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nur 112 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Diabetes type I

A

uAbsolute insulin deficiency (auto immune)
uDependent on Insulin Rx
uQuick onset, <age 40
uNormal or under ideal body weight
uRecent sudden weight loss

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2
Q

EFFECTS ON THE BODY: Type 1

A

uElevated serum blood glucose level
uGlycosuria (BS high spills into urine)
uCHO not broken down, fat and protein used for energy
uKetonuria (by-product of fat metabolism)

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3
Q

S/S of Type I

A

uPolyuria occurs as the body tries to rid itself of excess glucose and
ketones
uPolydipsia results d/t excess urination and a dehydrated state of
cells d/t high glucose levels
u Polyphagia occurs because the cells are starving for energy despite
the high glucose levels
uRapid weight loss, muscle wasting, irritability, and decreased wound
healing

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4
Q

Diabetes type II

A

uCell insulin resistance
uDecrease in pancreas ability to produce insulin, doesn’t respond
correctly to body needs
u90-95% of diabetic pts

correctly to body needs
u90-95% of diabetic pts
uSlow onset
ur/t heredity & obesity
u
uIncrease abdominal fat>insulin resistance
uSedentary lifestyle
uHR ethnic groups: African American, Native American, Hispanic,
Asian American, and Pacific Islanders.
uGrowing number of children and adolescents are developing type 2
diabetes

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5
Q

Type 2 Diabetes
* S/S:
* At the time of diagnosis, _______ of patients will have complications
already beginning

A

same as type I (polyuria, polydipsia, polyphagia) along with
frequent infections, numbness and tingling in hands and feet, fatigue,
blurred vision, prolonged wound healing. Most people do not have
any signs and symptoms
* At the time of diagnosis, 50% of patients will have complications
already beginning

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6
Q

Normal Blood Sugar

A

Normal fasting blood sugar 74-106

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7
Q

Diagnosis of DM
* Fasting plasma glucose > ______ (first indicator)

  • A1C lab result______ or higher
  • ______ hr plasma glucose level during 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.

before liquid and again at _____mins after and _____mins after
consumption.
* _____________Prediabetes
* Greater than or equal to ________mg/dL confirms DM

A

Diagnosis of DM
* Fasting plasma glucose > 126 (first indicator)

  • A1C lab result 6.5% or higher
  • 2 hr plasma glucose level during 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.

before liquid and again at 60 mins after and 120 mins after
consumption.
* 140-199 Prediabetes
* Greater than or equal to 200mg/dL confirms DM

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8
Q

Raise BS

8

A

uIllness/Sickness
uFatigue
uStress
uLack of exercise
uFood
uGrowth
uMedications (steroids)
uMenstrual cycle
u

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9
Q

uLower BS

A

uInsulin
uOral antidiabetic meds
uExercise
uFasting
uDelay meal eating
uMedication side effects

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10
Q

Finger stick blood sugar monitoring

A

uLog kept for self glucose monitoring
uMore accurate than urine testing
uRotate times for accurate picture of how diet and exercise impact
levels per HCP
uTypical hospital monitoring: ac meals and at hs (using a sliding
insulin scale)

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11
Q

Dexcom

A

usmall, wearable sensor and transmitter sends your glucose numbers
to a smart device† or receiver every 5 minutes
uZero Fingersticks
uCustomizable Alerts & Alarms-See your glucose numbers with just a
quick glance at your smart device.† Set your range to get notified
when you’re too high or low.

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12
Q

Glycosylated hemoglobin-HgbA1c

A

uAmount of HgB that has glucose attached to it
uResults 6.5% or higher indicative of DM

uAmount of HgB that has glucose attached to it
uResults 6.5% or higher indicative of DM
uMeasures how the blood sugar has been maintained over a three
month period

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13
Q

uHgb A1C results:
* ____ avg bld sugar 129
*_____avg bld sugar 146
* ___avg bld sugar 169
*____avg bld sugar 192
* ____avg bld sugar 214
* ___ avg bld sugar 237
uResults _____ good control, _______ fair control, greater than ______ poor
control

A

uHgb A1C results:
* 6.5% avg bld sugar 129
* 7% avg bld sugar 146
* 8% avg bld sugar 169
* 9% avg bld sugar 192
* 10% avg bld sugar 214
* 11% avg bld sugar 237
uResults 2-5% good control, 6-8% fair control, greater than 8 poor
control

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14
Q

Oral Antidiabetic Agents-

A
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15
Q

Parenteral Agents

A
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16
Q

Insulin Therapies

A

Exogenous source (insulin from outside source)
* Therapies- single type or mixed(rarely mixed, see agency protocol)
* Ac meal, QD, BID, TID, at hs (pt specific)
* Rainbow coverage using rapid-acting insulin / sliding scale based
upon BS results
* Most common times are ac meals & hs
* Differ based on onset, peak action, and duration

  • Categorized as rapid-acting, short-acting, intermediate-acting, long-
    acting
17
Q

Administer subcutaneously
* Sites –
* ___-degree angle, no aspiration or rub
* Use U____marked syringes, either ______

A

abdomen, arm, thigh, back, buttock (rotate sites and areas
within a site)

  • 90-degree angle, no aspiration or rub
  • Use U100 marked syringes, either 1.0ml, or 0.5ml
18
Q

Insulin pen

A

uCompact portable device with insulin (usually about 300 units
cartridges)
uOffer convenience and flexibility, more discreet
uPrefilled, either reusable or disposable
uNeed to attach a needle
uHas a dial to indicate units of insulin
uInject with SQ technique and press the dose knob on end of pen
uSlowly count to 5-10 (depending on the dose) to make sure all
insulin has been injected then remove
uDispose of needle properly. Can keep insulin pen at room
temperature for up to 28 days then discard. Keep unused pens in
refrigerator.

19
Q

Insulin pump

A

uInsulin pump
* Delivers rapid-acting insulin continuously and/or bolus
* Pumps programed to deliver a continuous infusion 24hr/day (Basal
rate), and may or may not require a bolus at mealtime depending on
amt of CHO consumed
* Insulin filled cartridge connected by plastic tubing to a catheter
inserted into subcutaneous tissue.
* Site is changed q2-3days
* Monitoring of blood glucose levels (4xday)

20
Q

Afrezza inhaled insulin

A

urapid-acting, given @ mealtime. In conjunction with long-acting.
Type I & II DM

21
Q

Insulin Products
ØRapid-acting: aspart(Novolog), lispro(Humalog)
Ø Short-acting: regular(Novolin R, Humulin R)
ØIntermediate-acting: NPH(Humulin N, Novolin N)
ØCombination: NPH/regular (Humulin 70/30, Novolin 70/30)
ØLong-acting: glargine(Lantus)

A
22
Q

Insulin label

A
23
Q

Interpreting Blood Sugar Results using sliding scale

A
24
Q

Exercise p.

A
  • Increase the use of glucose at muscle
  • Increase insulin sensitivity/reduction of insulin resistance
  • May lead to low blood sugar levels
  • May lower insulin regularly
  • 30mins/5xweek
  • Promotes weight loss
  • Monitor for s/s of hypoglycemia
  • Have fast-acting source of CHO (glucose tablet, hard candies)
    available
25
Q

Health Teaching (cont’)

A
  • Regular eye exams, Call if changes in vision (blurry, specks, etc)
  • Regular dental visits: daily brushing/flossing
  • Regular doctor visits
  • Medi alert- Identification bracelet
  • Carry source of quick-acting glucose
26
Q

Hyperglycemia signs & symptoms

A

uElevated blood glucose
uExtreme thirst
uIncrease urination
uIncrease appetite
uBlurred vision
uWeakness, fatigue
uHeadache
uGlycosuria
uNausea & vomiting
uAbdominal cramps

27
Q

Hypoglycemia signs & symptoms “ intoxication”

A

uBlood glucose <70 mg/dL
uCold and clammy skin
uPallor
uShakiness, nervousness
uDiaphoresis, weakness
uDizziness
uHunger
uTachycardia
- LOC is gone/ speaking
numbness around mouth, toes
- unsteady gait
-palpitations

28
Q

Treatment for low blood sugar

A

uCheck blood glucose level: less than 70 requires immediate action
uUse 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 push, or administer Glucagon IM or SQ (use deltoid muscle)

29
Q

Complications of Diabetes “angiopathy”/ Decrease oxygenation to the tissues

A

uStroke
uHypertension
uCoronary artery disease
uAtherosclerosis
uNephropathy
uRetinopathy, Cataracts, Glaucoma, Blindness
uPeripheral vascular disease/ neuropathy
uNeurogenic bladder
uInfections
uGangrene

30
Q
A

nur 112 (23 decks)

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