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Fundamentals of Nursing > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is insulin?

A

A hormone secreted by beta-cells in the islet of Langerhans in the pancreas

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2
Q

Glycogenolysis

A

breakdown of stored glucose

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3
Q

Gluconeogenesis

A

Production of new glucose from amino acids and other substrates.

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4
Q

What is glucagon?

A

Secreted by alpha-cells, secreted when blood glucose levels decrease

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5
Q

Glucagon stimulates the liver to

A

Release stored glucose

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6
Q

Type 1 diabetes

A

Destruction of beta cells. Autoimmune response. Glucose cannot be stored in the liver but instead remains in the bloodstream.

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7
Q

Clinical characteristics of Type 1 diabetes

A 
Onset at any age but usually before 30
Normal weight,
Etiology includes genetic and immunologic
Often have islet cell antibodies
Needs insulin to live
Body does not maki insulin 
Ketosis prone
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8
Q

Type 2 diabetes

A

Not enough insulin is being produced. Insulin is less effective at stimulating glucose uptake

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9
Q

Clinical characteristics of Type 2 diabetes

A 
Onset at any age, usually after 30
Usually obese at time of dx
Causes include obesity, heredity and environmental factors.
No islet cell antibodies
Can be controlled by diet and exercise
Ketosis is uncommon
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10
Q

What is insulin resistance?

A

Insulin is not as effective and does not allow glucose into cells effectively causing blood sugar levels to rise

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11
Q

What are the classic clinical manifestations of diabetes? (3 P’s)

A

Polydipsia
Polyphagia
Polyuria

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12
Q

Other S/S of diabetes

A 
Fatigue
Weakness
Sudden vision changes
Tingling or numbness
Poor healing wounds
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13
Q

Blood sugar and an A1C less than 7% can protect what organs

A 
Heart
Brain 
Blood vessels
Eyes
Kidneys
Feet and nerves
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14
Q

What does A1C measure

A

How much sugar has been sticking to RBC over a 3 month period (Goal is <7%)

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15
Q

S/S of hyperglycemia

A 
Extreme thirst
Frequent urination
Dry skin
Hunger
Blurred vision
Drowsiness
Decreased healing
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16
Q

Causes of hyperglycemia

A

Too much food
Too little insulin or diabetes medicine
Illness
Stress

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17
Q

S/S of hypoglycemia

A 
Shaking
Fast heartbeat
Sweating
Dizziness, anxiety
Hunger
Impaired vision
Weakness, fatigue
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18
Q

Causes of hypoglycemia

A

Too little food
Too much insulin/diabetes medicine
Extra activity or exercise

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19
Q

How is diabetes diagnosed?

A

Hx of the 3 P’s
Blood glucose higher than 126 fasting (twice)
A1C
Fasting lipid profile

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20
Q

Most patients over 35 with diabetes would benefit from key medications such as

A 
Cholesterol (Statins)
BP meds (ACE inhibitors or ARB)
Blood thinners (Baby aspirin)
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21
Q

What body parts/organs should you monitor with diabetes

A

Feet
Eyes
Heart
Kidneys

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22
Q

Sulfonylureas

Glyburide, Glipizide

A

Tell the pancreas to make more insulin

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23
Q

Metformin

A

Tells the liver to stop sending out sugar

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24
Q

Side effects of metformin

A

May help lose weight
Upset stomach and diarrhea
Doesn’t cause blood sugar to go too low

25
Q

Glitazones

Avandia and Actos

A

Help insulin in the body work better

26
Q

Side effects of glitazones

A

Weight gain and swelling (most common)
Takes 6-12wks before you can see full benefit
Liver problems (rare)

27
Q

Meglitinides

Prandin, Starlix

A

Tell the pancreas to make more insulin. Taken with meals

28
Q

Side effects of meglitinides

A

Main side effect is low sugars

29
Q

Alpha-glucosidase inhibitors

Precose, Glyset

A

Slow down the absorption of cabs from the intestines after you eat

30
Q

Side effects of alpha-glucosidase inhibitors

A

Stomach upset and gas

31
Q

Rapid acting insulin

Humalog, Novolog, Apidra

A

Eat no more than 5-15min after inj
Clear
Peak is 30min-3hrs
Duration is 2-6hrs

32
Q

Short acting insulin

Humalong R, Novolin R

A 
"Regular insulin" 
Clear
Usually administered 20-30min before meal
Only insulin approved for IV use
Peak is 2-3hrs
Duration is 4-6hrs
33
Q

Intermediate acting insulin

Novolin N, Humulin N

A

Appear cloudy and white
Lasts about 12-18hrs
Not crucial to be taken with meals
Usually taken twice a day

34
Q

Long acting insulin

Lantus, Levemir

A

Clear
Absorbed slowly over 24hrs
No peak
Lantus is taken once a day at the same times

35
Q

Insulin mixes

A

Cloudy
Usually taken bid with meals
Depends on very consistent meal patterns
Long acting part works better when taken later at night (8-10pm)

36
Q

What is lipoatrophy?

A

Loss of subcutaneous fat; appears as a slight dimpling or pitting of subcutaneous fat

37
Q

What is lipohypertrophy?

A

Development of fibrofatty masses at inj site, caused by repeated use of an inj site

38
Q

Examples of injection sites

A

Anywhere on abdomen at least 2in away from belly button
Outer thigh
Back of arms

39
Q

Diabetic ketoacidosis is caused by

A

An absence or inadequate amount of insulin resulting in disorders in the metabolism of carbs, proteins and fats

40
Q

3 main sx of diabetic ketoacidosis

A

Hyperglycemia
Dehydration and electrolyte loss
Acidosis

41
Q

Free fatty acids and glycerol are converted into _____

A

Ketone bodies by the liver

42
Q

3 main causes of DKA

A

Decreased or missed insulin dose
Illness of infection
Undx or untreated diabetes

43
Q

What is hyperglycemic hyperosmolar syndrome (HHS)?

A

Metabolic disorder of type 2 diabetes resulting from a relative insulin deficiency initiated by an illness that raises the demand for insulin

44
Q

What is the difference between DKA and HHS?

A

In HHS there is insulin present but it is too low to prevent hyperglycemia but high enough to prevent fat breakdown. In DKA there is no insulin present

45
Q

Humalog (Rapid acting)
Onset?
Peak?
Duration?

A

Onset: 10-15min
Peak: 1 hour
Duration: 2-4hrs

46
Q

Novolog (Rapid Acting)
Onset?
Peak?
Duration?

A

Onset: 5-15min
Peak: 40-50min
Duration: 2-4hrs

47
Q

Apidra (Rapid acting)
Onset?
Peak?
Duration?

A

Onset: 5-15min
Peak: 30-60min
Duration: 2hrs

48
Q

Humalog R, Novolin R (short acting)
Onset?
Peak?
Duration?

A

Onset: 1.5 hours
Peak: 2-3hrs
Duration: 4-6 hrs

49
Q

NPH (intermediate acting)
Onset?
Peak?
Duration?

A

Onset: 2-4hrs
Peak: 4-12hrs
Duration: 16-20 hrs

50
Q

Humulin N, Iletin Lente, Novolin N (intermediate acting)
Onset?
Peak?
Duration?

A

Onset: 3-4 hrs
Peak: 4-12hrs
Duration: 16-20 hrs

51
Q

Lantus and levemir (long acting)
Onset?
Peak?
Duration?

A

Onset: 1hr
Peak: Continuous, no peak
Duration: 24hrs

52
Q

What is diabetic neuropathy?

A

A group of diseases that affect all types of nerves, including peripheral, autonomic, and spinal nerves.

53
Q

The speed of absorption of insulin is greatest in

A

The abdomen, And decreases progressively in the arm, thigh, and hip

54
Q

Insulin should not be injected into the limb that will be exercised because that will cause

A

The drug to be absorbed faster which may result in hypoglycemia

55
Q

Insulin should not be stored in

A

Freezing temperatures or be kept in direct sunlight or in a hot car

56
Q

Cloudy insulin should be thoroughly mixed by

A

Gently inverting the vial or rolling it b/w the hands

57
Q

Intermediate acting insulin should be inspected for

A

Flocculation ( frosted, whitish coating inside the bottle)

58
Q

The major electrolyte concern during DKA is

A

Potassium

59
Q

What type of insulin is the only insulin approved for IV use

A

Regular insulin

Fundamentals of Nursing (12 decks)

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