Diabetes Flashcards
DM type 1
lack of insulin
- juvenile onset
- ketone prone `
DM type 2
insulin resistant
adult onset
- not ketosis prone
treatment for type 1
DIE
diet
insulin *
exercise
treatment for type 2
diet *
oral hypoglycemic
activity
diet for type 2 diabetes
calorie restriction
1,200, 1,400, 1,600
small frequent meals- keeps bs more stable
SIADH
soaked inside= lack of antidiuretic hormone
- oliguria, no thirst
- decreased uo
- low osmoality
- high gravity
slightly elevated bp normal
Diabetes Insipidus
dry inside
basically dm without glucose element
-polyuria
- polydipsia
-decreased serum gravity
high osmolality
low gravity
1.005-1.030
Regular insulin
Rapid run in the IV
clear solution
onset :1
peak: 2
duration:4
(1,2,4)
NPH
Not so fast or in the bag
cloudy solution can’t go in bag= precipitates and overdose
onset: 6
peak: 8-10
duration: 12
(6, 8-10-12) most tested
NPH
Not so fast or in the bag
cloudy solution can’t go in bag= precipitates and overdose
onset: 6
peak: 8-10
duration: 12
(6, 8-10-12) most tested
Lispro
fastest acting insulin
*don’t give before meals give with
onset: 15 min
peak: 30 min
duration: 3hours
(15,30,3)
Glargine
long acting insulin
no peak
duration 12-24 hrs
only one you can give at hs
little hypoglycemia risk
Manufacturer date rules for insulin
Always check before giving
*once opened, the new expiration date is 30 after
- opened insulin refrigerator optional
- unopened must be refrigerated
how do exercise impact insulin use
acts like another shot insulin
insulin should be reduced for exercise
how does being sick impact insulin use
serum glucose goes up
need insulin even if not eating
make sure they drink water = dehydration easily
What two problems does any diabetic pt have
dehydration and hyperglycemia
S/s of hypoglycemia
drunk/ shock
- staggering gait
- slurred speech
- labile emotions
- slow reaction time
shock
- tachycardia
- cool clammy skin
- mottled skin
How to treat hypoglycemia
give pt sugars or carbs
*boards want sugar and starch or protein
apple juice and turkey
1/2 cup of skim milk not full fat because of ketones
where to give glucose in an uncoils patient
DKA
high glucose in a type 1
type two doesn’t produce ketones
DKA causes
1 acute upper resp infect within last two weeks *
stress raises glucose, fat is burned as fuel
too much food, not enough exercise or insulin
DKA s/s
dehydration- dry, poor skin turgor, warm skin- water is a coolant
ketones- high K, kussmaul resp
acidosi- acetone breathe, anorexia from nausea
Treatment for DKA
Regular Insulin IV (only one you can run IV)
IV fluid (200ml/hr) fast
not d10 or d50- cause hyperglycemia
Hyperosmolar hyperglycemic state (HHNK, HHS, or HHNS)
high blood sugar in type 2 diabetes
Severe fvd
intervention: rehydration
dry, flushed skin, decreased turgor, increased hr
long term complication of diabetes
poor perfusion
peripheral neuropathy
Lispro
fastest acting insulin
*don’t give before meals give with
onset: 15 min
peak: 30 min
duration: 3hours
(15,30,3)
HB A1C
average blood sugar over 90 days
6 and lower good
7 borderline
8 and up is bad
