Diabetes Flashcards
(41 cards)
patho review of type 1
- more common in younger people
- more abrupt onset
- 5-10%
- No endogenous insulin production
- 3 P’s most common symptoms
patho review of type 2
- more common in adults
- can go undiagnosed for years
- insulin resistant
the 3 p’s
- polydipsia: excessive thirst
- polyphagia: excessive hunger
- polyuria: frequent urination
other symptoms of diabetes
- fatigue
- recurrent infections (sick)
- slow wound healing
risk factors of t2
non modifiable
- fam history, over 45, race/ethnicity, had gestational diabetes
modifiable
- physical inactivity, obesity, high bp, high cholesterol
fasting blood glucose
normal below 126 mg/dL
- fast for 8 hours before
casual blood glucose
normal below 200 mg/dL
urine ketones
high ketones associated w hyperglycemia
- medical emergency above 300 mg/dL
lipid profile
hdl will be low
triglycerides and ldls will be high
oral glucose tolerance test
used to test for gestational diabetes
- fasting glucose drawn prior, then consumes glucose, and obtain new glucose after 30 mins for 2 hrs
- fasting should be less than 120
- 1 hr: less than 180
- 2 hr: less than 140
glycosylated hemoglobin (HbA1C)
avg glucose level over 3 mons
- used to diagnosis and evaluate effectiveness of treatment
- normal 4-6%
- greater 6.5% is diabetic, typical goal is 7%
criteria to get diagnosed w diabetes
at least one of the following
- A1C 6.5%+
- fasting level greater than 126
- OGTT 12 hr level of 200 mg/dL
- classic symptom of hyperglycemia
repeat labs to verify
care plan for pre diabetic
impaired glucose tolerance, fasting glucose, or both
- typically no symptoms
- alc: 5.7-6.4%, fasting blood sugar: 100-125, ogtt: 140-199
what to do to treat pre diabetic
- teach
- lifestyle modfications
- monitoring glucose levels, a1c
- monitor for symptoms
- diet modifications
pharmo nursing management
- oral meds started on low does then inc
- oral meds often stopped in hospitals
- hold metformin before procedures
how to treat sick DM pt
- steroids inc bs
- inc body stress which can inc glucose
- inc risk of DKA, HHNS
- stomach virus can dec glucose, still need to take med
teach points for sick DM pt (yellow)
- notify HCP
- monitor bs more frequently
- continue meds
- hydrate
- meet carb needs
- rest
teach points for sick DM pt (red)
- urine ketones
- bs greater than 250
- fever greater than 101.5, not responding to meds
- feeling confused, disoriented, rapid breathing
- persistant nausea, vomit, diarrhea
- cant tolerate liquids
- lasts more than 2 days
frequency of bs checks depends on
- glycemic goals
- types of diabetes
- med regimen
- access to supplies and equip
- pt willingness
nursing management
- mimic bodies normal production
- combine basal w meal time (basal bolus regimen)
- rapid and short acting before meals
- use background insulin once a day
- 4 injections a day –> lantus, levemir or novolog, regular
types of insulin (more details in patho)
- rapid
- regular, short
- intermediate
- long
high alert med, what to do
insulin, always check current glucose levels
- check diet order and intake tolerance
what to know about meds
- insulin peak
- duration of insulin
- signs of hypoglycemia and interventions (assessment, food, drug therapy, etc)
- NPO–> what do I do to give them insulin
teaching points
- teach pt self admin
- pt knows their body better than we
- understand timing of insulin
- understand s/s of hypoglycemia
