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Nur 111 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Diabetes Mellitus

secreted by:
of the :

A

INSULIN- from pancreas a hormone secreted by the BETA CELLS of the ISLETS OF LANGERHANS in the PANCREAS in response to an INCREASE

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2
Q

How much units

A

40-60 units secreted by pancreas

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3
Q

Normal blood glucose range

A

74-106 mg/dl

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4
Q

Insulin

A

AIDS in transport and metabolism glucose for energy

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5
Q

Glucagon

A

Glucose in liver storage

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6
Q

Insulin role (5)

A

Stimulates storage of glucose in the liver as glycogen

*Signals the liver to stop the release of glucose

*Enhances the storage of dietary fat in adipose tissue

*Accelerates protein synthesis into cells of the muscles

*Facilitates the release of stored glucose, protein from muscle and fat from adipose tissue

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7
Q

Polyphagia

A

Increase hunger

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8
Q

Polydypsia

A

Increased thirst

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9
Q

Glycouria

A

Sugar in urine

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10
Q

3 p’s in db type 1

s/s (4)

A

Polyuria, Polydipsia, Polyphagia

quick onset/ less than 30/ normal or under BMI/ ketones

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11
Q

type 1 vs type 2

A

type 1: insulin deficiency. autoimmune. Requires insulin therapy.

type 2: (lifestyle) insulin resistant. receptor cells are resistant to insulin. Can be genetic.

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12
Q

type 2 s/s (6)

A

Chronic
Frequent infections (yeast infections)
-prolonged wound healing
Numbness+ tingling in hands and feet
Fatigue (harder to diagnosis)
Blurred vision

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13
Q

risk for type 2:

waist

triglycerides

HDL

BP

Fasting Glucose ( state normal)

A

waist: men greater than 37 inches
women greater than 33

triglycerides greater than 150

men less than 40
women less than 50

greater than 130/85

greater than 106 (Normal is
74-106mg/dl)

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14
Q

RISK FACTORS FOR TYPE II
DM (9)

A
  • Obesity- 25 lbs. above ideal weight (abdominal
    fat)
  • Hereditary
  • Age >45 years
  • Stress
  • Race: African American, Native American, Hispanic,
    Asian American and Pacific Islanders
  • Sedentary lifestyle
  • Dx of Prediabetes or gestational DM
  • Hypertension
  • High Cholesterol
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15
Q

GESTATIONAL DIABETES (4)

whenare moms screened/risk factors 3

A

Occurs in 2 -10%
pregnancies in US

Increases the risk of C-
section delivery,
Preeclampsia and fetal
macrosomia

Risk factors include obesity,
advanced maternal age,
family hx of DM

Moms screened at 24-28
wks with OGTT (oral glucose
tolerance test)

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16
Q

SECONDARY DIABETES ( 3)

A

Associated with pancreatic & endocrine
disorders such as Cushings syndrome,
acromegaly

Use of certain medications such as
corticosteroids (prednisone), estrogen,
thiazides

Contribute to diabetes d/t damages to the B-
cell functioning in the pancreas

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17
Q

PREDIABETES
(define/ IFG/ IGT/interventions *2)

A

Blood sugar levels elevated but not high enough to be classified as diabetic- most
likely will progress to type 2

  • IFG: Fasting blood glucose levels 106-
    125mg/dl
  • IGT: Glucose tolerance test 140-199mg/dl

Interventions :
a. Losing weight and increase activity may prevent or delay DM

b. Monitor blood glucose levels, HgA1C levels,
assess for s/s DM

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18
Q

**DIAGNOSIS OF DM **
Fasting Plasma Glucose=
Confirmed by:
A1C= * remember what professor d said*
Fasting=
2hr =
Glucose Tolerance =

A
  • Fasting plasma glucose > 126
  • Confirmed by repeat test on another day:
    preferred
  • A1C lab result 6.5% or higher !
  • 2 hr Oral glucose tolerance test (OGTT)
  • Fasting at least 8hr, drink glucose liquid (75gm),
    blood drawn before liquid and again at 60 mins
    after and 120 mins after consumption.
  • 140-199 Prediabetes

urine = negative

  • Glucose tolerance >200 confirms DM
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19
Q

FACTORS AFFECTING BLOOD
GLUCOSE LEVELS (RAISE) 7

A
  • Food
  • Stress
  • Growth
  • Meds(steroids, epinephrine)
  • Menstrual cycle
  • Fatigue
  • Lack of exercise
20
Q

FACTORS help BLOOD
GLUCOSE LEVELS (LOWER) 6

A
  • Insulin
  • Oral diabetic meds
  • Exercise
  • Fasting
    alcohol
  • Medications
21
Q

Tips( hint discharge chart) Treatment regimen (5)

A

Education
* Nutrition
* Exercise
* Medications
* Self-monitoring

22
Q

4 GOALS OF DIETARY
MANAGEMENT

A
  1. Achieve and maintain reasonable body
    weight
  2. Maintain near normal blood sugars
  3. Reduce fat and salt intake
  4. Maintain proper nutrition
23
Q

NUTRITION RECOMMENDATIONS (8)
* Adequate calories:

  • Protein:
  • CHO:
  • FAT:
  • Cholesterol:
  • NA:
  • Fiber:
  • Alcohol:
A
  • Adequate calories: (1800 – 2200
    ADA)
  • Protein: 15-20% of calories
  • CHO: 45 – 60gm/meal
  • FAT: saturated fats 7% of total
    calories
  • Cholesterol: < 200 mg/day
  • NA: 2300 or less mg/day
  • Fiber: 25-30 GM/day
  • Alcohol: limit to 1 glass/day
24
Q

Main Diet Points (6)

A
  • Eat same time
  • Eat from all food groups
  • Maintain CHO control with each meal
    (45-60gm/meal)
  • Limit fats and sugars
  • Eat about same amounts (portion control)
  • Include low CHO snacks between meals to
    prevent low blood sugar & keep blood glucose
    even
25
Q

Lab Test/monitoring (5)
-Glucose levels can vary from

A

-Glucose levels can vary from 70 -400mg/dl in a single day

Log kept for self glucose monitoring

More accurate than urine testing

Rotate times for accurate picture of how diet and
exercise impact levels

Typical hospital monitoring: ac meals and at hs (using
a sliding insulin scale)

26
Q

Typical hospital monitoring:( think of math class)

A

ac meals and at hs (using
a sliding insulin scale)

27
Q

GLYCOSYLATED HEMOGLOBIN
(HGBA1C) 2

A
  • Amount of HgB that has glucose
    attached to it
  • Measures how the blood sugar has been
    maintained over a three-month period
28
Q

HGBA1C results (3) ( define state ideal)

A

measures how the blood sugar has maintained over three month period !~Ideal less than 7 % ( diabetic pts)

2-5% good control ( good glucose level)
6-8% fair control, greater
than 8 poor controls (need to review diabetic care)

29
Q

exercise (6)

A

Increase the use of glucose at
muscle

  • Increase insulin
    sensitivity/reduction of insulin
    resistance
  • May lead to low blood sugar
    levels
  • 30mins/5xweek
  • Promotes weight loss
  • Monitor for s/s of hypoglycemia
30
Q

Health teaching (6)

A

Control blood glucose levels

  • Follow meal plan, Regular exercise
  • Quit smoking
  • Control blood pressure, Limit salt, Limit alcohol
  • Insulin administration
  • S/S hyper/hypoglycemia
    -eye exams
  • dental
  • doctors
    -foot doctor (podratic)
    -medical bracelets
31
Q

TREATMENT FOR LOW BLOOD
SUGAR:

Check blood glucose level:

Rule 15 ( 2 )

In the hospital :

A

Check blood glucose level: less than 70 requires
immediate action

Use rule of 15:
-Give 15gm simple, fast-acting CHO (4-6oz regular
soda, 4-6oz OJ, 1TBS honey, 6 jellybeans, 2-3 glucose
tablets)

-Retest after 15 minutes: if BS still less than 70 give
additional 15gm CHO, then recheck in 15 mins. If no
improvement call MD

In the hospital, treat with 20-50ml 50% dextrose IV (50% glucose)
push, or administer Glucagon IM or SQ (use deltoid)

32
Q

HYPOGLYCEMIA ( define state the number)
( causes)4 state the analogy

think of mall cop

A

LOW Blood glucose
Below 70mg/dl

Causes:
Too much medication
Too little food
Too much activity
Cool and Clammy = need some candy

33
Q

SIGNS AND SYMPTOMS of Hypo (7)( TIRED)

A
  • “cold and clammy get the candy”
  • Shaking, Sweating
  • Tachycardia
  • Anxious/dizziness
  • Impaired vision ( colors) ( pilsbury)
  • Weakness, fatigue
  • Headache, irritable, confusion
34
Q

HYPERGLYCEMIA (9)

A
  • “warm and dry sugar’s high” ( dry skin )
  • Extreme thirst
  • Increased urination
  • Increase hunger
  • Glycosuria
  • Blurred vision
  • Drowsiness, weakness, fatigue
  • Nausea & vomiting, fruity breath
  • LOC is loss
35
Q

COMPLICATIONS OF DM (heart/eyes/kidney/body)

heart 5, eyes 5, kidney1 , Nervous system * 1* , body 2

A

Heart***
Stroke
* Coronary artery disease
* Atherosclerosis
* Hypertension
* Peripheral artery
disease

eyes
* Diabetic retinopathy
* Cataracts
* Glaucoma
* Blindness

Kidney
* Chronic kidney disease
* * Diabetic nephropathy

**Nervous system **
* Peripheral neuropathy

Body
* Infections
* Gangrene (tissue death)

36
Q

A1C purpose

A

shows physicians how compliance with their diet. regardless how well they ate prior to testing this is the real test.

37
Q

PT with type 1 requires

A

insulin to survive!!!

38
Q

twice a day monitoring

A

diabetes 1

39
Q

twice a week monitoring

A

diabtes 2

40
Q

gestational diabetes FG ( when do we screen)

A

greater than 200

24-28 weeks

41
Q

diabetes ( A1C / fasting blood glucose/ glucose tolerance test )

A

6.5 or greater

126 or greater

200 or greater ( drink the drink within a hour)

42
Q

prediabetes ( A1C / fasting blood glucose/ glucose tolerance test )

A

5.7 - 6.4

100-125 mg/dl

140-199 md/dl

43
Q

normal rates diabetes ( A1C / fasting blood glucose/ glucose tolerance test )

A

5.7 equal to or less

99( or 106) or less

140 equal to or less

44
Q

obese rates

A

greater than 25

45
Q

glucagon vs glycogen

A

when glucose is gone. released

glycogen stored in the liver

Nur 111 (18 decks)

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