Brunner 51

Question 1

Risk factors of DM

Answer 1

family hx, obesity, race (black, hispanic, native american, asian, islanders) >45 ys old, HTN, gestational DM or born over 9lbs

Question 2

what is insulin

Answer 2

Anabolic storage hormone secreted by beta cells from the islets of Langerhans in the pancreas. it moves glucose from the blood into cells

Question 3

actions of insulin

Answer 3

transport and metabolize glucose for energy
signal liver to stop releasing glucose
stimulate storage of glucose in muscle and liver (glycogen)
enhances storage of dietary fat in adipose
inhibits breakdown of stored glucose, fat and protein
speeds up trans ports of AA from protein into cells

Question 4

Signs and symptoms of DM

Answer 4

polyuria: increased urination
polydipsia: increased thirst
polyphagia: increased appetite
poor wound healing
fatigue
weight loss (type 1)
blurred vision
numbness and tingling in extremities

Question 5

5 components of diabetes management

Answer 5

nutritional therapy
exercise
monitoring
pharm therapy
education

Question 6

exercise precaution in diabetics

Answer 6

BGL > 250 or keytones in urine should not exercise.

exercise cause the release of glucagon which will cause liver to release more glucose and elevate BGL even more

Question 7

causes of a normal BGL result but a high glycated hemoglobin result

Answer 7

error in testing method of BGL
error in recording BGL results
frequent elevations in BGL when PT isn’t usually monitoring them.

Question 8

when to test urine for keytones

Answer 8

more than 240 BGL twice in a row
during illness
during pregnancy
during gestational diabetes

Question 9

lispro (Humalog)
type:
onset:
peak: 
duration: 
use:

Answer 9

rapid acting

onset: 10-15 min
peak: 1 hr
duration: 2-4 hr
use: rapid reduction of glucose

Question 10

aspart (Novolog)
type:
onset:
peak: 
duration: 
use:

Answer 10

rapid acting

onset: 5-15 min
peak: 40-50 min
duration: 2-4 hr
use: rapid reduction of glucose

Question 11

glulisine (Apidra)
type:
onset:
peak: 
duration: 
use:

Answer 11

rapid acting

onset: 5-15 min
peak: 30-60 min
duration: 2 hr
use: rapid reduction of glucose

Question 12

regular insulin (Humalog R, Novolog R)
type:
onset:
peak: 
duration: 
use:

Answer 12

short acting

onset: 60-90 min
peak: 2-3 hr
duration: 4-6 hr
use: taken 20-30 min before a meal.

Question 13

NPH 
type:
onset:
peak: 
duration: 
use:

Answer 13

intermediate acting

onset: 2-4 hr
peak: 4-12 hr
duration: 16-20 hr
use: taken after food

Question 14

glargine (Lantus)
type:
onset:
peak: 
duration: 
use:

Answer 14

very long acting

onset: 1 hr
peak: continuous (no peak)
duration: 24 hr
use: basal dose

Question 15

DKA and HHA Nursing diagnoses

Answer 15

Risk for deficient fluid volume related to polyuria and dehydration
Risk for electrolyte imbalance related to fluid loss
Deficient knowledge about DM self care skills or information