DIABETES Flashcards by M. B.

What are the 3 acute complications of diabetes

Low blood glucose/ hypoglycemia
DKA (Type 1 DM)
HHK or HHS or HHNS (Type 2)

How well did you know this?

Not at all

Perfectly

What is the #1 diagnosis with HHK

Fluid deficit

How well did you know this?

Not at all

Perfectly

Intervention with HHNK / HHS / HHNS

Give fluids!

How well did you know this?

Not at all

Perfectly

Between DKA and HHNK is insulin essential in treating?

DKA

How well did you know this?

Not at all

Perfectly

1 treatment with HHNK

Fluids!

How well did you know this?

Not at all

Perfectly

Which of DKA or HHNK is higher priority?

DKA is a more acute condition and responds very quickly to insulin

How well did you know this?

Not at all

Perfectly

What are long-term complications of diabetes

RELATED TO :
- Poor tissue perfusion
- Peripheral neuropathy
EXAMPLES: renal failure, gangrene. Heart failure, urinary incontinence pt cant feel a burn on the foot

How well did you know this?

Not at all

Perfectly

What is the best indicator of long-tern blood glucose level

Hb A1C, a.k.a. glycosated Hb or glycosylated Hb

How well did you know this?

Not at all

Perfectly

What is the nirmal Hb A1C

< 6

How well did you know this?

Not at all

Perfectly

What hb A1c means you’re out of control?

> 8

How well did you know this?

Not at all

Perfectly

What # of hb A1C is borderline

How well did you know this?

Not at all

Perfectly

What do we see with alkalosis?

Tachycardia
Tachypnea
HTN
Seizures
Irritability
Spastic
Diarrhea
Borborygmi (increase bowel sounds)
Hyperreflexia
HYPOKALEMIA

How well did you know this?

Not at all

Perfectly

What is the nursing intervention for alkalosis?

Pt needs SUCTIONING because of seizures

How well did you know this?

Not at all

Perfectly

What is the opposite of DIABETES INSIPIDUS

SIADH

How well did you know this?

Not at all

Perfectly

What does SIADH mean

Symptom of inappropriate ADH (antidiuretic hormone)

How well did you know this?

Not at all

Perfectly

It presents w/ oliguria and no thirst
Decrease in urine output
And then, decrease serum specific gravity (due to retention of water)
Increase urine specific gravity (due to decrease urine volume)

SIADH

How well did you know this?

Not at all

Perfectly

Whic =h is DM/DI, SIADH

Losts of urine retaines, specific gravity is low
Fluid volume deficit
Fluid VOlume Excess

SIADH
DM/DI
SIADH

How well did you know this?

Not at all

Perfectly

Insulin dependent, Ketosis prone

TYPE I DM

How well did you know this?

Not at all

Perfectly

Non-insulin dependent, Non-ketosis prone

TYPE II DM

How well did you know this?

Not at all

Perfectly

What are signs and symptoms of DM

Polyuria
Polydipsia
Polyphagia (eat/swallow a lot)

What is the treatment for DM I

(If u dont treat, they will die)

D Diet (calories from carbs, least important)
I Insulin (MOST important)
E Exercise

What are treatent for DM II

They are DOA

D Diet (most important)
O oral hypoglycemic (only use insulin if BG if poorkly uncontrolled)
A Activity

R- regular insulin

Onset:
Peak:
Duration:

Onset: 1 hour
Peak: 2 hours
Duration: 4 hours

1-2-4

What kind of insulin do we NOT use for IV drip?

N-NPH, Intermediate insulin,

IT IS CLOUDY= Suspension = it precipitates(particles fall under when), CANNOT GIVE IV drip

*there is a general rule thatg do not put a cludy sol’n on a IV bag

N-NPH, Intermediate Insulin Onset: Peak: Duration:

Onset: 6 hours Peak: 8-10 hours Duration: 12 hours 6-8-10-12

How would the board ask question about peak of insulin? For instance, you give 30 units of insulin NPH to a pt at 7 a.m. When do you check for hypoglycemia?

Answer = Add the insulin peak time to the time of insulin administration • For instance, if the pt was given NPH at 7 a.m., add 8 to 10 hours to the time • Answer = Check for hypoglycemia between 3 and 5 p.m.

What is a fast acting insulin

LISPRO (Humalog)

What is a long acting insulin

GLARGINE (LANTUS)

Lispro (Humalog) Onset: Peak: Duration:

Onset: 15 min Peak: 30 min Duration: 3 hours 15-30-3

Rule in giving lispro (humalog)?

Don’t give it AC (before meal)… Give it with the meal

What action invalidates the manufacturers date? (Insulin)

• Opening the package month • Once the package is open, the new expiration date is 30 days after that * • Open package without an opening or expiration date should be thrown out • Label the package either with o “OPEN” and date package is open or “EXP” and expiration date • Once the package is open, refrigeration is optional o However, unopened bottle must be kept refrigerated o Although it is good practice to teach pt to refrigerate insulin at home

What are 3 acute complications of Diabetes

1. Low blood glucose 2. DKA - High Glucose in a Type 1 (keto is the clue!) 3. HHNK or HHS or HHNS

What does hypoglycemia look like?

Think of Drunk pt in Shock • Drunk o Staggering gait o Slurred speech o Cerebral impairment (labile) ra pidly A- emotions /fluctuating o Slow reaction time o Decrease social inhibition • Shock—Vasomotor collapse o Tachycardia, tachypnea, Low BP o Cold/clammy, mottled skin

What are signs and symptoms of hypoglycemia

• Drunk o Staggering gait o Slurred speech o Cerebral impairment (labile) ra pidly A- emotions /fluctuating o Slow reaction time o Decrease social inhibition • Shock—Vasomotor collapse o Tachycardia, tachypnea, Low BP o Cold/clammy, mottled skin

It is when there is high glucose in TYPE I DM (kete)

DKA

What are causes of DKA

Too much food Not enough insulin Not enough exercise However, THE #1 CAUSE IS acute viral Upper Respiratory Infection within last 2 weeks

Treatment for hypoglucemia

1 sugar (sugar/crb) 1 starch (protein)

What do u give an unconcious hypoglycemic pt

Glucagon IM Dextrose IV (D10, D50) if in ER

What are signs and symptoms of DKA

D Dehydration (dry, poor skin elasticity and turgor, warm)… Water is a coolant (you overheat, dehydration = increase in temperature) K Ketones in serum, Kussmauls, High K+ AAcidoses, Acetone breath, Anorexia due to nausea Nite: Ketone in urine does not necessarily mean DKA

What is the treatment for DKA

Insulin IV (REGULAR!) IV Fluid! 200 mL/hr (some of the fastest rate)

• High blood sugar in a Type 2 • These pts don’t burn ketones, no acid • Whenever you see this, think dehydration • Severe Dehydration! o Skin is dry, flushed, decreased turgor, increased HR o #1 Nursing diagnosis: fluid volume deficit (same as dehydration) o #1 Nursing intervention: Rehydration! * DO NOT give insulin o Outcomes in successful treatment: Increase urine output, Moist mucous membrane, etc. o Long-term complications: Poor perfusion, Peripheral neuropathy

HHNK or HHS or HHNS (Hyperglycemic, hyperosmotic, nonketotic)

Between DKA and HHNK, which os more dependent on insulin?

DKA is more dependent on insulin HHNK pt needs to be rehydrated

Between DKA and HHNK, which one has a higher mortality rate?

HHNK

Between DKA and HHNK, which is higher priority?

o DKA is a more acute condition and responds very quickly to insulin o HHN pts show up late in the emergency room and do not readily respond to treatment

What are long term complications of diabetes?

Related to poor tissue perfusion, or poor peripheral neuropathy Examples of long term complication: Renal failure, Gangrene, heart failure, Urinary incontinence, Pt can’t feel a burn on the foot *renal failure is a cause of poor perfusion *unirnary incontinent in a cause of peripheral neuropathy

Which lab test is the best indicator of long-term blood glucose level?

Hb A1C, a.k.a. glycosated Hb or glycosylated Hb o Average blood sugar over last 90 days

What A1C Hb is normal

< 6

What Hb A1C is out of control

> 8

Brainscape's Knowledge GenomeTM

DIABETES Flashcards

Brainscape's Knowledge Genome^TM