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Med Surg 1 (term 4) > Chapter 46 > Flashcards

Chapter 46 Flashcards

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1
Q

Elevated level of glucose in the blood is called?

A

Hyperglycemia

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2
Q

What type of diabetes?
Usually young <30 yo
Thin at diagnosis
Ketosis prone when insulin is absent
Genetic
Needs exogenous insulin to preserve life

A

Type 1 diabetes

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3
Q

What type of diabetes?
usually >30 yo
Obesity
Make control blood glucose through weight loss
Ketosis is uncommon
May need insulin on a short or long term basis

A

Type 2 diabetes

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4
Q

What type of diabetes?
Onset during pregnancy in the second or third trimester
Caused by hormones
obesity
Age >30
Family history of diabetes 

A

Gestational diabetes

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5
Q

What type of diabetes has genetic tendencies that have been found and people with certain human leukocyte antigen types?

A

Type 1 diabetes

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6
Q

When excess glucose is excreted in the urine, it is accompanied by loss of fluids and electrolytes, what is this called?

A

Osmotic diuresis

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7
Q

A highly acidic substance formed when the liver breaks down free fatty acids in the absence of insulin is called? 

A

Ketones

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8
Q

A metabolic arrangement that occurs more commonly and people with type 1 diabetes
Deficiency of insulin
highly acidic ketone bodies are formed
Metabolic acidosis occurs

A

diabetic ketoacidosis (DKA)

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9
Q

What are symptoms of DKA?

A

Polyuria
Polydipsia
n/v
Fatigue
Stupor and coma if not treated 

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10
Q

What are the two main problems related to insulin and type 2 diabetes?

A

Insulin resistance
Impaired insulin secretion

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11
Q

Symptoms of type 2 diabetes include?

A

Irritability
fatigue
polyuria
polydipsia
poor wound healing 
vaginal infections
blurred vision

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12
Q

What are long-term diabetes complications

A

Eye disease
Peripheral neuropathy
peripheral vascular disease

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13
Q

Women at high risk for gestational diabetes should be screened by a blood glucose test when?

A

At the first prenatal visit

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14
Q

Women with a history of gestational diabetes should be screened when?

A

Every 3 years

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15
Q

What are the 3 Ps with diabetes

A

Polyuria
Polydisia
Polyphagia

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16
Q

Polydipsia

A

Increased thirst

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17
Q

What is a normal hemoglobin A1C

A

<6.5%

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18
Q

To promote a 1 to 2 pound weight loss per week how much calories are taken away from the daily total? 

A

500 to 1000 calories

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19
Q

What onset symptom is associated with type 1 diabetes 

A

Weight loss

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20
Q

What nutrient has the greatest effect on blood glucose levels because they are more quickly digested than other foods and are converted into glucose rapidly

A

Carbs

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21
Q

What are examples of soluble fibers

A

Legumes, oats, and some fruits

22
Q

What does soluble fiber do?

A

Slows stomach emptying

23
Q

Type of insulin
Lispro, aspart, glulisine
Onset 15-30 min
Peak 30-90

A

Rapid acting

24
Q

Type of insulin
Regular
Onset 30-60 min
Peak 2-3 hr
Can be given IV
Given 15 min before meal

A

Short acting

25
Q

Type of insulin
NPH
onset 1-1.5 hr
Peak 4-12 hr
Food should be given around the peak time

A

Intermediate acting

26
Q

Type of insulin
Glargine
Onset 3-6hr
Continuous (no peak)

A

Long acting

27
Q

Milky cloud insulin

A

Intermediate acting insulin

28
Q

If insulin is injected into scarred areas what may happen?

A

Absorption may be delayed

29
Q

Characterized by a relatively normal blood glucose level until approximately 3 AM when blood glucose level begins to rise

A

Dawn phenomenon

30
Q

Nocturnal hypoglycemia followed by rebound hyperglycemia

A

Somogyi effect

31
Q

What is a class of oral antidiabetic medication‘s that reduce insulin resistance and target tissues

A

Thiazolidinediones

32
Q

When mixing rapid and short acting insulin‘s in a vial what should be drawn up first?

A

Short acting (regular)

33
Q

The speed of absorption with insulin is greatest in what area of the body

A

Abdomen 

34
Q

Glucose that falls less than 70mg/dL

A

Hypoglycemia

35
Q

What are symptoms of hypoglycemia

A

 sweating
Tremor
tachycardia
palpitations
nervousness
hunger

36
Q

In a severe case of hypoglycemia what type of symptoms may the patient have?

A

Impaired function of the CNS
Disoriented behavior, seizures, loss of consciousness

37
Q

When blood glucose becomes too low what is recommended for the patient to do? 

A

Consume 15 to 20 g of carbs
A small juice or soda

38
Q

And an adult who is glucose level is less than 54mg/dL and who is unconscious what should they take? 

A

1mg of glucagon

39
Q

Patients with severe DKA may lose up to how much water

A

6.5 L

40
Q

When a patient has nausea and vomiting should they take their regular insulin dose

A

Take usual dose and consume frequent small portions of carbs

41
Q

Absence or inadequate amount of insulin
Seen in type 1 diabetes
High sugars
Ketones present
Dehydration
Kussmauls respirations
Abdominal pain

A

DKA

42
Q

What is the main goal with treating DKA?

A

Treat dehydration first w/ 0.9% NS
Then start lowering blood glucose

43
Q

High sugars of DKA range from what?

A

250-800 sometimes 1000

44
Q

Metabolic disorder resulting from relative insulin deficiency initiated by an illness.
Often associated with type 2 diabetes
High sugar
Dehydration
Neuro symptoms (confusion)

A

Hyperglycemic hyperosmolar syndrome
(HHS)

45
Q

After HHS is resolved how long will it take for Neuro symptoms to clear up?

A

3-5 days

46
Q

What are symptoms of diabetic neuropathy?

A

Prickling, tingling, burning
Normally in feet

47
Q

What is a symptom that is associated with autonomic neuropathy?

A

Urinary retention

48
Q

Neuropathic condition
Decrease or absence of anhidrosis (sweating) of body

A

Sudomotor neuropathy

49
Q

Poor circulation of the lower extremities
Development of gangrene

A

Peripheral vascular disease

50
Q

In a hospital setting what can be given to provide calories to avoid hypoglycemia?

A

IV dextrose

51
Q

What insulin should be taken alone?

A

(Glargine)
a peak less basal insulin

52
Q

With a diabetic foot ulcer what technique should you use when changing the dressing?

A

Sterile technique

Med Surg 1 (term 4) (9 decks)

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