Diabetes Part 3 Notes

• The nurse's statement, "You are at increased risk for developing diabetes," is not the best choice as it does not provide a specific time frame for when diabetes may develop.
• The nurse's statement, "You will develop type 2 diabetes within 5 years," is not the best choice as it is not based on the individual's current health status.
• The nurse's statement, "The laboratory test result is positive for type 2 diabetes," is the best choice as it provides definitive information about the individual's health status.
• The nurse's statement, "The test is normal, and diabetes is not a problem," is not the best choice as it does not take into account the individual's risk factors.
• Drinking cool fluids with high glucose content is also important for this client.
• Staying in good glucose control is a must to reduce complications such as angiopathy, which leads to cardiovascular disease (CVD) including CAD & PAD.
• Retinopathy can lead to blindness.
• Neuropathy can lead to neurotrophic ulceration.
• Using a less strenuous form of exercise than usual until the illness resolves is advisable for this client.
• A client screened for diabetes at a clinic has a fasting serum glucose level of 120 mg/dL (6.7 mmoL/L).
• Nephropathy can lead to renal failure.
• The most important advice for the nurse to give this client is to withhold the regular dose of insulin.
• Ambulatory care enables the client to reach an optimal level of independence and self-management.
• Skin changes and infections can occur in diabetes.
• Checking the blood glucose level every 2 to 4 hours is crucial for this client.
• Supporting needed lifestyle changes can help clients maintain their independence and self-management.
• Reduction of other barriers such as inadequacy, ineffective coping, and unwillingness to change can help clients maintain their independence and self-management.
• Foot care in diabetes includes inspecting daily, avoiding going barefoot, using proper footwear, treating cuts, avoiding hot water, using cotton stockings, drying between toes, and trimming nails.
• A client with type 1 diabetes calls the clinic with complaints of nausea, vomiting, and diarrhea.
• Necrotic toe before and after amputation is a common complication of diabetes.
• Teaching prevention of common complications can help clients maintain their independence and self-management.
• Evaluating outcomes in diabetes involves checking blood sugar and lab values, preventing episodes of hypoglycemia, modifying diet and lifestyle, and consulting a healthcare provider.
• Neuropathy can lead to numbness and injuries.
• Nursing Management: Assessment for Hyperglycemia includes the classic 3 Ps, blurred vision, vomiting, fatigue, fruity breath, dry mouth, warm, moist skin, altered reflexes, restlessness, wound healing, infections, numbness, tingling, weight gain/loss, muscle wasting, confusion, stupor, coma.
• Nursing Management: Problems & Plan includes clinical problems such as altered blood glucose level, deficient knowledge, risk for injury, impaired endocrine function, neurologic problem, and planning/goals which include self-care behaviors and life-style adjustments, glucose management, and reducing risk for complications with no emergencies.
• If unconscious in a health care setting, give IV Dextrose 50% immediately.
• Sick Day Management for Hyperglycemia includes increasing caloric, noncaloric fluids, always taking insulin or other meds even if not eating, testing blood glucose every 4 hours, and if type 1 DM, checking urine for ketones if have fever (greater than 101.4 ◦ F), BG>240 mg/dL, or vomiting.
• Health Promotion for Hyperglycemia includes reduction of risks for developing type 2 DM through screening and prevention, diet, exercise, weight loss, stress reduction.
• Taking action for Hypoglycemia may be due to insulin level (reaction), too much insulin with little/no food, increase exercise, delayed eating, can occur when high BS levels fall too rapidly or <70, can occur with both insulin and oral agents but mostly with insulin.
• The Rule of 15 for Hypoglycemia states that if alert, immediately have the client eat or drink 15 grams of a carbohydrate food (or, if near mealtime-eat) and retest in 15 minutes.
• Should speak to a provider before adjusting any insulin.
• Nursing Assessment: Cues client has Hypoglycemia includes cold, clammy skin, profuse sweating, feeling funny, pale, fatigue, blurred or double vision, anxious, shaky, hungry, irritability, nervousness, difficulty speaking, difficulty focusing or concentrating, confusion.