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VCE Quiz Diabetes Mellitus, Part 2 Diabetes Mellitus, Part 2 Exercise 2 - Virtual Hospital Activity • Sign in to work at Pacific View Regional Hospital for Period of Care 1. (Note: If you are alread... y in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) • From the Patient List, select Harry George (Room 401). • Click on Go to Nurses’ Station. • Click on Chart and then on 401. • Click on Emergency Department. Exercise 2 - Question 1 What two medications were ordered to control Harry George’s diabetes? Include the dose and route for each. Question 2 / 1 pts Exercise 2 - Question 2 How would you give the IV insulin? (Hint: You can access the Drug Guide by clicking on the Drugicon in the lower left corner of the screen in the Nurses’ Station.) Question 3 / 1 pts Exercise 2 - Question 3 Find the Emergency Department physician's progress notes for Monday at 1345. What does the physician plan to order for the sliding scale insulin coverage? Question 4 / 1 pts • Click on Physician’s Orders. Exercise 2 - Question 4 Look at the orders for Monday at 1345. What was the actual sliding scale insulin order? Question 5 / 1 pts • Click on Return to Nurses' Station. • Click on Kardex and then on 401 to access the correct record. Exercise 2 - Question 5 According to the Kardex, how often should the capillary blood glucose be tested? Question 6 / 1 pts • Click on Return to Nurses’ Station. • Click on MAR and then on 401 for Harry George’s records. Exercise 2 - Question 6 According to the MAR, when should the insulin sliding scale be administered? What was the time of this order? Question 7 / 1 pts Exercise 2 - Question 7 What would you do regarding the inconsistencies identified above? Question 8 / 1 pts Exercise 2 - Question 8 What problems might occur if Harry George does not receive insulin at bedtime? Question 9 / 1 pts • Click on Return to Nurses' Station. • Click on 401 at the bottom of the screen. • Click on Clinical Alerts. Exercise 2 - Question 9 What is the clinical alert for 0730? Question 10 / 1 pts Prepare and administer the sliding scale insulin for this glucose level by following these steps: • Click on Medication Room on the bottom of the screen. • Click on MAR or on Review MAR at any time to verify how much insulin to administer based on sliding scale. (Hint: You must click on the correct room number within the MAR. Remember to look at the patient name on the MAR to make sure you have the correct patient's records.) Click on Return to Medication Room after reviewing the correct MAR. • Click on Unit Dosage and then on drawer 401 for Harry George’s medications. • Select Insulin Regular, put medication on tray, and then close the drawer. • Click on View Medication Room. • Click on Preparation and choose the correct medication to administer. Click on Prepare. • Click on Next, choose the correct patient to administer this medication to, and click on Finish. • You can click on Review Your Medications and then on Return to Medication Room when ready. Once you are back in the Medication Room, you may go directly to Harry George’s room by clicking on 401 at the bottom of the screen. • Click on Patient Care. • Click on Medication Administration and follow the steps in the Administration Wizard to complete the insulin administration. Exercise 2 - Question 10 How much insulin should be administered? Question 11 / 1 pts Exercise 2 - Question 11 What is the preferred site of administration for fastest absorption? Question 12 / 1 pts Exercise 2 - Question 12 List the expected onset, peak, and duration for the insulin you just administered. What actual times would you expect the onset, peak, and duration for Harry George, based on giving the insulin at 0730? Expected length of time: • Onset • Peak • Duration Actual Time After 0730 Dose: • Onset • Peak • Duration Question 13 / 1 pts Exercise 2 - Question 13 At what time would Harry George be at most risk for hypoglycemia? Describe the signs and symptoms that would indicate this acute complication. Question 14 / 1 pts Exercise 2 - Question 14 While you are preparing to administer Harry George’s insulin, he asks you why he is taking this because he did not use insulin at home. How would you answer this? Question 15 / 1 pts Exercise 2 - Question 15 For what side effects should you monitor Harry George related to his insulin regimen? Question 16 / 1 pts Exercise 3 - Virtual Hospital Activity • Sign in to work at Pacific View Regional Hospital for Period of Care 4. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) • Click on Chart and then on 401 for Harry George's chart. (Remember: You are not able to visit patients or administer medications during Period of Care 4. You are able to review patient records only.) • Click on Nurses' Notes. Exercise 3 - Question 1 Read the notes for Wednesday at 1730. What does the patient say regarding glyburide? Question 17 / 1 pts Exercise 3 - Question 2 How would you respond to the patient's demands? Question 18 / 1 pts Exercise 3 - Question 3 How often did Harry George take the glyburide at home? Question 19 / 1 pts Exercise 3 - Question 4 Why do you think this was increased in the hospital? What concerns might you have regarding this increase? (Hint: This patient is also receiving insulin.) Question 20 / 1 pts Exercise 3 - Question 5 What classification of oral hypoglycemic does glyburide belong to? (Hint: For help, click on the Drug Guide located on the counter in the Nurses' Station.) Question 21 / 1 pts Exercise 3 - Question 6 For what side effects of glyburide should you assess Harry George? Question 22 / 1 pts Exercise 3 - Question 7 What specific patient teaching points should you give this patient regarding glyburide? Exercise 3 - Question 8 List the date and time, blood glucose levels, and insulin doses received since Harry George's admission. (Hint: There are eight. You will need to access the chart and review the expired MARs to obtain the sliding scale doses.) Question 24 / 1 pts Exercise 3 - Question 9 Based on Harry George’s pattern of blood glucose levels, would you evaluate his current therapy as effective? If not, how might the physician further treat his diabetes? Question 25 / 1 pts Exercise 3 - Question 10 If you were reviewing the chart orders and the EPR on Wednesday evening and found the information recorded in the table in question 8, what would you be ethically and legally bound to report? [Show More]

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