, and monitoring of blood glucose and urine ketones)
-Recognition, treatment, and prevention of acute complications (hypo/hyperglycemia)
-Pragmatic information (where to buy and store insulin, syringes, and glucose monitoring supplies,
when and how to contact the primary provider)
What is the effect of insulin and exercise on the BG of someone with DM?
decreased BG
, What is the effect of food and stress (including illness and infections) on the BG of someone with DM?
Increased BG
What are clinical manifestations of hypoglycemia?
-mild cases: sweating, tremor, tachycardia, palpitation, nervousness, and hunger
-moderate: inability to concentrate, headache, lightheadedness, confusion, memory lapses,
numbness of the lips and tongue, slurred speech, impaired coordination, emotional changes,
irrational or combative behavior, double vision, and drowsiness
-severe: disoriented behavior, seizures, difficulty arousing from sleep, or loss of consiousness
How to treat hypoglycemia at home?
give them 15g of a fast-acting concentrated source of carbs
How do we treat hypoglycemia in emergency settings?
we can give them 1 mg glucagon injection after they regain consciousness they should also be given a
snack
What are the clinical manifestations of DKA?
polyuria, polydipsia, marked fatigue, blurred vision, weakness, and headache
What are sick day rules to prevent DKA?
-take insulin or oral antidiabetic agents as usual
-test blood glucose and urine ketones every 3 to 4 hours
-report elevated glucose levels as specified or urine ketones to primary
-take supp doses of reg insulin every 3 to 4 hours if needed
-substitute soft foods
-take liquids every half hour to an hour to prevent dehydration and to provide calories if vomiting,
diarrhea, or fever persists
-report nausea, vomiting, and diarrhea to your primary because extreme fluid loss can be dangerous
-be aware that if you are unable to retain oral fluids, you may require hospitalization to avoid DKA and
possibly coma
Management for DKA
rehydration is important, NS will be given rapidly for the first few hours and then it will be switched to
half normal saline; they may need potassium replacement through IV; regular insulin may be added to
IV solutions to reverse acidosis
Clinical manifestations for HHS
hypotension, profound dehydration, tachycardia, variable neurologic signs
Management of HHS
similar to DKA
close monitoring of volume and electrolytes
Replace fluid losses (carefully- a little slower than DKA; takes days to replace fluid loss)
Insulin replacement therapy
Nursing Interventions for HHS
ANSWERS GRADED A+
What is the insulin to carb ratio?
1 unit to 15gm carbs
What are the food classification categories?
carbs, fats, proteins (fiber)
What 5 things should someone with diabetes that wants to drink alcohol do?
1. Talk to MD
2. glucagon and hypoglycemia
3. Get a medical bracelet
4. Understand alcoholic intake quantity
5. Educate friends
What happens to the blood sugar of someone with diabetes when they drink alcohol?
moderate amounts of alcohol may cause blood sugar to rise, excess alcohol can actually decrease
your blood sugar level, sometimes causing it to drop into dangerous levels, especially for people with
type 1 diabetes
What are some considerations with exercising with diabetes?
exercise three times each week, perform resistance training twice a week if you have type 2 diabetes,
exercise at the same time of day (when BG is at it's peak), use proper footwear, avoid trauma to the
lower extremities (especially if you have numbness), inspect feet daily after exercise, avoid exercise in
extreme heat or cold, avoid exercise during periods or poor metabolic control, stretch for 10 to 15
minutes before exercising
What should you teach someone with DM about alcohol consumption?
large amounts can be converted into fats which increases the risk for DKA
They are at danger for hypoglycemia.
Eat while drinking to maintain blood sugar
Alcohol can lead to excessive weight gain, hyperlipidemia, and elevated glucose levels
What are some survival skills for people with diabetes?
-Know the pathophysiology of DM (basic definition of DM, normal BG levels, effect of insulin and
exercise, effect of food and stress, including illness and infections, basic treatment approaches)
-Know treatment modalities(administration of insulin and oral antidiabetes medications, meal
planning, and monitoring of blood glucose and urine ketones)
-Recognition, treatment, and prevention of acute complications (hypo/hyperglycemia)
-Pragmatic information (where to buy and store insulin, syringes, and glucose monitoring supplies,
when and how to contact the primary provider)
What is the effect of insulin and exercise on the BG of someone with DM?
decreased BG
, What is the effect of food and stress (including illness and infections) on the BG of someone with DM?
Increased BG
What are clinical manifestations of hypoglycemia?
-mild cases: sweating, tremor, tachycardia, palpitation, nervousness, and hunger
-moderate: inability to concentrate, headache, lightheadedness, confusion, memory lapses,
numbness of the lips and tongue, slurred speech, impaired coordination, emotional changes,
irrational or combative behavior, double vision, and drowsiness
-severe: disoriented behavior, seizures, difficulty arousing from sleep, or loss of consiousness
How to treat hypoglycemia at home?
give them 15g of a fast-acting concentrated source of carbs
How do we treat hypoglycemia in emergency settings?
we can give them 1 mg glucagon injection after they regain consciousness they should also be given a
snack
What are the clinical manifestations of DKA?
polyuria, polydipsia, marked fatigue, blurred vision, weakness, and headache
What are sick day rules to prevent DKA?
-take insulin or oral antidiabetic agents as usual
-test blood glucose and urine ketones every 3 to 4 hours
-report elevated glucose levels as specified or urine ketones to primary
-take supp doses of reg insulin every 3 to 4 hours if needed
-substitute soft foods
-take liquids every half hour to an hour to prevent dehydration and to provide calories if vomiting,
diarrhea, or fever persists
-report nausea, vomiting, and diarrhea to your primary because extreme fluid loss can be dangerous
-be aware that if you are unable to retain oral fluids, you may require hospitalization to avoid DKA and
possibly coma
Management for DKA
rehydration is important, NS will be given rapidly for the first few hours and then it will be switched to
half normal saline; they may need potassium replacement through IV; regular insulin may be added to
IV solutions to reverse acidosis
Clinical manifestations for HHS
hypotension, profound dehydration, tachycardia, variable neurologic signs
Management of HHS
similar to DKA
close monitoring of volume and electrolytes
Replace fluid losses (carefully- a little slower than DKA; takes days to replace fluid loss)
Insulin replacement therapy
Nursing Interventions for HHS
