CDE exam Flashcards
What is a Loss of protective sensation (LOPS) test and how often is it recommended?
This noninvasive procedure uses a flexible bristle to touch the sole, or plantar surfaces of the feet, testing the client’s ability to detect injury to the foot. People who cannot feel the monofilament are at higher risk for undetected foot injury and amputation. Once a year
Ankle Brachial Index (ABI)
The ABI is a test for peripheral artery disease (PAD). Clients with symptoms of PAD, such as intermittent claudication, should have a diagnostic ABI. Intermittent claudication is described as lower extremity pain that occurs during physical activity such as walking and subsides with rest. Other criteria for performing an ABI include people with diabetes over the age of 50, smoking, HTN, HLD, or diabetes duration of over 10 years.
Hypertrophy
A thickening of the fatty tissue that results from overuse of the same site
Acanthosis nigricans
A skin condition that occurs in up top 90% of children with DM2. It is an indicator of hyperinsulinemia and insulin resistance. It is characterized by raised, dark brownish to black patches that are velvety to the touch. Usually occurs on the back of the neck and other body folds.
The condition usually resolves when the unerlying insulin resistance is addressed.
How much do you reduce rapid or short-acting insulin prior to exercise?
Reducing 30-50% effectively decreases risk of hypoglycemia.
How much do you reduce intermediate-acting insulin prior to exercise?
Reducing by 10% is recommended.
When accuracy of the meter is in question, assessment can be done by the following
- Meter accuracy should be checked against laboratory values, not against another meter
- The laboratory test used for comparison should be a fasting plasma glucose test
- The laboratory test and the meter test should be performed at the same time
- The test done using he meter should use capillary blood collected from the fingertip or alternate puncutre site. A drop of blood from the venous sample should not be placed on the meter strip.
- The venous blood collected in the laboratory should be spum in the centrifuge within 30 minutes of collection
What is the most common source of user error in SMBG?
Failure to obtain an adequate blood sample
When should patients with DM1 test for ketones?
- Whenever BG is persistently elevated over 300 mg/dL
- When they are on a weight reduction diet or when ill, especially with febrile illness or infections process
When should patients with DM2 monitor for ketones?
- During illness or when an infection is present
- It is also recommended that they monitor regularly when they are on hypocaloric weight loss diets
When should pregnant clients with diabetes check for ketones?
- some may need to monitor daily, expecially if inappropriate calorie restriction is suspected
- When ill, undergoing severe stress, or significantly increasing physical activity
Who is eligible for Medicare?
- Age over 65
- Disabled, any age
- End-stage renal disease, any age
Medicare Part A
Covers hospital, skilled nursing, home health, or hospice. Beneficiary pays deductible.
Medicare Part B
Covers physician office visits, outpatient services, laboratory costs, equiptment and supplies. Part B is elective and the beneficiary pays the premiums.
Medicare Part D
Is rx drug insurance that lowers the cost of medications. Beneficiaries pay a monthly premium and choose a drug plan from a participating private company.
