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Sas 34

1. Criteria for diagnosing diabetes mellitus include hemoglobin A1C levels, fasting plasma glucose levels, oral glucose tolerance tests, or symptoms with random plasma glucose levels. 2. Intermediate and premixed insulins will be cloudy; routine hygiene is adequate for skin preparation during self-injections; unused insulin vials can be kept at room temperature for up to 4 weeks if under 86°F, rotating injection sites within one area like the abdomen is recommended instead of between sites. 3. Consuming carbohydrates with alcohol reduces hypoglycemia risk; intensified insulin allows flexibility if adjusted; saturated fat and protein intake should still be limited but fiber intake is recommended.

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87 views3 pages

Sas 34

1. Criteria for diagnosing diabetes mellitus include hemoglobin A1C levels, fasting plasma glucose levels, oral glucose tolerance tests, or symptoms with random plasma glucose levels. 2. Intermediate and premixed insulins will be cloudy; routine hygiene is adequate for skin preparation during self-injections; unused insulin vials can be kept at room temperature for up to 4 weeks if under 86°F, rotating injection sites within one area like the abdomen is recommended instead of between sites. 3. Consuming carbohydrates with alcohol reduces hypoglycemia risk; intensified insulin allows flexibility if adjusted; saturated fat and protein intake should still be limited but fiber intake is recommended.

Uploaded by

Sistine Rose Labajo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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SAS 34

1. A

Criteria for a diagnosis of diabetes mellitus include a hemoglobin A1C


=6.5%, fasting plasma glucose level =126 mg/dL, 2-hour plasma glucose
level =200 mg/dL during an oral glucose tolerance test, or classic symptoms
of hyperglycemia or hyperglycemic crisis with a random plasma glucose
=200 mg/dL.

2. A

Intermediate-acting insulin and combination premixed insulin will be cloudy


in appearance. Routine hygiene such as washing with soap and rinsing with
water is adequate for skin preparation for the patient during self-injections.
Insulin vials that the patient is currently using may be left at room
temperature for up to 4 weeks unless the room temperature is higher than
86° F (30° C) or below freezing (less than 32° F [0° C]). Rotating sites to
different anatomic sites is no longer recommended. Patients should rotate
the injection within one particular site, such as the abdomen.

3. B

The risk for alcohol-induced hypoglycemia is reduced by eating


carbohydrates when drinking alcohol. Intensified insulin therapy, such as the
use of an insulin pump, allows considerable flexibility in food selection and
can be adjusted for alterations from usual eating and exercise habits.
However, saturated fat intake should still be limited to less than 7% of total
daily calories. Daily fiber intake of 14 g/1000 kcal is recommended for the
general population and for patients with diabetes mellitus. High-protein diets
are not recommended for weight loss.

4. B

Hypoglycemic unawareness is a condition in which a person does not


experience the warning signs and symptoms of hypoglycemia until the
person becomes incoherent and combative or loses consciousness.
Hypoglycemic awareness is related to autonomic neuropathy of diabetes that
interferes with the secretion of counterregulatory hormones that produce
these symptoms. Older patients and patients who use â-adrenergic blockers
(e.g., propranolol) are at risk for hypoglycemic unawareness.
5. B

Diabetic nephropathy is a microvascular complication associated with


damage to the small blood vessels that supply the glomeruli of the kidney.
Risk factors for the development of diabetic nephropathy include
hypertension, genetic predisposition, smoking, and chronic hyperglycemia.
Patients with diabetes are screened for nephropathy annually with a
measurement of the albumin-to-creatinine ratio in urine; a serum creatinine
is also needed.

6. B

In type 2 diabetes mellitus, the secretion of insulin by the pancreas is


reduced, and/or the cells of the body become resistant to insulin. The
pancreas becomes inflamed with pancreatitis. The patient is totally
dependent on exogenous insulin and may have had autoantibodies destroy
the β-cells in the pancreas with type 1 diabetes mellitus.

7. D

A glycosylated hemoglobin level detects the amount of glucose that is bound


to red blood cells (RBCs). When circulating glucose levels are high, glucose
attaches to the RBCs and remains there for the life of the blood cell, which is
approximately 120 days. Thus the test can give an indication of glycemic
control over approximately 2 to 3 months. The prealbumin level is used to
establish nutritional status and is unrelated to past glucose control. The
urine ketone level will only show that hyperglycemia or starvation is
probably currently occurring. The fasting glucose level only indicates current
glucose control.

8. A

The patient should select a site on the sides of the fingertips, not on the
center of the finger pad as this area contains many nerve endings and would
be unnecessarily painful. Washing hands, warming the finger, and knowing
the results that indicate good control all show understanding of the teaching.
9. A

In order for teaching to be effective, the first step is to assess the patient.
Teaching can be individualized once the nurse is aware of what a diagnosis
of diabetes means to the patient. After the initial assessment, current
knowledge can be assessed, and goals should be set with the patient.
Assuming responsibility for all of the patient's care will not facilitate the
patient's health.

10. B

Patients with diabetes mellitus need to inspect their feet daily for broken
areas that are at risk for infection and delayed wound healing. Properly fitted
(not tight) shoes should be worn at all times. Water temperature should be
tested with the hands first.

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