Diabetes Flashcards
Diabetes Mellitus is an error of glucose metabolism
Describe type 1 & 2
- Born with. Body doesn’t produce insulin
- Insulin resistance. Body doesn’t respond to insulin
Diabetes Insipidus is Polyuria & Polydipsia leading to _____ due to low _____
Dehydration/ AHD
Diabetes Insipidus is a type of Diabetes Mellitus
True or False
False
It’s just the fluid part
Polyuria & Polydipsia leading to dehydration - due to low ADH
How are DI & SIADH related to one another
Describe: Urine output, Urine Concentration, Fluid levels, Serum & Urine specific gravity levels
DI
Urine Output: High Dilute
Fluid levels: Deficte Overload
Serum Specific Gravity: Increased
Urine Specific Gravity: Decreased
SIADH: Body retains water
Urine Output: Low Concentrated
Fluid levels: Fluid Overload
Serum Specific Gravity: Decreased
Urine Specific Gravity: Increased
Type 1
Treat with
Diet, insulin, exercise
Which is most important
Insulin
Type II
Treat
Diet, oral hypoglycemia, active
Which is most important
Diet
S&S of Diabetes Mellitus 1 & 2
(3)
Polyuria, polydipsia,polyphagia
Primary dietary restriction in Type 2
Calorie restriction
How many meals should a type 2 eat daily
6
Which is best to restrict calories to 1600 or divide daily food into 6 meals for type 2 diabetic
Calorie restrictions
Regular Insulin (R) Clear, IV drip, rapid/intermediate
Onset
Peak
Duration
Pattern
Onset: 1h
Peak: 2h
Duration: 4h
Pattern: 1-2-4
Regular Insulin (R)
(Clear/ Cloudy)
(IV drip / Suspension)
(Rapid/intermediate)
Clear
IV drip
Rapid / Intermediate
NPH (N) -cloudy, suspension (precipitate), NO IV, intermediate
Onset:
Peak:
Duration:
Pattern:
Onset: 6
Peak: 8 - 10
Duration: 12
Pattern: 6 -8 -10 -12
NPH (N)
(Clear /cloudy)
(IV Drip / suspension (precipitate))
( intermediate / rapid)
Cloudy
Suspension (precipitate)
Intermediate
Lispro- Short Acting - don’t give AC, give with food
Onset:
Peak:
Duration:
Pattern:
Onset: 15 mins
Peak: 30 mins
Duration: 3 hrs
Pattern: 15 - 30 - 3
When do you give lispro
With food
Glargin (Lantis): long acting - little
Duration
Safety precaution
Duration: 12 - 24
Safety precautions: Never mix
If pt was given NPH at 0700, when do you check for hypoglycemia
1500 - 1700
Once insulin package is opened, when is the new expiration date?
30 days after opening
Does opened insulin need to be put in the refrigerator in the hospital?
How about at home?
Refrigeration not need in hospital
Needed at Home
If a patient has to exercise (increase / decrease) insulin dose.
Should the patient consume fast acting carbs snacks?
Decrease insulin with exercise
Eat fast acting carb snacks
Sick day
When sick serum glucose (down / up)
If a patient doesn’t eat when sick do you still administer insulin?
Glucose levels go up
Give insulin to Sick patients even if they didn’t eat
3 acute symptoms of Diabetes
Low blood Glucose: Causes Too much Insulin / Exercise. Not enough Food
Danger BRAIN DAMAGE
DKA: #1 Acute Viral Upper Respitory Infections W/in last 2 Weeks
Other Causes Too much Food, not enough insulin, not enough exercise
S & S
Dehydration
K Ketones (in blood), Kussmaul, K hgh
A acidosis metabolic, acetone breath, Anorexia
HHNK (TYPE 2)
S&S Dehydration
Skin: Hot Flushed dry
Nursing Intervention: Give fluids
Outcomes: increases output
(Must Know) S&S Hypoglycemic
Drunk and in Shock
Labile (All over the place)
Judgements, reaction time, emotions
Staggering, Slurred Speech
(SHOCK)
SWEATY
TACHYCARDIA/ LOW BP
Skin Cold Clammy, Mottled
What do you do if a patient is hypoglycemic
What to do: Give
Sugar & Startch / Sugar & Protein
Admin Juice, honey, jam + Crackers
Possible 15 grams wait 15 mins
If patient is unconscious from hypoglycemia
What do you do?
Give
Glucagon IM
Dextrose 10 / 50 IV
A patient is hypoglycemic and just passed out.
The 2 options to help are:
Give
Glucagon IM
Dextrose 10 / 50 IV
What would determine when to give each medication
Glucagon IM for home patients not hooked up to IV
Dextrose if they already have an IV running
In which will you need to use Insulin
DKA / HHNK
DKA
Long term complications of DM
Related to 2 problems
Every symptom can be attributed to one of these
Poor tissue perfusion
Peripheral neuropathy
Long terms complications of DM
Renal failure
Gangrene
Statis Ulcers
Blindness impotence
Heart disease
Long term complications DM
- Renal failure
- Lost control of bladder, incontinence
- Can’t feel it when they injur themselves
- Poor healing when they injury themselves
- Poor tissue perfusion
- Peripheral neuropathy
- Peripheral neuropathy
- Poor tissue perfusion
Which lab test is best to evaluate long-term blood glucose levels
Hemoglobin HA1C
HA1C desirable level
HA1C Out of Control Level
<6
7 mean Dr’s have to look at you
>8
