Diabetes Flashcards
angiopathy
damage to blood vessels secondary to chronic hyperglycemia
macrovascular complications
diseases of the large and medium-sized blood vessels that occur with greater frequency in people with DM (stroke, cardivascular disease, amputations)
What are risk factors of macrovascular complications?
obesity, smoking, hypertension, high fat intake, sedentary life style
Prevention of macrovascular complications
control of BP, management of altered lipid profile, control of hyperglycemia
Microvascular Complications
result from thickening of the vessels in the capillaries and arterioles in response to chronic hyperglycemia. most noticable in the eyes, kidney, skin
Diabetic retinopathy
microvascular damage to retina as a result of chronic hyperglycemia
non-proliferative retinopathy
most common form, microaneurysms develop, capillary fluid leak, retinal edema, hard exudates develop
proliferative retinopathy
most severe form, vitreous and retina, new blood vessels form, fragile vessels,easily hemorrhage, detachment may occur
Care of retinopathy
early diagnosis and treatment, annual dilated eye exam, performed by an ophthalmologist
Treatment retinopathy
laser photocoagulation
Virectomy
small incision to remove blood and fibers
Sensory nuropathy treatment
control of blood glucose the only treatment, medications may be used to treat symptoms, topicals, antidepressants, anti-seizure medications
Autonomic neuropathy
a nerve disorder that affects involuntary body functions, including heart rate, blood pressure, prespiration and digestion. all body systems can be affected
Autonomic neuropathy complications
- gastroparesis
- cardivascular changes
- sexual dysfunction
- neurogenic bladder
Complications of feet and lower extremities in diabetics
common cause of hospitalizations in diabetics, combination of macrovascular and microvascular changes
Risk factors for complications of feet and lower extremities
sensory neuropathy, peripheral arterial disease, smoking, clotting abnormalities, impaired immune function
Amputations
loss of protective sensation can lead to foot injury, infection, and amputation, PAD can also lead to amputation
Infection in diabetes clients
more susceptible to infections, prolonged wound healing, defect in mobilization of inflammatory cells, impairment of phagocytosis
Dental disease in diabetics
periodontal disease more common in people with DM, twice the risk compared to those without DM, 1/3 of people with DM have severe peridontal disease with loss of attachment of gum to teeth
Mental illness diabetics
high rates of depression, depression can lead to poor adherence, type 1 has increased risk of eating disorders
Prevention of diabetic complications
collaborative approach, glucose control, blood pressure control, blood lipid control, preventative care practices for eyes, kidneys, and feet, early detection and treatment
ABCs of DM
Monitor A1C
Monitor blood pressure
Monitor cholesterol levels
Exam for cardivascular disease complications
blood pressure, lipid panel, exercise stress testing
When is lipid panel done?
annually
When is exercise stress testing done?
based on risk factors
When is a dilated eye exam done for retinopathy?
annually
When is urinalysis for albuminuria done for nephropathy?
annually
What should be included ina foot exam?
visual, sensory, palpation
Nursing management for diabetes
prevent or delay chronic complications, teach good glycemic control, lifestyle management
TNIs for diabetes
teach patient:
daily foot exam, report infections immediately, do not use commercial remedies to remove calluses and corns, cut toe nails with contour of toes, do not use hot water bottles/heating pads, exercise feet daily
paraesthesia
tingling, burning
