NR325 / NR325 Adult Health II | Med – Surg 2 | Exam 2 (Latest 2021 / 2022) - Chamberlain

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NR325 / NR325 Adult Health II | Med – Surg 2 | Exam 2 (Latest 2021 / 2022) - Chamberlain-A patient is exhibiting s/s of hypothyroidism. What dx test will the nurse expect to be performed first? Thy... roid stimulating Hormone (TSH) Why is TSH the first Dx done in order to assess for hypothyroidism? b/c it is the most sensitive of the T3/T4/ TSH TSH is most sensitive in discovering hypothyroidism A patient with Type 1 Diabetes (T1D) calls the clinic w/ complaints of nausea, vomiting , and diarrhea. What is most important to advise your patient to do? Check blood glucose levels every 2-4 hours Why should T1D's check blood glucose levels every 2-3 hours when stressed? B/c Stressors (sickness, trauma, stress, etc) cause an INCREASE in blood glucose levels A patient screened for diabetes at a clinic has a fasting plasma BG level of 120 mg/dL (6.7 mmol/L). Which statement is best? You are at an increased risk for developing diabetes How long should a patient fast for prior to a fasting blood glucose/2-hour plasma glucose test is taken? 8-12 hours What is the normal value of a fasting blood glucose level? 74-106 What result of a fasting blood glucose level indicates at risk for developing diabetes? 100-120 What are some reasons for non-normal range of fasting blood glucose levels? Not fasting for 8-12 hours before some medications What is the reasoning for performing a fasting blood glucose test/ 2 hours plasma glucose test? Aids in the diagnosis of diabetes What is the normal range for a 2 hours plasma glucose test for patients ages 0-50? < 140 mg/dL OR 7.4 mmol/L What is the normal range for a 2 hours plasma glucose test for patients ages 50-60? < 150 mg./dL What is the normal range for a 2 hours plasma glucose test for patients ages >60? < 160 mg/dL How many grams of carbohydrates should a patient taking a 2 hour plasma test consume prior to the exam starting? 75 grams What are some requirements that a patient must comply with during the 2-hour plasma test? - - no exercising during the exam must fast after initial 75g of carbs are consumed What are some factors in developing Type 2 diabetes (T2D)? Overweight - Obesity - Advanced age - Family history - Certain ethnical groups A nurse plans a class for patients who are newly diagnosed with T2D. Which goal is most appropriate? enable the patient to become active participants in the management of their disease What are some s/s of thyroid storm? Elevated Temperature - s/s of heart failure - s/s of Hyperthyroidism What electrolyte imbalances are associated with diabetic ketoacidosis (DKA)? Hyponatremia - Hypokalemia - Hypophosphatemia - Hypochloremia - Hypomagnesemia What are some s/s of diabetic ketoacidosis (DKA)? Nausea - Vomiting - Fluid deficits - Electrolyte imbalances What sensations are s/s of DKA? Thirst What respiratory s/s are r/t DKA? Kussmaul respirations What type of fluid deficit s/s are r/t DKA? Dehydration What urinary s/s are r/t DKA? Ketonuria What breath odors s/s are r/t DKA? Sweet, fruity breath odor What type of diabetes is associated with autoimmune / genetic predisposition? Type one diabetes (T1D) What is the stereotypical age associated with dx of T1D? < 40 years old What is the main issue r/t T2D? Problem with glucose metabolism - problem with moving glucose in/out of cells What is the main goal of treatment for diabetes? Stabilize the blood glucose levels What does stabilizing blood glucose levels cause? a reduction in complications of diabetes What are some nursing dx r/t diabetes? Imbalanced nutrition - unstable blood-glucose levels What the three P's s/s that are r/t diabetes? Polydipsia - Polyuria - Polyphagia What does polydipsia mean? Excessive thirst What does polyphagia mean? Excessive hunger What are some s/s of weight r/t type 1 diabetes? Weight loss What are some weight s/s that are r/t to T2D? Weight gain What type of LOC changes are r/t to diabetes? Fatigue What hemoglobin A1C level indicates diabetes? 6.5% or higher What Fasting Plasma Glucose level indicates diabetes? > 126 mg/dL What 2-hour plasma glucose during OGTT indicates diabetes? Greater or equal to 200 mg/dL (with glucose load of 75g) What blood glucose level indicated hyperglycemia? > 200mg/dL What percentage of diabetics is type 2 diabetes (T2D)? 90-95% How is insulin impacted with T2D? causes insulin resistance - Decreases insulin production What does T2D cause on glucose levels? increases hepatic glucose production How is insulin impacted with T1D? - - No insulin is produced - Patient is insulin dependent What is T2D strongly associated with? - - Obesity and insulin resistance resulting from reduction of insulin receptors What is the normal range of an Hemoglobin A1C (HgbA1C)? - - < 6.4% What type of insulin is regular insulin considered to be? - - Short acting insulin What type of insulin is Glargine (Lantus) insulin considered to be? - - Long-acting insulin What type of insulin is insulin Lispro considered to be? - - Rapid-acting insulin What type of insulin is NPH considered to be? - - Intermediate-acting insulin What is the peak time associated with Rapid acting insulin? - - 30 minutes to 3 hours What is the peak time associated with Short acting insulin? - - 2-5 hours What is the peak time associated with Intermediate acting insulin? - - 4-12 hours What is the peak time associated with long acting insulin? - - 24+ hours What is the first step to withdrawing insulin? - - Roll bottle of NPH insulin What is the second step to withdrawing insulin? - - Swab both tops of both insulins What is the third step to withdrawing insulin? - - Inject air into NPH insulin FIRST What is the fourth step to withdrawing insulin? - - Inject air into regular insulin vial Which vial of insulin, when mixing NPH and regular insulin, do you inject air into first? - - NPH What insulin is drawn up first when mixing NPH and regular insulin? - - Regular [Show More]

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