The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents?
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Solution
Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily
When Type II diabetics lose weight through diet and exercise they sometimes have an improvement in insulin efficiency sufficient to the degree they no longer require oral hypoglycemic agents.
When taking a health history, the nurse screens for manifestations suggestive of Diabetes Type I. Which of the following manifestations are considered the primary manifestations of Diabetes Type I and would be most suggestive and require follow-up investigation?
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Solution
An increase in three areas: thirst, intake of fluids, and hunger
The primary manifestations of diabetes type I are polyuria (increased urine output), polydipsia (increased thirst), polyphagia (increased hunger).
The nurse working in the physician’s office is reviewing lab results on the clients seen that day. One of the clients who has classic diabetic symptoms had an eight-hour fasting plasma glucose (FPG) test done. The nurse realizes that diagnostic criteria developed by the American Diabetes Association for diabetes include classic diabetic symptoms plus which of the following fasting plasma glucose levels?
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Solution
Higher than 126 mg/dl
Diabetes is diagnosed at fasting blood glucose of greater than or equal to 126 mg/dl.
The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT:
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Solution
Unlimited intake of total fat, saturated fat and cholesterol
The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT option B, unlimited intake of total fat, saturated fat and cholesterol.
The goal for pre-prandial blood glucose for those with Type 1 diabetes mellitus is:
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Solution
<130 mg/dl
The goal for pre-prandial blood glucose for those with Type 1 diabetes mellitus is <130 mg/dl.
Nurse Shey is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client? Select all that apply.
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Solution
Answer: A, B, C, D
Gestational diabetes can occur between the 16th and 28th week of pregnancy. If not responsive to diet and exercise, insulin injections may be necessary. Concentrated sugars should be avoided. Weight gain should continue, but not in excessive amounts. Usually, gestational diabetes disappears after the infant is born. However, diabetes can develop 5 to 10 years after the pregnancy.
Billy is being asked concerning his health in the emergency department. When obtaining a health history from a patient with acute pancreatitis, the nurse asks the patient specifically about a history of
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Solution
alcohol use.
Alcohol use is one of the most common risk factors for pancreatitis in the United States.
Joko has recently been diagnosed with Type I diabetes and asks Nurse Jessica for help formulating a nutrition plan. Which of the following recommendations would the nurse make to help the client increase calorie consumption to offset absorption problems?
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Solution
Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.
Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.
At the time Cherrie Ann found out that the symptoms of diabetes were caused by high levels of blood glucose, she decided to break the habit of eating carbohydrates. With this, the nurse would be aware that the client might develop what complication?
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Solution
acidosis
When a client’s carbohydrate consumption is inadequate, ketones are produced from the breakdown of fat. These ketones lower the pH of the blood, potentially causing acidosis that can lead to a diabetic coma.
During lecture, the clinical instructor tells the students that 50% to 60% of daily calories should come from carbohydrates. What should the nurse say about the types of carbohydrates that can be eaten?
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Solution
Try to limit simple sugars to between 10% and 20% of daily calories.
It is recommended that carbohydrates provide 50% to 60% of the daily calories. Approximately 40% to 50% should be from complex carbohydrates. The remaining 10% to 20 % of carbohydrates could be from simple sugars. Studies give no evidence that carbohydrates from simple sugars are digested and absorbed more rapidly that are complex carbohydrates, and they do not appear to affect blood sugar control.