Diabetes Flashcards
What is a normal fasting blood glucose range?
<100mg/dL
What is a normal range for a glucose tolerance test?
<140mg/dL
What is the normal range of a hemoglobin A1C test?
4-6%
Symptoms of T1DM?
polyphagia, polydipsia, polyuria, and weight loss.
Symptoms of T2DM?
polyphagia, polydipsia, polyuria, fatigue, recurrent infections, prolonged wound healing, and vision changes.
Acute complications of T1DM?
DKA caused by absence of insulin and production of ketones
Acute complications of T2DM?
HHS caused by insulin deficiency and profound dehydration
What are risk factors for diabetes?
genetics, high BMI, limited physical inactivity, high cholesterol levels, metabolic syndrome, hx of POS and cardiovascular disease.
What is metabolic syndrome?
HTN, insulin resistance, abnormal cholesterol levels, large abdominal circumference.
What causes polyphagia in diabetes?
Because the glucose is all in the bloodstream the cells receive no glucose and therefore cell starvation triggers polyphagia
Criteria for the diagnosis of pre-diabetes?
fasting blood glucose > 100-125mg/dL
glucose tolerance test > 140-199mg/dL
A1C 5.7-6.4
Criteria for the diagnosis of diabetes?
A1C> 6.5% AND fasting blood glucose or equal to 126mg/dL.
OR
2hr blood glucose = or > 200mg/dL during oral glucose tolerance test.
OR
client showing classic manifestations of hyperglycemia or hyperglycemic crisis, a random blood glucose concentration greater than 200mg/dL
T/F. Patients with T1DM often have weight loss and increased appetite during the weeks before diagnosis.
True
Which test is generally used for the diagnosis of gestational diabetes?
oral glucose tolerance test
Which tests are generally used for the diagnosis of diabetes in non pregnant adults?
A1C and fasting blood glucose
Patients w/ diabetes should wash their feet daily with what?
Lukewarm water and soap
Should patients with diabetes apply lotion to their feet?
Yes, but not between the toes
Can patients with diabetes soak their feet?
No, unless specified by provider
What sugar level is considered mild hypoglycemia?
<70mg/dL
What are the sx of mild hypoglycemia?
hungry, irritable, shaky, nervousness
Patient education for mild hypoglycemia?
consume 15g of carbs, retest blood sugar in 15 minutes, repeat tx if glucose remains <70, eat a small snack of carbs and protein if your next meal is more than 1 hour away.
What sugar level is considered moderate hypoglycemia?
<40mg/dL
What are the sx of moderate hypoglycemia?
cold, clammy skin, pale, rapid pulse, rapid shallow respirations, marked change in mood, drowsiness
Patient education for treating moderate hypoglycemia?
consume 30g of rapidly absorbed carbs, retest glucose in 15 minutes, repeat if glucose is <60
What glucose level is considered severe hypoglycemia?
<20mg/dL
Sx of severe hypoglycemia?
unable to swallow, unconscious, difficulty arousing, and convulsions
Patient education for tx of severe hypoglycemia?
Give prescribed dose of glucagon, give second dose in 10 minutes if patient remains unconscious, if still unconscious call 911
Risk of hypoglycemia increases when food is delayed for how long?
more than 10 minutes
Insulin storage education?
store in the refrigerator, keep out of sunlight and heat, have a spare supply of each type of insulin used, store pre-filled syringes in upright position, inspect vial for changes in clarity, precipitation, or color.
What labs are checked for the management of diabetes?
A1C, blood glucose, urinalysis, and BUN/creatinine
How are the Dawn phenomenon and Somogyi effect similar?
both associated with increased blood glucose in the morning
What is the Dawn phenomenon?
when fasting blood glucose levels are high in the morning because the body does not have enough insulin
What is the Somogyi effect?
Too much insulin at night causes the blood glucose to drop so the body responds by releasing hormones and glucose stores from the liver to increase blood glucose.
When should patients check blood sugar levels to determine if they are experiencing the Dawn or Somogyi effect?
2-3am
If the blood sugar is low at 2am but high in the morning the patient is experiencing what?
Somogyi effect
If the blood sugar is normal or high at 2am, and high in the morning the patient is experiencing what?
Dawn phenomenon
How can the Dawn phenomenon be managed?
providing more insulin for the overnight period (intermediate or long acting)
How is the Somogyi effect managed?
adequate dietary intake at bedtime or reduce level of insulin at night
Under what circumstances might a patient need to check blood sugar more frequently?
use of insulin pumps, new use of insulin or medications, acute illness/disease process, when fasting, feeling symptomatic, before and after exercise
How many grams of carbs should be ingested for every hour of moderate intensity exercise?
10-15g
Simple carbohydrates that a diabetic person can carry to treat hypoglycemia?
- glucose tablets or glucose gel
- 6-10 Life Savers or hard candy
- 4tsp of sugar
- 4 sugar cubes
- 1 tbsp of honey or syrup
- 1/2 cup of fruit juice or regular (nondiet) soft drink
- 8oz of low fat milk
- 6 saltine crackers
- 3 graham crackers
If a patient is experiencing sx of hypoglycemia but a glucose monitor is not available what is the priority nursing action?
assume hypoglycemia and treat accordingly
If a patient is experiencing altered level of consciousness what is the priority tx?
injectable glucagon or 50% dextrose
A patient being treated for DKA needs to be monitored closely for what possible complication?
cerebral edema and increased intracranial pressure
T/F. Patients should avoid wearing shoes for 3 days in a row
False, for 2 days in a row
An insulin pump administers what kind of insulin?
Short duration
What is the main cause of HHS in a diabetic patient?
infection or severe illness
What symptoms will most likely be seen with HHS d/t severe dehydration?
Mental status changes
What is the most common side effect of Metformin that indicates lactic acidosis?
diarrhea
When should patients administer insulin Lispro before a meal?
10 minutes before
