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RNSG 1251 UNIT 3 > ch. 29: endocrine and metabolic disorders > Flashcards

ch. 29: endocrine and metabolic disorders Flashcards

1
Q

What are the 3 Ps of HYPERGLYCEMIA?

A

P olyphagia: excessive hunger
P olydipsia: excessive thirst
P olyuria: excessive voiding

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2
Q

During the first trimester, insulin requirements ____

A

DECREASE due to dietary changes (n/v) to prevent hypoglycemia

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3
Q

During the 2nd and 3rd trimester insulin requirements _____

A

INCREASE to prevent hyperglycemia

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4
Q

How many calories should pts consume each day during the first trimester?

A

2,200 cal

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5
Q

How many calories should pts consume each day during the 2nd and 3rd trimester?

A

2,500 cal

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6
Q

How many meals and snacks should pts eat?

A

3 meals and 3 snacks

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7
Q

How much exercise is encouraged?

A

30-60 min/ day

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8
Q

In what intervals should pts check their BLOOD GLUCOSE LEVEL during EXERCISE?

A

before, during, and after

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9
Q

What should the pt do if their BG level is < 100 mg/dl while exercising?

A

consume 15-30 g of carbs to prevent hypoglycemia

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10
Q

When should pts AVOID EXERCISE?

A

-if BG level > 200 mg/dl OR ketones in urine
-bc HYPERGLYCEMIA AND KETOSIS CAN WORSEN W/ PHYSICAL ACTIVITY

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11
Q

What is the target FASTING glucose level during pregnancy?

A

60- 105

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12
Q

What is the target POSTMEAL 1 HR glucose level during pregnancy?

A

< 140

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13
Q

What is the target POSTMEAL 2 HR glucose level during pregnancy?

A

≤ 120

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14
Q

What is the target BG level at 2am to 6 am?

A

> 60

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15
Q

What are the s/s of HYPOGLYCEMIA?

A

“COLD AND CLAMMY”
-nervousness
-HA
-fatigue
-shaking
-irritability
-tachycardia
-hunger
-blurred vision
-sweaty
-tingling of mouth/ extremities

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16
Q

What should a pt do if their BG level is < 70 mg/dl after feeling symptoms of hypoglycemia?

A

immediately eat 2-4 glucose tabs

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17
Q

What should pts do if glucose tabs are unavailable?

A

eat/drink 15 g of simple carbs:
-1/2 cup unsweetened OJ
-1/2 cup of regular sode
-5 to 6 hard candies
-1 cup of skim milk

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18
Q

What should a pt do if the glucose stabilizes their BG level?

A

eat a meal

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19
Q

What should a pt do if the glucose DOES NOT stabilizes their BG level?

A

-eat another 2 to 4 glucose tabs
-wait 15 min and recheck BG level
-if still < 70, NOTIFY HCP

20
Q

What is the first step of the ORAL GLUCOSE TOLERANCE TEST (OGTT)?

A

-administer 50 g of oral glucose and RECHECK BG level in 1 HR

21
Q

What BG level is a NEGATIVE result in STEP 1 of OGTT?

A

< 130-140

22
Q

What BG level is a POSITIVE result in STEP 1 of OGTT?

A

> 130-140

23
Q

What is step 2 of the OGTT screen?

A

-positive step 1
-fast night b4
-check BG level before exam
-check BG level at 1, 2, 3 hrs

24
Q

What is considered a POSITIVE result in step 2 of OGTT screen?

A

if 2 or more values are MET or EXCEEDED

25
Q

What is the FASTING BG level range for step 2 of OGTT screen?

A

95 or 105

26
Q

What is the 1 hr BG level range for step 2 of OGTT screen?

A

180 or 190

27
Q

What is the 2 hr BG level range for step 2 of OGTT screen?

A

155 or 165

28
Q

What is the 3 hr BG level range for step 2 of OGTT screen?

A

140 or 145

29
Q

What are maternal risks of gestational diabetes?

A

-↑ risk for preeclampsia, HTN, preterm birth
-miscarriage
-↑ risk for macrosomia (BW> 4000-4500 g)
-polyhydramnios
-↑ risk for skin and vaginal infections and UTIs
-DKA

30
Q

What are fetal risks of gestational diabetes?

A

-intrauterine fetal demise
-fetal congenital malformation
-hyperglycemia can affect organ formation
-macrosomia
-hypoglycemia at first 1-6 hrs after birth
-respiratory distress syndrome (RDS)

31
Q

What type of insulin is Lispro (Humalog)?

A

rapid acting

32
Q

What is the ONSET of RAPID acting insulin?

A

15 min

33
Q

What is the PEAK of RAPID acting insulin?

A

30- 90 min

34
Q

What is the DURATION of RAPID acting insulin?

A

4- 5 hr

35
Q

What type of insulin is Humulin NPH?

A

Intermediate acting

36
Q

What is the ONSET of INTERMEDIATE acting insulin?

A

1- 2 hr

37
Q

What is the PEAK of INTERMEDIATE acting insulin?

A

6- 12 hr

38
Q

What is the DURATION of INTERMEDIATE acting insulin?

A

18- 24 hr

39
Q

What type of inulin is Glargine (Lantus)?

A

long acting

40
Q

What is the ONSET of LONG acting insulin?

A

1 hr

41
Q

What is the PEAK of LONG acting insulin?

A

NONE

42
Q

What is the DURATION of LONG acting insulin?

A

24 hr

43
Q

Why is a pre-bedtime snack important?

A

to prevent hypoglycemia at night
-must include protein and complex carb

44
Q

What insulin can be mixed w/ Humulin NPH?

A

Lispro (Humalog)
-CLEAR(rapid) TO CLOUDY (NPH)

45
Q

What should pts do if illness occurs?

A

-take insulin even if appetite decreases
-call HCP w/ s/s, temp, BG level, urine ketones, time of last insulin dose
-↑ fluids, rest
-if unable to reach HCP and u have BG level> 200 & moderate ketones in urine, SEEK EMERGENCY TREATMENT TO AVOID DKA

RNSG 1251 UNIT 3 (4 decks)

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