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NURS 232 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Diabetes Mellitus

A

metabolic disorder characterized by the presence of hyperglycemia from defective insulin secretion, action or both

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2
Q

Metabolic syndrome

A

a collection of risk factors that increased an individuals chance of developing cardiovascular disease and DM

GERTH
HTN
Dyslipidemia
Insulin resistance
dysglycemia
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3
Q

DM Pathophysiology

A

Pancreas

  • beta cells regulate insulin (increases cellular uptake of glucose)
  • alpha cells regulate glucagon (increases release of glucose by the liver)
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4
Q

Type 1

A

Pancreatic beta-cell destruction, autoimmune response
= lack of insulin secretion

Typically <30yrs
cachexic appearance
Diagnosis is predisposed by stress
Insulin required for survival

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5
Q

Type 1 Manifestations

A 
Polyuria
Polydipsia
Polyphagia
Weight loss
Ketonuria and Ketoacidosis
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6
Q

Type 2

A

Insulin resistance

  • body tissues do not respond to action of insulin
  • decreased responsiveness of beta cells to hyperglycemia
  • decreased ability to produce insulin

Onset >45
Slow gradual onset
combination of environmental and genetic factors
Insulin may be necessary

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7
Q

Type 2 Manifestations

A 
Weakness and fatigue
Chronic blurred vision
Recurrent infections
neuropathic pain
Weight gain
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8
Q

DM Goals of care

A

Reduce symptoms
Prevent and manage complications
Delay onset and progression
Attain a desirable body weight

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9
Q

Glycogen

A

Stored glucose in the liver and muscle

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10
Q

Glucose

A

Source of energy in the body

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11
Q

Glucagon

A

Strongly opposes the action of insulin (stimulates conversion of glycogen to glucose)

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12
Q

Gluconeogenesis

A

making glucose from non-carbohydrate sources

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13
Q

Glycogenolysis

A

glycogen breakdown to make glucose

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14
Q

Hyperglycemia symptoms

A

Polyuria
Polydipsia
Polyphagia

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15
Q

Hypoglycemia Symptoms

A

Diaphoresis, tremors, hunger, nervousness, anxiety, pallor, palpations

Irritability, visual disturbances, difficulty speaking, confusion, coma

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16
Q

Hypoglycemia Tx

A

Treat if BS <4mmol/L

Dysphagia = administer 13-20g simple carb

17
Q

Diabetic Ketoacidosis (DKA)

A

Profound deficiency of insulin
hyperglycemia + dehydration

Cells are starved for glucose and fats are metabolized instead

Usually because of the mismanagement of DM lifestyle

18
Q

S&S DKA

A

polyuria, polyphagia, polydipsia

Dehydration

N/V, abd pain, Kussmauls resps

BG > 14mmol/L

Ketones in blood and urine

19
Q

DKA tx

A

HYDRATE!! (dilute glucose)

  • bolus 1-2 L
  • IV access

Insulin infusion

  • 3-4 mls per hour
  • need to be careful because you want to make sure to keep K in normal range

Maintain electrolytes

20
Q

Hyperglycemic, Hyperosmolar, Nonketotic Syndrome (HHS)

A

occurs in pts able to produce insulin to prevent DKA, but not enough to prevent severe hyperglycemia, osmotic diuresis and ECG depletion

People with DM type 2

21
Q

Chronic Complications of DM

A

Insulin resistance
Dyslipidemia and risk of vascular complications
Macrovascular complications (coronary artery disease, stroke, HTN, PVD
Microvascular complications (retinopathy, neuropathy, peripheral)

22
Q

DM Care

A 
A1C (optimal glycemic control)
BP
Cholesterol < 1.2 mmol/L
Drugs (ACE inhibitors, statins, ASA if indicated)
Exercise and Eating healthy

Screening for complications
Smoking cessation
Self management of stress and other barriers of self care

23
Q

SMBG/Blood glucose testing

A

A way to monitor DM

  1. All people taking insulin or oral hypoglycemic meds
  2. before meals and after meals
  3. Keep accurate record of activities to compare rhythms of heart in comparison
24
Q

Pharmacological management

A

oral antihyperglycemic agents

  • sulfonylureas (glyburide) - increase beta cell production
  • Biguanides (metfomin) - decrease glucose production by liver
25
Q

Rapid insulin

A

onset: 10-15 minutes
peak: 60-90 minutes
Duration: 3-5 hours

26
Q

Short acting insulins

A

onset: 1 hour
peak: 2-4 hours
Duration: 5-8 hours

27
Q

Intermediate Acting insulins

A

onset: 1-3 hours
peak: 6-8 hours
duration: 12-16 hours

28
Q

Extended Long acting insulins

A

onset: 1-2 hours
peak: none
Duration: 24 hours

29
Q

Lispo, aspart

A

Rapid acting insulin

30
Q

humulin R

A

Short acting insulin example

31
Q

NPH

A

Intermediate acting insulin example

32
Q

Lantis, levemir

A

Extended long acting insulin

33
Q

SADMANS

A

Hold meds when dehydrated

Sulfonureas
ACE inhibitors
Diuretics and direct renin inhibitors
Metformin
Angiotensin receptor blockers
Non-steroidal anti-inflammatories
SGLT 2 Inhibitors

NURS 232 (19 decks)

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