1. Nursing Management: Diabetes Mellitus
Chapter 49
Nursing Management: Diabetes Mellitus

2. 1. Ideally, the goal of patient diabetes education is to
1. make all patients responsible for the management of their disease.
2. involve the patient’s family and significant others in the care of the patient.
3. enable the patient to become the most active participant in the management of the diabetes.
4. provide the patient with as much information as soon as possible to prevent complications of diabetes.
Answer: 3
Rationale: The goal of diabetes education is to enable the patient to become the most active participant in his or her own care.

3. 1. is diagnostic for diabetes.
2. A patient screened for diabetes at a clinic has a fasting plasma glucose of 120 mg/dL (6.7 mmoL/L). The nurse explains to the patient that this value
1. is diagnostic for diabetes.
2. is normal, and diabetes is not a problem.
3. reflects impaired glucose tolerance, which is an early stage of diabetes.
4. indicates an intermediate stage between normal glucose use and diabetes.
Answer: 3
Rationale: Impaired fasting glucose (fasting blood glucose level between 100 and 126 mg/dL) and impaired glucose tolerance (2-hour plasma glucose level between 140 and 199 mg/dL) represent an intermediate stage between normal glucose homeostasis and diabetes. This stage is called prediabetes.

4. 1. hold the regular dose of insulin.
3. A patient with type 1 diabetes calls the clinic with complaints of nausea, vomiting, and diarrhea. It is most important that the nurse advise the patient to
1. hold the regular dose of insulin.
2. drink cool fluids with high glucose content.
3. check the blood glucose level every 2- to 4- hours.
4. use a less strenuous form of exercise than usual until the illness resolves.
Answer: 3
Rationale: If a person with type 1 diabetes mellitus is ill, he or she should test blood glucose levels at least at 2- to 4-hour intervals to determine the effects of this stressor on the blood glucose level.

5. 1. dysrhythmias resulting from hypokalemia.
4. Cardiac monitoring is initiated for a patient in diabetic ketoacidosis. The nurse recognizes that this measure is important to identify
1. dysrhythmias resulting from hypokalemia.
2. fluid overload resulting from aggressive fluid replacement.
3. the presence of hypovolemic shock related to osmotic diuresis.
4. cardiovascular collapse resulting from the effects of excess glucose on cardiac cells.
Answer: 1
Rationale: Electrolytes are depleted in diabetic ketoacidosis. Osmotic diuresis occurs with depletion of sodium, potassium, chloride, magnesium, and phosphate. Hypokalemia may lead to ventricular dysrhythmias such as premature ventricular complexes and bradycardia.