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NCLEX > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Causes of type one

A

Auto-immune, idiopathic

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2
Q

What is usually the first sign of type one?

A

DKA

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3
Q

When you breakdown fats, you get what?

A

Ketones

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4
Q

Polyuria, think what?

A

Shock

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5
Q

How is type two discovered?

A

By accident when the client comes in for a wound that won’t heal or repeated vaginal infections. Not as abrupt as type one

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6
Q

Metabolic syndrome/Syndrome X

A 
Insulin resistance
Abdominal obesity (>40 in for male, >35 for female)
Increased BP and triglycerides
Decreased HDL
CAD
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7
Q

Who should you evaluate for metabolic syndrome?

A

Type two

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8
Q

Tx for type two

A

First-diet and exercise
Second-oral meds
Third-insulin

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9
Q

Gestational diabetes

A

Resembles type two
Needs 2-3x more insulin than normal
Screen moms at 24-28 weeks
Screen at first visit if risk factors

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10
Q

Complications to the baby of gestational diabetes

A

Increased birth weight and hypoglycemia

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11
Q

Majority of calories should come from what?

A

Complex carbs, then fats, then protein

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12
Q

Daily protein for diabetics

A

10-20%

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13
Q

Diabetics tend to have what?

A

Renal dz

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14
Q

Why are diabetics prone to CAD?

A

Sugar destroys vessels just like fat

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15
Q

Fiber for diabetics

A

High fiber diet, keeps BS steady, they might have to decrease insulin
High fiber slows down glucose absorption in the intestines, eliminating the sharp rise/fall in BS

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16
Q

When do you exercise?

A

When BS normalizes, eat first, exercise when BS is at the highest and at the same time/amount daily

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17
Q

How do oral hypoglycemic agents work?

A

Stimulate the pancreas to make insulin or work to decrease the amount of circulating glucose

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18
Q

Oral diabetic meds

A

Glipizide, Metformin, Pioglitazone, Sitagliptin

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19
Q

What is the average dose of adult insulin?

A

0.4-1.0 units/kg/day

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20
Q

When is the insulin dose adjusted until?

A

BS is normal, no more glucose and ketones in urine

21
Q

Regular insulin

A

Clear, standard insulin given IV, onset 30 min

22
Q

NPH insulin

A

Cloudy, intermediate acting onset 1.5 hours, peak 4-12, duration 16-24
-novulin N, humulin N

23
Q

Lantus

A

Clear insulin, long acting, can’t mix, given once a day, no peak, popular since there is no fluctuation of BS
Onset 2-4 hours, duration 24

24
Q

Most common method of daily dosing insulin

A

Vasobolus

25
Q

Rapid acting insulin

A

Never give without food, given throughout the day before meals, covers the food eaten at meals
-Novalog

26
Q

Are snack required with basal.bolus insulin dosing?

A

No, but clients still must eat when dosing with rapid acting, so have food available

27
Q

When should clients eat with insulin?

A

When it’s at its peak

28
Q

When insulin is at its peak, the BS is what?

A

The lowest

29
Q

Will you see metabolic acidosis/DKA with type two?

A

No, they make enough insulin to keep from breaking down fats for energy

30
Q

HbA1c

A

Gives an average of BS over past 3 months

31
Q

What should diabetics’ HbA1c be?

A

4-6% or less

32
Q

Diagnostic HbA1c level for diabetes

A

6.5-7%

33
Q

What does BS do when you’re sick or stressed?

A

Increase, normal action to help you fight the illness, normal pancreas can handle these fluctuations

34
Q

Illness, think what?

A

DKA

35
Q

Insulin infusion pumps

A

Alternative to daily injections, only rapid acting, better control of BS by getting a basal (continuous) level of insulin and boluses as needed with meals or if they have an increase in BS

36
Q

What is the only insulin that can be given in IV fluids as an IV infusion?

A

Regular

37
Q

What is the only insulin given as a subq infusion pump?

A

Rapid acting

38
Q

S/S of hypoglycemia

A 
Cold/clammy
HA
Shaky
Nervous
Nausea
Increased HR
Confused
39
Q

What should the hypoglycemic pt do?

A

Drink or eat a simple sugar, once BS is up, eat a meal

40
Q

Glucose absorption is delayed in what foods?

A

Fats

41
Q

How to treat a passed out client with hypoglycemia

A

D50W (hard to push, use large bore IV)
Injectable glucagon-used when there is not IV access, it’s IM
Put sugar under their tongue

42
Q

Food choices for hypoglycemia

A

4-6 oz of orange juice, apply juice, coke, milk, raisins, NOT chocolate or cookies

43
Q

S/S of DKA

A

Polyuria, polydipsia, polyphagia
Fat breakdown leads to acidosis
Kussmaul’s respirations to blow off CO2 to compensate for metabolic acidosis
As the pt becomes more acidotic, the LOC goes down

44
Q

Treatment of DKA

A

Hourly BS and K
IV insulin
ECG
Hourly outputs (polyuria causes shock)
ABGs
IVFs-start with NS, then when BS is about 300 switch to D5W to prevent throwing them into hypoglycemia
Doc will want to add K to their solution at some point

45
Q

Hyperosmolar Hyperglycemic Nonketosis (HHNK)

A

Happens only to type two
Looks like DKA, but no acidosis
Making just enough insulin to not break down body fat so no ketones or acidosis, no kussmaul’s

46
Q

IV insulin causes what?

A

Hypoglycemia and hypokalemia

47
Q

Problems with neuropathy

A

Sexual problems: impotence/decreased sensation
Foot/leg pain/paresthesia/numbness
Neurogenic bladder: doesn’t empty properly, empties spontaneously, retention
Gastroparesis: stomach emptying is delayed, aspiration
Risk for infection
Nephropathy-end up on dialysis
Retinopathy-eyes are very vascular

48
Q

How should the diabetic cut their toenails?

A

Straight across

NCLEX (14 decks)

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