Diabetes

Question 1

What is Diabetes?

So what does that really mean ?

Answer 1

Diabetes = error of glucose metabolism.

Meaning you don’t metabolize your glucose well

Question 2

Glucose is what ?

Answer 2

Primary fuel source and without cells die

Question 3

Diabetes Insipidus=

What is it cause by?

Answer 3

Diabetes Insipidus polyuris, polydipsia leading to dehydration

Cause by low ADH

Question 4

the less the urine out; the higher the _________?

the more the urine out; the lower the ________?

Answer 4

the less the urine out; the higher the specific gravity…

the more the urine out; the lower the specific gravity

Question 5

The amount of Urine and specific gravity of urine have a?

Answer 5

Inverse relationship meaning they’re opposite

Question 6

TREATMENT
Type 1: DIE… _____, ______, _____
Type 2: DOA… ______, _____ _____, _____

What is the most important treatment for type 1?

What is the least important for type 1?

What is the most important treatment for type 2?

Answer 6

TREATMENT
Type 1: DIE… diet, insulin, exercise
Type 2: DOA… diet, oral hypoglycemic, activity

Type 1: most important is insulin , the least important is Diet. They have a regular diet

Type 2: most important is diet , the least important is

Question 7

When we talk about diet which type of diabetes are we talking abt primarily?

Answer 7

Type 2

Question 8

What modification do we make to TYpe 2’s diet?

Answer 8

Type 2: calorie restriction, 6 small meals…

Question 9

What does insulin do to the blood glucose?

Answer 9

What does insulin do to the blood glucose? LOWERS it!

Question 10

How many type of insulin do you need to know for NCLEX.

Answer 10

4 types

Question 11

For regular insulin

What is the onset :

What is the peak :

What is the duration?

What color is it?

Iwhat type ?

Answer 11

onset: 1 hr..
peak: 2 hrs..
duration: 4 hrs.

It’s clear so it can be use (can be IV drip)

rapid short acting RAPID & RUN

Question 12

What is the Dawn Phenomenon?

Answer 12

The dawn phenomenon is when the client has hyperglycemia in the morning caused by early morning release of growth hormone and cortisol (both of these hormones increase insulin).

Treatment is to increase the insulin dose at bedtime or change the time insulin is given.

Question 13

What is the Somogyi phenomenon?

Answer 13

The Somogyi phenomenon is when hypoglycemia occurs around 2 - 3 a.m. Then the body compensates by rebounding with hyperglycemia in the morning.

Client may report night sweats and nightmares from hypoglycemia. Treatment is to decrease the insulin or give a bedtime snack (or both).

Question 14

What is the treatment for an unconscious client with hypoglycemia?

Answer 14

GIve 50% dextrose by IV or IM.

Do not give oral glucose to an unconscious client due to risk of aspiration. Side note: very difficult to get an IV started in a hypoglycemic client due to vasoconstriction.

Question 15

Describe:

Hyperosmolar hyperglycemic syndrome (HHS)

Immediate complication

Answer 15

HHS is extremely high blood sugar: 600 mg/dL (33.3 mmol/L) or higher for clients with type II diabetes.

There is still a little bit of insulin, so the body doesn’t make ketones.

Question 16

Describe:

Diabetic ketone acidosis (DKA)

Immediate complication

Answer 16

DKA is extremely high blood sugar: 300 mg/dL (16.6 mmol/L) or higher for clients with type I diabetes.

The body makes no insulin, so fat breaks down instead for energy making ketones (ketones are an acid).

Question 17

Interventions:

DKA and HHS

Answer 17

DKA and HHS interventions are similar because the goal is to decrease the blood glucose level and replace lost fluids:

• give IV fluids such 0.9% NS or 0.45% NS
• add dextrose when blood glucose is between 250 and 300 (3.9 and 16.7)
• give regular insulin IV
• assess for potassium imbalance since insulin can drive the potassium back into the cells causing hypokalemia
• cardiac monitor due to potassium imbalances