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kdkrenik kdkrenik
wrote...
Posts: 354
Rep: 1 0
6 years ago
A patient beginning insulin for type 2 diabetes is experiencing blurred vision and is concerned about becoming blind. What response by the nurse is most appropriate?
 
  1. I will make an appointment for you to see an ophthalmologist.
  2. I will call the physician to report your symptoms.
  3. Blurry vision is very common. Do not worry.
  4. This is a normal response when insulin therapy is initiated.

Question 2

A patient with type 1 diabetes mellitus who had one episode of vomiting in the past 2 hours asks if the routine insulin injection should be taken. What action by the nurse is best at this time?
 
  1. Contact the physician.
  2. Explain the need to take the insulin.
  3. Document the refusal and continue on with the planned care.
  4. Check the patient's fasting serum glucose level.

Question 3

A patient recently diagnosed with diabetes wants to check the urine for glucose instead of using capillary blood because of the cost. Which response should the nurse make to the patient?
 
  1. Urine testing is best when combined with serum testing.
  2. Urine testing is as reliable as finger stick testing.
  3. Yes, urine testing is cheaper than glucose test strips.
  4. Would you like to switch to this method of monitoring?

Question 4

A 78-year-old patient without polyuria, polydipsia, or polyphagia has a serum glucose level of 130 mg/dL. What should the nurse conclude about this patient?
 
  1. The patient might have eaten a meal with high sugar content prior to the testing.
  2. The laboratory results might be erroneous.
  3. The patient has type 1 diabetes mellitus.
  4. The patient will need to be assessed for other manifestations of diabetes.
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Replies
wrote...
6 years ago
The answer to question 1

Correct Answer: 4
Vision changes are normal during the first weeks of insulin therapy. They will gradually resolve. It is beyond the scope of practice for the nurse to make a referral to another physician. Contacting the physician is premature. Telling the patient it is nothing minimizes the concerns voiced, and does not provide adequate information to the patient.

The answer to question 2

Correct Answer: 2
Taking the insulin is the best course of action. The usual dose of insulin should be taken even if ill. Contacting the physician at this time is premature. Documentation of the patient's refusal is premature, as efforts have not been made to discuss the need for the medication. Checking the morning fasting serum glucose will not reflect the patient's current glucose level.

The answer to question 3

Correct Answer: 1
Urine glucose testing is no longer recommended for the patient with diabetes who is self-managing the condition. The blood glucose level is likely to be drastically different than a urine level because urine may sit in the bladder for several hours. If the result is negative, the blood glucose could be normal, hyperglycemic (up to 180 mg/dL), or hypoglycemic (less than 70 mg/dL). Advising the patient the method of testing is not reliable is not entirely correct and does not provide needed information to the patient. Telling the patient he is correct does not provide adequate information. It is inappropriate for the nurse to make such a suggestion about the method of testing to be utilized to the patient.

The answer to question 4

Correct Answer: 4
Older adults with diabetes might not present with the classic symptoms of polyuria, polyphagia, or polydipsia. Symptoms of diabetes in older patients can include hypotension, periodontal disease, infections, and strokes. A slight elevation in serum glucose level warrants further investigation. In an adequately functioning endocrine system, dietary intake is managed by the needed amounts of insulin produced by the pancreas. There is no reason to question the laboratory results at this time. There is inadequate information to make a diagnosis of type 1 diabetes mellitus.
kdkrenik Author
wrote...
6 years ago
Thank you, thank you, thank you!
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