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Nursing III > Diabetes > Flashcards

Diabetes Flashcards

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1
Q

s/s of type 1 Diabetes

A

abrupt s/s. polyphagia, polydipsia, polyuria, wt loss & fatigue. children: severe diaper rash

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2
Q

What does a person need to have in order to be placed on insulin therapy

A

BS over 250, HA1c over 9%, ketoacidosis

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3
Q

Pediatric dietary changes

A

15% Protein, 30% fat, 55% Carbs

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4
Q

Pediatric BS should be no higher than ___ before meals and ___ at night

A

120; 100-140

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5
Q

During Ketoacidosis, what will your BS be? your ph, bicarbonate level, & K+, Na+ and Cl- levels? and what will have to the extracellular fluid?

A

BS=250 or higher, ph=7.35, bicarb ll have serum and urine ketones, Extracellular fluid will be depleted (K+ will come out of cell and be lost in urine).

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6
Q

Ketoacidosis s/s

A

slow onset, increased thirst and urination, high BS, weak, vomiting, abdominal pain, Kussmal breathing, fruity breath

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7
Q

Ketoacidosis treatment

A

Initally you give NS IV then once their fluid balance comes back, they will give 1/2 NS then they will be put on an insulin drip until glues=250 then they are put on dextrose & sliding scale

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8
Q

critically ill patients should keep BS around?

A

110

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9
Q

Non critally ill patients should keep BS around

A

<126

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10
Q

Things that can lower bs

A

exercise, stimulants, salicylates, alcohol

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11
Q

hypoglycemia BS range

A

<45-60

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12
Q

15g of rapid acting sugar that you can give to someone who is hypoglycemic

A

1/2 fruit juice, 3 glucose tabs, 3 tsp sugar/honey, 6 crackers, 8 oz skim milk

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13
Q

<50 BS means that the person is

A

severe hypoglycemic

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14
Q

Dawn phenomenon

A

Rise in BS between 4am-8am in both type 1&2

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15
Q

Somogyi effect

A

occurs with long acting insulin. No bedtime snack, normal or elevated BS at bedtime then low BS at 2-3am then high BS in am

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16
Q

Hyperosmolar Hyperlycemic Nonketotic syndrome means?

A

a severe dehydrated state with an increase in glucose level and normal pH (they aren’t spilling ketones)

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17
Q

Hyperosmolar Hyperlycemic Nonketotic syndrome s/s

A

BS >600, extreme thirst, dry mouth, decreased BP, increased P, fever over 101, blurred vision, NO kussmal breathing, NO ketones in urine, No fruity breath. There is NO metabolic acidosis.

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18
Q

Hyperosmolar Hyperlycemic Nonketotic syndrome treatment

A

Establish/maintain ventilation, correct/maintain electrolytes, K+ replacement, insulin until BS is at 250

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19
Q

Insulin is used to treat what other than diabetes?

A

hyperkalemia, its given IV

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20
Q

Rapid Acting Insulin examples

A

Lispro(Humalog), Aspart (Novolog), Apidra (Glulisine)

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21
Q

Lispro(Humalog), Aspart (Novolog), Apidra (Glulisine) are what kind of insulin?

A

Rapid acting

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22
Q

Rapid acting works in how many minutes? when does it peak? How long does it last?

A

works in 5-15 mins, peaks in 40-50 mins and lasts 3-5 hours

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23
Q

Regular or short acting insulin examples?

A

Regular (Humalin R)

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24
Q

Regular or short acting insulin works in how many minutes? when does it peak? How long does it last?

A

works in 30 minutes, peaks in 2-3 hours and lasts 4-6 hours

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25
Q

Intermediate insulin examples

A

NPH (Humalin N)

26
Q

Intermediate insulin works in how many hours? when does it peak? How long does it last?

A

works in 2-4 hours, peaks in 6-8 hours and lasts 12-16 hours.

27
Q

Long acting insulin examples

A

Levemir (Detemir) & Lantus (Glargine)

28
Q

Levemir (Detemir) & Lantus (Glargine) are what kind of insulin?

A

long acting

29
Q

Long acting insulin works in how many hours? when does it peak? How long does it last?

A

works in 2 hours, peak continuous and lasts 24+ hours.

30
Q

Combination insulin works in how many minutes? when does it peak? How long does it last?

A

works in 30 minutes, peaks in 4-8 hours and lasts 24 hours

31
Q

Patients with Continuous subcutaneous insulin infusion (CSII) use what kind of insulin?

A

Rapid acting

32
Q

Can long acting Lantus be mixed?

A

no

33
Q

How long are prefilled syringes good for in stored in fridge?

A

30 days

34
Q

CHO=__cal/gram Protein=__cal/gram Fat= __cal/gram

A

CHO=4cal/gram, Protein= 4 cal/gram, Fat=9 cal/gram

35
Q

1st generation Sulfonlureas can increase the chance of what disease?

A

cardiovascular disease

36
Q

2nd generation Sulfonlureas are excreted where?

A

in the urine and bile

37
Q

Do 2nd generation Sulfonlureas have a long or short duration of action?

A

long

38
Q

Sulfonlureas action

A

stimulate insulin release & improve binding to insulin receptors

39
Q

Sulfonlureas adverse effects

A

Hypoglycemia, wt gain and sun sensitivity

40
Q

Glimepiride (Amaryl), Glyberide (DiaBeta/Micronase), Glipizide (Glucotrol XL) & Glyburide (Glynase PresTab) are examples of?

A

second generation Sulfonylurea drugs

41
Q

Biguanides action

A

decrease amount of glucose formed in liver, makes muscle tissue more sensitive to insulin

42
Q

Biguanides are taken when?

A

taken two times a day

43
Q

A Biguanides medication

A

Metformin (Glucophage)

44
Q

What medication needs to be held if a cat scan is needed?

A

Metformin (Glucophage)

45
Q

Risk factors for Gestational Diabetes/

A

Family history, Older maternal age, decreased physical activity, obesity, high blood pressure, high cholesterol,

46
Q

If you are at high risk for GD when is oral glucose tolerance test done? If you are not at high risk, when is test done?

A

High risk = first prenatal visit, Not high risk = 24-28 weeks

47
Q

1st trimester, does mom need extra insulin? what are the risks for mom and baby during this time?

A

No, hypoglycemia is the biggest risk for mom and hyperglycemia is the biggest risk for baby

48
Q

what happens during 2nd & 3rd trimester with insulin needs and baby?

A

mom needs extra insulin, baby will produce its own insulin. Baby will get more glucose than needed from mom and it will be stored as fat. After birth, baby is at risk for hypoglycemia because it will be producing insulin but it will not be getting the same amount of glucose from mom

49
Q

Risks to baby during 1st trimester?

A

congenital anomalies if mom is having extreme highs and lows

50
Q

Risks to baby during 2nd & 3rd trimester?

A

increased amniotic fluid, increased subcutaneous fat deposits & cephalopelvic disproportion (head is too big to fit out of pelvis)

51
Q

Babies are at risk for what after birth?

A

hypoglycemia, Respiratory distress syndrome (hyperglycemia delays lung maturity), hypocalcemia, hyperbilirubinemia, may have depressed ABGAR score after 5mins

52
Q

During labor and delivery glucose should be between?

A

70-110

53
Q

mothers glucose level should return to normal after L&D after how many hours? what if they have type 1 or type II?

A

24; if they have type 1 or type II it will take a few days or a month to return to pre-pregnant levels

54
Q

does breast feeding increase or decrease the need for insulin?

A

decreases

55
Q

s/s of hypocalcemia in baby

A

jittery, irritable and may have seizures

56
Q

What do you want your A1C score to be? what will your score be if you are a pre-diabetic or you have diabetes?

A

Normal =less than 6%, Pre-diabetic = 5.7%-6.4%, Diabetic=6.5% or higher

57
Q

Glucose tolerance test

A

NPO for 10 hours, hold meds that alter BS. you drink oral glucose and blood and urine is collected at 30 mins, 1 hr, 2 hr and maybe at 5 hrs. no smoking/caffeine/alcohol/food, can drink water.

58
Q

Factors that effect a blood sugar test

A

not enough blood on test strip, acetaminophen, ascorbic acid, ibuprofen, aspirin, tetracycline, increased triglycerides

59
Q

Adult dietary changes

A

25-35% but less than 7% saturated fats, 12-20% Protein, 45-60% carbs (whole grains etc)

60
Q

Caloric requirements are based on what?

A

age, sex, height, activity level

61
Q

Maternal Fasting glucose should be between what after 2 hrs after eating?

A

95-100

Nursing III (25 decks)

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