NR 601 MATURE AND AGING ADULT
Which of the following laboratory results meets criteria for diagnosis of diabetes?
random blood glucose greater than 126 mg/dL with classic symptoms of hyperglycemia
positi
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NR 601 MATURE AND AGING ADULT
Which of the following laboratory results meets criteria for diagnosis of diabetes?
random blood glucose greater than 126 mg/dL with classic symptoms of hyperglycemia
positive urine ketones
random glucose greater than 200 mg/dL with classic symptoms of hyperglycemia
Hgb A1C 6.4%
The criterion for the diagnosis of diabetes is either two fasting blood glucose readings with results greater than or equal to 126 mg/dL or a random blood glucose reading greater than or equal to 200 mg/dL if symptoms of diabetes are present. Random glucose is not the appropriate test. In older adults, the glucose reading after a 2-hour oral glucose tolerance test (OGTT) rises more rapidly than the fasting glucose. Kennedy p.370
Which “P” is a component of “the 3 P’s” of diabetes mellitus?
polygraphia
polyphagia
pain
paresthesia
The 3 Ps of diabetes are polyphagia, polyuria and polydipsia. Kennedy p. 370
A patient with Type 2 diabetes comes to the clinic after reading a magazine article about metformin and has some concerns about taking metformin. Which condition listed below would be a contraindication to taking metformin?
chronic obstructive pulmonary disease
ulcerative colitis
renal disease
inflammatory bowel disease
Metformin is contraindicated in renal disease, abnormal creatnine clearance, acute myocardial infarction or septicemia. Dunphy p. 927
The nurse practitioner student is reviewing the lab results from an annual an annual exam. The CMP fasting glucose was 128 mg/dL. What is the nurse practitioner student's next action?
Correct Answer
order a Hgb A1c
prescribe Metformin 500 mg po daily
repeat fasting glucose in 1 week
repeat fasting glucose in 1 year
A fasting plasma glucose > 126 mg/dL requires further testing. In the absense of unequivocal hyperglycemia, result should be confirmed by repeat testing . A HgbA1C is the correct answer becasue the repeat testing should be completed without delay.
Retesting in a week or a year is a delay. Metformin should not be initatiated until the diagnosis is confirmed . Dunphy p.925
A newly diagnosed patient with Type 2 diabetes mellitus (DM) is 66 inches in height. The patient's weight is 200 lbs, and the A1c is 7.1%. What is the best initial treatment?
Correct Answer
diet, exercise, and metformin
diet, exercise, and insulin
diet and exercise
no treatment necessary at this time
At 66 in and a weight of 200 lbs. the patient has a BMI of 32.3. If you did not have an ability to calculate, the weight of 200 is higher than a normal BMI. The ADA and AACE recommend that patients with recent onset T2DM (A1C < 7.5%) start with lifestyle changes and monotherapy. Dunphy p.927
Week 6 DE QS 106 Endocrine and Metabolic Problems and Urgent Care Issues
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