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Illness and Patho 1 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

How much insulin does the pancreas secrete daily?

A

40-50 units

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2
Q

What is the first major organ that insulin reaches?

A

The liver

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3
Q

What secretes insulin?

A

The beta cells of the Islets of Langerhan of the Pancreas gland

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4
Q

What does insulin promote in muscles?

A

Protein and glycogen synthesis

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5
Q

Converting fats to acids

A

Ketogenesis

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6
Q

What is insulin made of?

A

Alpha and Beta chains

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7
Q

What is the secretion of low levels of insulin during fasting called?

A

Basal insulin secretion

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8
Q

Promotes the production and storage of glycogen

A

Glycogenisis

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9
Q

What are the characteristics of diabetes mellitus?

A

Hyperglycemia, Glycosuria, and Ketonuria

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10
Q

How does insulin inhibit tissue breakdown?

A

Inhibits liver glycogenolysis, ketogenesis, and gluconeogenisis

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11
Q

Conversion of proteins to glucose

A

Gluconeogenisis

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12
Q

Precursors of insulin

A

Preproinsulin and Proinsulin

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13
Q

Which insulin precursor must be made smaller before becoming active?

A

Preproinsulin

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14
Q

Which electrolyte does insulin allow to pass from the ECF to the ICF?

A

Potassium

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15
Q

Inhibits glycogen breakdown into glucose

A

Glycogenolysis

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16
Q

What is increased when a patient is stressed?

A

Glycogenisis

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17
Q

What is the increased level of insulin after eating called?

A

Prandial Secretion

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18
Q

An endocrine disorder in which there is insufficient amount or lack of insulin secretion to metabolize carbohydrates

A

Diabetes Mellitus

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19
Q

What does insulin promote in fat cells?

A

Triglyceride storage

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20
Q

What molecules does insulin increase the synthesis of?

A

Proteins and lipids

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21
Q

What is proinsulin made of?

A

Alpha, beta, and c-peptide chains

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22
Q

What is the main fuel for the CNS?

A

Glucose

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23
Q

What is insulin’s purpose?

A

Takes sugar into the cells

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24
Q

How long after eating is insulin released?

A

10 minutes

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25
Q

Which of the precursors of insulin is inactive?

A

Preproinsulin

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26
Q

What historical questions should a patient be asked during an assessment for diabetes?

A

How long they have been feeling off and if they’ve lost any weight

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27
Q

What types of carbohydrates should diabetics eat?

A

Complex carbs

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28
Q

What is the most accurate blood test for diabetes?

A

A1c

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29
Q

Finger-stick test used to monitor blood sugar

A

FSBS

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30
Q

What happens in the absence of insulin?

A

Hyperglycemia, polyuria, polydipsia, polyphagia, hemoconcentration, hypervolemia, hyperviscosity, hypoperfusion, hypoxia, acidosis, Kussmaul respirations, hypokalemia, or hyperkalemia

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31
Q

What are the clinical manifestations of hypoglycemia?

A

Sudden onset of weakness, diaphoretic, sweat, pallor, tremors, nervousness, hunger, diplopia, confusion, aphasia, vertigo, and convulsions

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32
Q

What level does a patient’s fasting blood glucose have to be at in order to be diagnosed with diabetes?

A

Greater than 110 mg/dL

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33
Q

How much glucose does the body need to support the brain?

A

70-100 mg/dL

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34
Q

Why do diabetics develop extensive skin wounds?

A

The excess glucose in the blood stream damages their nerves and skin integrity

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35
Q

What are the clinical manifestations of hyperglycemia?

A

Gradual onset of polyuria, polyphagia, polydispsia, dehydration, hypotension, mental changes, glycosuria, fever, hypokalemia, hyponatremia, seizures, and coma

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36
Q

Follows the life of a hemoglobin cell and its average glucose level

A

A1c

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37
Q

What chemical stops the production of insulin when glucose levels are decreased?

A

Glucagon

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38
Q

What are the respirations that diabetics demonstrate in the absence of insulin?

A

Kusmaul

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39
Q

What types of infection generally increases in patients with diabetes?

A

Vaginal infections

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40
Q

Why does the brain need a continuous supply of glucose?

A

Because it does not make or store it

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41
Q

At what level does an A1c indicate diabetes?

A

> 6.9%

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42
Q

What does the urine test of a diabetic test for?

A

Keytones, renal function, and glucose

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43
Q

How is glucose made?

A

Glycogenolysis

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44
Q

What is the best thing to eat to quickly raise blood sugar?

A

Milk, ice cream, cheese, and crackers

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45
Q

What is the treatment for hypoglycemia?

A

Sugar followed by a protein or IV glucose

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46
Q

When glucose is not available, what does the brain use for fuel?

A

Fatty acids (trigylcerides)

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47
Q

What is the priority nursing diagnosis for diabetics?

A

Risk for injury

48
Q

What are the nursing interventions to prevent injuries of diabetic patients?

A

Dietary interventions, blood glucose monitoring, and giving proper medications

49
Q

What is broken down if liver glucose is not available?

A

Fat or amino acids

50
Q

What does glucagon do?

A

Causes the release of glucose from the liver

51
Q

How long can insulins be kept?

A

Four weeks

52
Q

Surge of glucose released at dawn

A

Dawn’s phenomenon

53
Q

Why are intensified insulin therapy regimens the best?

A

Because they act more like regular body function

54
Q

What should the diet of a diabetic patient look like?

A

High protein, high fat, and no simple carbs

55
Q

How should two insulins be drawn into one syringe?

A

Clear before cloudy

56
Q

What are the complications of insulin therapy?

A

Hypoglycemia, lipoatrophy, Dawn phenomenon, and Somagyi’s phenomenon

57
Q

What is more dangerous, hypo or hyperglycemia?

A

Short term hypo, long term hyper

58
Q

What preventative actions should be taught to diabetics?

A

Proper skin and foot care, proper eye exams, proper diet and fluids, diabetic neuropathy, diabetic retinopathy, diabetic nephropathy, and diabetic gastroparesis

59
Q

When should diabetics not exercise?

A

If their blood sugar is over 250 or they have glycosuria

60
Q

What is the hallmark of diabetic ketoacidosis?

A

Presence of ketone bodies in the urine and blood

61
Q

What common complications can occur in patients with diabetes?

A

Hyperglycemia, hypoglycemia, diabetic ketoacidosis, and hyperosmolar hyperglycemic nonkeytonic syndrome

62
Q

Blood sugar drops rapidly over night

A

Somagyi’s phenomenon

63
Q

What are the nursing interventions for diabetic ketoacidosis?

A

Monitoring for manifestations, assessment of airway, LOC, hydration status, and blood glucose levels, and management of fluid and electrolytes

64
Q

What teaching should take place for patients on oral hypoglycemics?

A

Monitor serum glucose levels daily, teach the patients the signs and symptoms of hyper/hypoglycemia, altered liver or renal function will affect the medication’s action, avoid OTC drugs without MD’s approval, know appropriate times to administer the medications

65
Q

How often should diabetics exercise?

A

Three times a week

66
Q

What do patients with ketoacidosis need?

A

Hydration, insulin, and electrolyte replacement

67
Q

How long does ketoacidosis take to develop?

A

4-10 hours

68
Q

What are the blood sugar levels in patients with diabetic ketoacidosis?

A

Around 600

69
Q

Why does HHNC not occur in patients with type 1 diabetes?

A

Because they have absolutely no insulin

70
Q

What should the diet of a diabetic patient look like?

A

60% Carbs, 30% fats, and 12-20% protein

71
Q

What is the goal of drug therapy for patients with diabetic ketoacidosis?

A

Lower serum glucose by 75 to 150 mg/dL/hr

72
Q

What happens in patients with HHNC?

A

Fluid moves from indie to outside the cell causing diuresis and loss of sodium and potassium

73
Q

What does diabetic ketoacidosis occasionally occur with?

A

Infection

74
Q

What is the purpose of exercise for diabetics?

A

To control and lower blood glucose and reduce the amount of insulin needed

75
Q

What are the nursing interventions for patients with diabetic ketoacidosis?

A

Keep airway patent, suction, cardiac monitoring, vital signs monitoring, monitor central venous pressure, ABG, BS, chemistry panel, administration of sodium bicarb, foley to monitor fluid output, strict I/Os, and frequent repositioning

76
Q

What are the nursing interventions for diabetic patients with ineffective tissue perfusion?

A

Control of blood glucose levels, yearly evaluation of kidney function, control of blood pressure levels, prompt treatment of UTIs, avoidance of nephrotoxic drugs, diet therapy, fluid and electrolyte management

77
Q

Which types of patients are candidates for whole-pancreas transplantation?

A

Type 1 diabetics only

78
Q

What are the key nursing diagnoses for patients with diabetes?

A

Anxiety and fear, altered nutrition, pain, and fluid volume deficit

79
Q

What causes HHNC?

A

Lack of a thirst center, causing profound dehydration without thirst and severe hyper glycemia

80
Q

What interventions should be done for diabetics with chronic pain?

A

Maintenance of normal blood glucose levels, anticonvulsants, antidepressants, and capsaicin cream

81
Q

What is the drug therapy for diabetic patients with hypoglycemia?

A

Glucagon, 50% dextrose, diazoxide, and octreotide

82
Q

What are the nursing interventions for patients with diabetes?

A

Prevent complication, monitor blood sugars, administer meds and diet, teach diet and meds, and constantly assess

83
Q

What are the chronic complications of diabetes?

A

Cardiovascular disease, cerebrovascular disease, retinopathy problems, diabetic neuropathy, diabetic nephropathy, and male erectile dysfunction

84
Q

What should diabetics do to take care of their feet?

A

Cleanse and inspect feet daily, wear properly fitting shoes, avoid walking barefoot, trim toenails properly, report non healing breaks in the skin, and wear flat shoes

85
Q

What would a patient who in HHNC have blood sugars of?

A

1000s

86
Q

How soon should a patient in HHNC have their blood sugars restored to normal?

A

36-72 hours

87
Q

What interventions should be done for diabetic patients with disturbed sensory perception?

A

Blood glucose control, and environmental management

88
Q

What wound care should be performed for diabetic patients?

A

Wound environment, debridement, elimination of pressure on infected area, and growth factors applied to wounds

89
Q

What are the Sulfonylureas?

A

Glipizade and glucotrol XL

90
Q

What are the signs and symptoms of HHNC?

A

Hypotension, mental changes, dehydration, hypokalemia, and hyponatremia

91
Q

What are the meglitinide analogs?

A

Prandin and starlix

92
Q

How fast should a diabetic patient in HHNC be given insulin?

A

10 units/hour

93
Q

What are the biguanides?

A

Metformin and glucophage XL

94
Q

What is the onset of the meglitinide analogs?

A

Short acting

95
Q

What is the treatment for HHNC?

A

Give insulin and correct the fluid and electrolyte imbalances

96
Q

What should be monitored when taking thiazolidinediones?

A

Monitor liver function

97
Q

What needs to be monitored when taking alpha-glucosidase inhibitors?

A

Kidney function

98
Q

What are the thiazolidinediones?

A

Actos and avandia

99
Q

What are the alpha-glucosidase inhibitors?

A

Precose and Glyset

100
Q

Which type of oral hypoglycemics should be held 48 hours before tests with contrast dyes

A

Biguanides

101
Q

What is the onset and peak of Apidra?

A

Onset 20 minutes and peak 30-90 minutes

102
Q

What are the classifications of insulins?

A

Rapid-acting, short-acting, intermediate-acting and long-acting

103
Q

What are the types of short-acting insulin?

A

Novolin R and Humulin R

104
Q

What are the types of rapid acting insulins?

A

Novalog, Apidra, and Humalog

105
Q

What are the onset and peak of Humulin R?

A

Onset 30 minutes and peak 2-4 hours

106
Q

What are the classifications of oral hypoglycemics?

A

Sulfonylura, meglitinide analogs, biguanides, thiazolidinediones, and alpha-glycosidease inhibitors

107
Q

What are the onset and peak of Humulin R Concentrated?

A

Onset 90 minutes and peak 4-12 hours

108
Q

What is the onset and peak of Humalog?

A

Onset 15 minutes and peak 1-3 hours

109
Q

What is the onset and peak of Novolin R?

A

Onset 30 minutes and peak 2.5-5 hours

110
Q

What is the onset and peak of novolog?

A

Onset 15 min and peak 1-3 hours

111
Q

Which insulin should never be mixed with anything else?

A

Lantus

112
Q

What is the long-acting insulin?

A

Lantus

113
Q

What is the intermediate-acting insulin?

A

NPH, Humulin N, Novolin N, and ReliOn N

114
Q

What is the onset and peak of Lantus?

A

Onset 2-4 hours and no peak

115
Q

What is the onset and peak of NPH?

A

Onset 90 minutes and peak 4-12 hours

Illness and Patho 1 (12 decks)

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