Insulin is a hormone made by the beta cells of the pancreas in the islets of Langerhans. Normally insulin is released continually into the bloodstream in small amounts and increases release when food is eaten

DIABETES MELLITUS (DM)

Diabetes mellitus (DM), commonly known as diabetes, is a chronic multisystem disease of impaired glucose metabolism caused by abnormal insulin production and/or poor use of the available insulin

Normal Glucose & Insulin Metabolism

Cells break down glucose to make energy. Liver and muscle cells store excess glucose as glycogen. Blood glucose levels rise > insulin released from the pancreas > binds to glucose receptors in cell wall Blood glucose levels low > glucagon released from pancreas > liver releases glycogen (glucose)

Endogenous Insulin – insulin made inside the body
Dawn Phenomenon – hyperglycemia upon morning awakening
Exogenous Insulin – insulin from outside body
Somogyi Phenomenon – hyperglycemia occurring about 2 -3 a.m

Prediabetes

Impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or both. A stage between normal glucose homeostasis and diabetes. Blood glucose levels are elevated but not high enough to meet the diagnostic criteria for diabetes.

Diagnosis
Signs & Symptoms
  • 2-hour oral glucose tolerance test (OGTT) values are 140 to 199 mg/dL
  • Fasting blood glucose levels are 100 to 125 mg/dL

Asymptomatic, however, long-term damage to the body, especially the heart and blood vessels, may already be occurring

Gestational Diabetes

Placental hormones counteract insulin resulting in glucose intolerance during pregnancy. Women with gestational diabetes have a higher risk for cesarean delivery, and their babies have increased risk for perinatal death, birth injury, and neonatal complications. Most women with gestational diabetes have normal glucose levels within 6 weeks postpartum

Risk Factors
  • Obesity
  • Advanced age
  • Family history of diabetes
Patient Education

Monitor for symptoms of diabetes

  • Fatigue
  • Frequent infections
  • Slow-healing wounds
  • A1C checked regularly
  • Maintain healthy weight
  • Regular exercise
  • Healthy diet
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ABG Analysis

ABG Analysis

Mastering ABG analysis is essential for nursing practice and success on the NCLEX. Each question in this set emphasizes key concepts, including the identification of acid-base imbalances, physiological responses, and their implications for patient care. A strong grasp of these principles will enhance your ability to assess and respond effectively to patients' needs in various clinical situations.

The number of attempts remaining is 5

1 / 50

A patient in renal failure presents with pH 7.30 and HCO3- 15 mEq/L. What is the expected respiratory response?

2 / 50

A patient with renal failure presents with ABG results: pH 7.32, PaCO2 42 mmHg, HCO3- 16 mEq/L. What does this indicate?

3 / 50

A patient presents with a high HCO3- level and a pH of 7.50. What could this indicate?

4 / 50

A patient with a history of excessive alcohol consumption presents with ABG results: pH 7.30, PaCO2 40 mmHg, HCO3- 15 mEq/L. What is the likely diagnosis?

5 / 50

A patient with renal failure shows ABG results of pH 7.25, PaCO2 40 mmHg, HCO3- 16 mEq/L. This indicates:

6 / 50

A patient with chronic kidney disease shows signs of acidosis. What ABG change would be expected?

7 / 50

What is a common cause of metabolic acidosis?

8 / 50

ABG results show: pH 7.40, PaCO2 32 mmHg, HCO3- 19 mEq/L. Which acid-base balance does this indicate?

9 / 50

A nurse is assessing a patient with potential metabolic acidosis. Which sign would be most indicative?

10 / 50

The nurse is interpreting ABG results: pH 7.50, PaCO2 30 mmHg, HCO3- 24 mEq/L. What condition is indicated?

11 / 50

A patient with diabetic ketoacidosis has the following ABG results: pH 7.25, PaCO2 30 mmHg, HCO3- 15 mEq/L. What is the primary acid-base imbalance?

12 / 50

A nurse reviews an ABG report: pH 7.35, PaCO2 55 mmHg, HCO3- 22 mEq/L. Which nursing diagnosis is appropriate?

13 / 50

A patient with severe dehydration would likely exhibit which of the following ABG results?

14 / 50

A patient presents with tachycardia and muscle cramps. ABG analysis shows: pH 7.50, PaCO2 38 mmHg, HCO3- 30 mEq/L. What should the nurse assess for?

15 / 50

A patient with diabetes presents with a fruity odor on their breath. ABG results show: pH 7.25, PaCO2 40 mmHg, HCO3- 15 mEq/L. What condition is this indicative of?

16 / 50

A patient is hyperventilating due to anxiety. What would you expect their ABG results to show?

17 / 50

ABG results show: pH 7.47, PaCO2 38 mmHg, HCO3- 29 mEq/L. The nurse should assess for which of the following?

18 / 50

A nurse is reviewing ABG results: pH 7.35, PaCO2 50 mmHg, HCO3- 25 mEq/L. Which condition is most likely?

19 / 50

Which of the following ABG values would indicate respiratory alkalosis?

20 / 50

In a patient with respiratory acidosis, what is the expected change in the kidneys?

21 / 50

In which condition would you expect to see a decreased HCO3- level?

22 / 50

A patient presents with confusion and fatigue. Their ABG results show: pH 7.28, PaCO2 58 mmHg, HCO3- 22 mEq/L. What condition do these findings suggest?

23 / 50

A patient is hypoventilating after a drug overdose. What would their ABG likely show?

24 / 50

ABG results show: pH 7.45, PaCO2 35 mmHg, HCO3- 21 mEq/L. What is the interpretation?

25 / 50

A patient has a pH of 7.30, PaCO2 30 mmHg, HCO3- 18 mEq/L. What is the most likely diagnosis?

26 / 50

Which of the following ABG results would indicate metabolic acidosis?

27 / 50

Which of the following can lead to metabolic alkalosis?

28 / 50

In a patient with a suspected pulmonary embolism, what ABG changes might you expect?

29 / 50

If a patient is experiencing metabolic acidosis, what would you expect the respiratory compensation to be?

30 / 50

A patient presents with confusion and lethargy. ABG analysis reveals pH 7.34, PaCO2 55 mmHg, HCO3- 26 mEq/L. Which of the following interventions is the priority?

31 / 50

A patient with chronic respiratory acidosis may develop:

32 / 50

A patient with an acute asthma attack is likely to have which of the following ABG results?

33 / 50

A patient’s ABG indicates a pH of 7.50, what should the nurse suspect?

34 / 50

What is the normal range for arterial blood pH?

35 / 50

A patient has the following ABG results: pH 7.30, PaCO2 50 mmHg, HCO3- 24 mEq/L. What is the primary acid-base disturbance?

36 / 50

ABG results show: pH 7.38, PaCO2 48 mmHg, HCO3- 26 mEq/L. This indicates which type of compensation?

37 / 50

A nurse notices a patient has rapid, shallow breathing. The patient’s ABG shows: pH 7.45, PaCO2 30 mmHg, HCO3- 22 mEq/L. What is the likely diagnosis?

38 / 50

A patient presents with tachypnea and lightheadedness. Which ABG finding would be expected?

39 / 50

A patient’s ABG shows: pH 7.45, PaCO2 48 mmHg, HCO3- 36 mEq/L. What condition does this most likely indicate?

40 / 50

The nurse is caring for a patient with COPD. Which ABG result would indicate respiratory acidosis?

41 / 50

Which patient condition would most likely cause metabolic alkalosis?

42 / 50

A patient with a history of COPD is experiencing respiratory acidosis. Which intervention is most appropriate?

43 / 50

A patient with chronic kidney disease has a pH of 7.35 and HCO3- of 18 mEq/L. What is the likely diagnosis?

44 / 50

A patient has a pH of 7.39, PaCO2 of 52 mmHg, and HCO3- of 28 mEq/L. This patient is likely experiencing:

45 / 50

ABG results show: pH 7.48, PaCO2 42 mmHg, HCO3- 30 mEq/L. What does this indicate?

46 / 50

Which of the following scenarios would likely lead to respiratory alkalosis?

47 / 50

If a patient is experiencing metabolic alkalosis, which ABG result might be expected?

48 / 50

A patient has a pH of 7.39, PaCO2 of 52 mmHg, and HCO3- of 28 mEq/L. This patient is likely experiencing:

49 / 50

If a patient’s ABG shows a pH of 7.28, what should the nurse suspect?

50 / 50

A patient is experiencing respiratory distress and has an ABG result of pH 7.32, PaCO2 52 mmHg, HCO3- 24 mEq/L. What does this indicate?

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