Diabetes

Question 1

People with type 1 diabetes may develop a condition called _____________________ .

Answer 1

Diabetic Ketoacidosis (DKA)

Question 2

People with type 2 diabetes may develop a condition called _____________________ .

Answer 2

Hyperglycemia hyperosmolar syndrome (HHS)

Question 3

Both DKA and HHS ‘ pathophysiology is similar and involve what?

Answer 3

Extreme hyperglycemia induced by acute insulin deficiency and lead to serum hyperosmolarity.

Question 4

DKA can develop in __________

Answer 4

hours

Question 5

HHNS can develop in _____

Answer 5

Several days

Question 6

What are the primary causes of DKA & HHNS?

Answer 6

Undiagnosed DM, illness/infection, and decreased or missed insulin doses.

Question 7

What are the 3 P’s that are the classic signs and symptoms of DM?

Answer 7

Polyuria - increased urination
Polydipsia - increased thirst
Polyphagia - increased hunger

Question 8

Apart from the 3 P’s, what are the other manifestations of DM?

Answer 8

• Fatigue
• Weakness
• Dehydration
• Frequent infections
• Skin infections that are slow to heal
• Tingling, numbness, and loss of sensation in the extremities (neuralgia)
• vision changes due to retinopathy

Question 9

What are 3 manifestations of DM complications?

Answer 9

• Hypoglycemia
• Diabetic Ketoacidosis
• Hyperglycemic hyperosmolar nonketoic syndrome (HHNS)

Question 10

To assess for DM, what 4 different blood tests may be used?

Answer 10

• Random blood glucose reading .200 mg/dl as well as symptoms of diabetes
• Fasting blood glucose reading >126 mg/dl - taken after 8-12 hr fasting
• Glucose tolerance test showing a level > 2000 mg/dl in the second hour and at least on one other occasion during the test.
• Glycosylated hemoglobin >6.5%. Average blood glucose over the past 3 months.

Question 11

Explain diabetic retinopathy.

Answer 11

It occurs when capillaries int eyes’ retina hemorrhage cause the patient with diabetes to report “floaters” and/or vision loss.

Question 12

Why would we test a patients urine for acetone to assess for DM?

Answer 12

Acetone is normally absent in the urine, it is one of the ketone bodies produced during fatty acid metabolism - its presence indicates that the person with type 1 diabetes has impaired glucose control and is at risk of DKA.

Question 13

How do we check for evidence of Diabetic neuropathy?

Answer 13

By testing the soles of the feet and lower legs for sensation.

Question 14

What type of Insulin is Lispro?

Answer 14

Fast acting

Question 15

What’s the onset time of Lispro?

Answer 15

15-30 min

Question 16

what is the peak time of Lispro?

Answer 16

30-90 min

Question 17

What’s duration of Lispro?

Answer 17

<5hr

Question 18

What type of insulin in Regular Insulin in terms of ‘time”

Answer 18

Short-acting

Question 19

What’s the onset, peak and duration of regular insulin?

Answer 19

Onset : 30-60 min, Peak : 2-3hr, Duration 4-6 hr

Question 20

Mention two long-acting Insulin preparations.

Answer 20

Detemir & Glargine

Question 21

What is the peak time of Detemir & Glargine?

Answer 21

There is no peak

Question 22

What’s the duration of Detemir & Glargine?

Answer 22

24 hr

Question 23

Explain what is meant by Dawn phenomenon.

Answer 23

It is a side effect of Insulin and presents itself as an early morning rise in blood glucose levels.

Question 24

What are some other side effects of Insulin?

Answer 24

• Hypoglycemia
• Lipodystrophy (skin changes r/t to using the same injection site)
• Insulin allergy
• Insulin resistance.

Question 25

As a nurse caring for diabetic patients in hospital, with what glucose reading should you alert the provider?

Answer 25

Readings below 70 mg/dl or over 250 mg/dl

Question 26

Insulin therapy begins to drive _____________ back into the cells.

Answer 26

Potassium.