Diabetes Flashcards
What is Diabetes Mellitus?
Insulin deficiency in the action or secretion
What are the gerontologic considerations?
- Changes in carb metabolism
- poor diet
- decreased activity
- decreased lean body mass
- altered insulin secretion
- increased fat tissue
What are the non modifiable risk factors for DM? (4)
- Age
- Ethnicity
- Familiar Hx
- Sex
Is DM more common in men or women? What about post menaposaul?
Men, and then more prevalent in women post menapause
What are the modifiable risk factors? (5)
- Diet
- Activity
- Smoking
- HTN
- Inflmm / Hypercoagulation
What are some diet changes that could be made?
Decrease lipids / sugars
The complications of DM can be Macro or Micro vascular.. define what each term means.
Macrovascular: affects large vessels, impeedes blood flow and perfusion
Microvascular: effects same vells
What are some examples of macrovascular complications of DM? (4)
- Stroke
- Heart disease / HTN
- Peripheral vascular disease
- Ulcers / amputation
What are some examples of microvascular complications? (3)
- Diabetic eye disease
- Renal disease (small vessels are affected in the kidney)
- Neuropathy
The neuropathy problems lead to a ____deficit
Neurodeficit
Which are more specific to the diabetic patient, macro or microvascular issues? What are they based on?
The microvascular: based on the basement membrane thinking (caused by the altered metabolism and deposition of glycolysated proteins on the endothelium –> impedes blood/oxygen flow
How does diabetes affect the cardiovascular system?
Vacular damage is caused by the altered metabolism and accumulation of lipid / protein metabolites in the blood.
- Glycolysated proteins deposit on the endothelium, imparing exchange
- Blood flow / perfusion impeded d/t platelet aggregation
Why are limb amputations and ulcers common in the DM population?
Due to the neurodeficit, patients are unable to feel foot pain
Why does retinopathy occur in a patient with DM?
Hyperglycemia –> damaged tiny blood vessels that nourish the retina –> aneurysms/rupturing or occluding –> visual impairment
What can a nurse do to help a patient with their retionapthy?
Encourage yearly eye exam and maintain blood glucose levels
How does the nephropathy occur to a patient with DM?
Prolonged damage to the kidneys (hyperglycemia –> exceeding renal threshhold…)
What can a nurse do to help with a patients nephropathy? (3)
- Monitor hydration / kidney fx.
- Report if hourly ouptut less than 30 ml/ hr
- monitor BP
What are a few of the other complications that can be caused by DM? (6)
- Skin infections
- Digestive problems (d/t altered metabolism)
- Thyroid problems
- Sexual dysfunction in men
- UTI / vaginal infections
- Carpal Tunnel syndrome
What are the S/S of hyperglycemia? (7)
- BG >7 mmol/L
- Polyuria
- Polyphagia
- Polydipsia
- Glucosuria
- Wt loss
- Fatigue
What are two ways that a diabetic can improve their helath after they have been properly identified as they are allowed to? (2)
- Exercise
2. Improve diet
What are the diagnostic tests involved in Diagnosing DM (7)
- BG (normal =3.9-11 mmol/L)
- FBG
- GTT
- HbAIC
- Cholesterol
- Urine
- Ketones
What is the pharmacological Therapy for DM?
Watch the vid!
Why is education an important aspect of a patient living with DM?
Because the complications are serious and can be relatively avoided if the patient controls blood glucose levels properly
BG self monitoring:
- What can this prevent?
- What is it dependant on?
- When do errors occur?
- What is important when teaching this?
- Hyper/hypoglycemia
- Skill level, cognitive ability, visual acuity, technology, comfort, cost
- Blood ammount too small, improper maintenance of machine, damaged monitor strips
- Evaluation: ensure the patient fully understands!
