Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

med/surg 2 > class 8 diabetes > Flashcards

class 8 diabetes Flashcards

1
Q

what is diabetes mellitus

A

a metabolic disorder characterized by the presence of hyperglycemia due to:
1. the impairment of insulin secretion, defective insulin production, action, or both
2. inefficient utilization of insulin in the body (insulin resistance
0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what happens if there is beta cell destruction in DM

A

absolute insulin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

classic symptoms of DM

A

polyuria, polydipsia, polyphagia (3 p’s), unexplained weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

controllable risk factors for DM

A

sedentary lifestyle
obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

uncontrollable risk factors for DM

A

-family hx
-race
-autoimmune
-metabolic conditons
-HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tx for type 1

A

insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

tx for type 2

A

lifestyle
po hypoglycemic
insulin as a last line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

tx for prediabetes

A

education & lifestyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3 things to minimize complications

A

-early screening
-intervention
-optimization of glycemic control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is prediabetes

A

a condition where blood sugar levels are higher than normal, but are not yet high enough to be diagnosed as type 2 diabetes
-they may not go on to develop diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does DKA develop

A

when there is no insulin to use blood glucose for energy the body breaks down fat stores to get energy when creates ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

age of onset for DM1

A

any age
peak incidence is age 10-15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

age of onset DM2

A

over 30/any age
increasing rates in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

symptoms of DM1

A

abrupt
-3 p’s: polyuria, polydipsia, polyphagia
-fatigue
-weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

symptoms of DM2

A

frequently none, gradual & vague
-s/s of glucose intolerance
-fatigue
-recurrent infections (^B/G=immune dysfunction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ketosis in DM1

A

can occur often
DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ketosis in DM2

A

very rare
can experience HHNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

management of DM1

A

insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

management of DM2

A

lifestyle mod
may need oral hypoglycemics
insulin if necessary (last resort)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

normal fasting b/g in adults

A

4-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

normal fasting b/g in kids

A

4-8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

hypoglycemia=

A

<4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

critical hypoglycemia

A

<2.8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

lab results for diagnosis of DM

A

-fasting plasma glucose (pg) >=7
-2h pg in a 75g OGTT >=11.1
-random pg >11.1
-HbgA1C: over 7 adults, 7.5 kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
HbgA1C: prediabetes
6.0-6.4
26
what is HbgA1C
measures the % of RBC's that are coated in glucose over a 120 day period
27
HbgA1c; # predict the development of retinopathy
6.5 or greater
28
how often should HbgA1C be taken if blood glucose targets are not being met/making changes to management
every 3 months
29
factors that can alter HbgA1c:
anything that affects RBC's -age -chronic conditions that affect RBC production -dec EPO -iron def anemia
30
nonpharm management of type 1 and 2
diet exercise maintaining a healthy weight regular screening for complications
31
potential causes of diabetes in ages 5-7
stress of school inc exposure to infectious disease
32
potential causes of diabetes in ages 11-13
puberty rapid growth inc emotional stress insulin antagonism of sex hormones
33
why is diabetes difficult to manage in children
-growing (spurts and plateaus) -energy expenditure (irregular) -varying nutritional needs (irregular) -psychosocial impacts (diagnosis, puberty, resentment)
34
signs and symptoms of hypoglycemia
-reduced cognition -tremors -diaphoresis -weakness -hunger -headache -irritability -seizure
35
signs of hyperglycemia
-3 p's -dehydration -fatigue -fruity breath -kussmaul breathing -weight loss -hunger -poor wound healing
36
hypoglycemia treatment
-early detection is key -if conscious give carbs/glucose tabs -pt should have usual meal or snack once b/d is safe -if normal meal is >1h away, 15g of carbs and a protein should be given -pt should not be encouraged to change normal eating schedules when low/high, just correct then continue with normal meals/snacks
37
tx of hypo in <5yr
5g carbs (40ml juice/soda/sweet drink, 2 dextrose tabs)
38
tx of hypo 5-10 yr
10g carbs (85ml juice/soda/sweet drink, 3 dex tabs)
39
tx hypo >10 yr
15g carbs (125ml juice/soda/sweet drink, 5 dex tabs)
40
tx of critical hypo in hospital
0.5-1g/kg of 50% dextrose IV over 1-3 minutes followed by continuous infusion
41
home management of unconscious critical hypo in <=5 yrs
0.5mg glucagon subcut or IM
42
home management of unconscious critical hypo in >5 yrs
1 mg glucagon subcut or IM
43
what causes DKA
absolute deficiency of insulin (very hyperglycemic)
44
onset of DKA (dm1)
sudden
45
symptoms of DKA (dm1)
ketosis kussmaul breathing "fruity" breath dehydration electrolyte loss
46
serum glucose in DKA (dm1)
>13.9mmol/L
47
serum ketones in DKA (dm1)
positive
48
arterial pH in DKA (dm1)
<7.3 (metabolic acidosis)
49
urine ketones in DKA (dm1)
positive
50
onset of HHNS (DM2)
gradual (inc mortality d/t going undetected)
51
symptoms of HHNS (DM2)
neurological symptoms dehydration electrolyte loss
52
serum glucose in HHNS (DM2)
>33.3mmol/L
53
serum ketones in HHNS (DM2)
negative
54
arterial pH in HHNS (DM2)
7.35-7.45
55
urine ketones in HHNS (DM2)
negative
56
priority with DKA pt's
1: ABC's 2: IV fluids (isotonic w insulin drip at very slow rate d/t potassium) neuro assessment BG Q1H ABG's, lytes EKG I&O (foley) tx source (ABX) transition to subcut insulin when well
57
what is Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)
-hyperglycemia that occurs without ketosis and acidosis -typical in type 2 diabetes -treatment includes insulin admin, fluid replacement & correction of electrolyte imbalances
58
long term complications: macrovascular
-coronary artery disease -cerebrovascular disease -peripheral vascular disease
59
long term complications: micro vascular
-retinopathy -nephropathy -neuropathy
60
complication: retinopathy
rupture of microvascular (viterous hemorrhage) and aneurysms in the retina -causes sudden blurred vision -can lead to retinal detachment and cataracts
61
clinical manifestations of nephropathy
-albuminuria (d/t kidney damage) -fatigue -thirst -anemia (dec EPO d/t dec kidney func) -weight loss -frequent UTI's
62
s&s of nephropathy
-swollen periphery -nausea & loss -fatigue/insomnia -dry/itchy skin -difficulty concentrating
63
clinical manifestations peripheral neuropathy
tingling, prickling, burning -leads to total numbness
64
clinical manifestations of autonomic neuropathies
-cardiac (silent, painless, ischemia), GI, & renal systems (subjective to UTI's)
65
clinical manifestations of sudomotor neuropathy
-dry feet; cracks->ulcers -profuse sweating up top
66
foot & leg symptoms neuropathy
-dry cracked, scaly feet, diabetic ulcers -peripheral vascular disease -immunocompromise -takes 10-15 years to develop these complications
67
diabetes and mental health
-stressful -financial burden -fear of complications/life implications -stigma -lifestyle management
68
hospital & community nursing care
-skin assessment -neurovascular assessment -monitor B/G -prevent infection -education -medication adherence -administer insulin (if necessary) -mental health/psychosocial assesment regularly
69
patient education
-about disease -insulin therapy and technique -self monitoring B/G -nutriton -urine testing -lifestyle
70
nutrition and activity
-match insulin to carb intake -individualized -encourage activity -have carb snack on had all the time
71
influences on blood glucose
-illness & infection (inc) -excercise (dec) -diet -alcohol (dec) -stress (inc)
72
insulin syringe guidelines
-4-8mm needle -re-suspension of cloudy insulin -subcut: 45-90 degree angle -site rotation
73
insulin pen guidelines
-dial -prime with 2 units -hold for at least 10 secs in -site rotation
74
insulin pump therapy
-continous subcut line -can bolus for meals -small amt of insulin administered 24/7 to mimic pancreas
75
common insulin pump problems
-site not working -tubing blocked, torn or leaking -air in tubing -reservoir empty -not changing sites every 3 days
76
implications for nursing
-regular assessment for LT complications -assess impact on mental health -education -promote self-management -engage in public awareness campaigns -early detection is critical -advocacy efforts to improve access to resource

med/surg 2 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions