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MK REVIEW > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Define Diabetes

A

When your body cannot metabolize glucose.

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2
Q

Define Diabetes Insipidous

A

Polyuria, Polydipsia, leading to dehydration to low ADH. Looks a lot like DM without the glucose.

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3
Q

Define SIADH

A

Opposite of Diabetes insipidous -

  • Oliguria
  • Retain water
  • No urine output
  • Urine decreases and specific gravity increases.
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4
Q

List 3 other names for Type 1 Diabetes

A
  1. Insulin Dependent
  2. Juvenile Diabetes
  3. Ketosis Prone
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5
Q

List 3 other names for Type 2 Diabetes

A
  1. Non-insulin Dependent
  2. Adult Onset
  3. Non-Ketosis Prone
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6
Q

What are the signs and symptoms of both T1 and T2 diabetes

A
  1. Polyuria
  2. Polydipsia
  3. Polyphagia (in diabetes this means eating not swallowing)
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7
Q

How do you Treat T1 Diabetes? (DIE)

A

Diet ( least important)
Insulin ( most important)
Exercise

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8
Q

How do you Treat T2 Diabetes? (DOA)

A

Diet ( most important)
Oral hypoglycemia
Activity

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9
Q

What type of diet restriction is the T2 Diabetic on?

A

Calorie restricted.

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10
Q

How many small feedings should a T2 diabetics eat per day?

A

6 small feeding per day within the restricted caloric allowance. This is to prevent big peaks achieving more more level glucose levels. Therefore, blood glucose is going to stay more normal glycemic.

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11
Q

If you have a T2 Diabetic What is the BEST dietary action take?

a) Restrict calories to appropriate amount per day 1600 cal.
b) Divide food into 6 feedings per day.

A

a) Restrict calories to appropriate amount per day 1600 cal.

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12
Q

Insulin acts to lower your ______ _______.

A

Blood Glucose

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13
Q

List/Describe the various types of insulin including onset, peak , duration etc…

A

Regular Insulin “R”

  • Regular
  • Onset: 1 hrs
  • Peak: 2hrs
  • Durations: 3hrs
  • Clear = solution therefore can be given I.V. drip.
  • Short rapid acting insulin

NPH Insulin “N”

  • Intermediate acting insulin
  • Onset: 6hrs
  • Peak: 8-10 hrs
  • Duration: 12 hrs
  • Cloudy = suspension, therefore no I.V. or you will overdose them and their brain will DIE! Never put anything cloudy in an I.V. bag.
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14
Q

R stands for ______ and _______?

N stands for ______ and _______?

A

Rapid (fast) and Run ( run i.v.)

Not so Fast ( intermediate) and Not I.V.

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15
Q

Describe the “ 1,2,4,6,8,10,12” acronym to remember “R” and “N” insulins.

A 
1 hr ONSET
2hr PEAK
4hr DURATION
6 hr ONSET
8-10hr PEAK
12hr DURATION
"R" = 1, 2, 4,
"N" = 6, 8, 10, 12
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16
Q

Only give “R” and “N” insulin at bedtime if….?

A

ACU check says to otherwise its not routine.

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17
Q

Hypoglycemia = ?

A

PEAK

18
Q

You give 30 units of “N” at 7am, when would you check for Hypoglycemia?

A

3pm-5pm when its due to PEAK 8-10hrs after administration.

19
Q

What is the onset, peak and duration for Humalog® (insulin lispro). When is the BEST time to administer?

A

Onset: 15min
Peak: 30min
Duration: 3hrs

Give WITH meals!

Fastest acting insulin.

20
Q

Describe Lantus/Glargine insulin

A
  • Long acting insulin
  • Slowly absorbed therefore no peaks.
  • Low risk for hypoglycemia therefore can give at bedtime.
  • Duration 12-24hrs
21
Q

What is the most important thing for the nurse to check on the insulin bottle?

A

Expiration date.

22
Q

What action by the nurse invalidates the manufacturers expiration date?

A

Opening the bottle

23
Q

How long is insulin good for after it has been open? and what must the nurse write on the bottle after it has been open?

A

30 days.
Write New expiration date 30 days after opening.
Write date of opening.

24
Q

When does the nurse refrigerate insulin?

A

Refrigeration is optional in an institution. However, the nurse must teach the Pt. to refriderate insulin at home.

In hospital, unopened viles should be in the fridge and once open write expiry date on the bottle and it no longer require refrigeration.

25
Q

Excercise potentiates insulin explain?

A

” And she exercised, and she got another shot of insulin.”

They more exercise a person gets the less insulin they require. The less a person exercises the more insulin they require.

26
Q

When a diabetic is sick their insulin will go______?

A

UP! So, they must take their insulin regardless if they are eating or not, because their glucose goes up being under the stress of illness.

27
Q

When sick a diabetic must take what?

A

sips of water because they get easily dehydated.

28
Q

Any diabetic thats sick has 2 problem what are they?

A
  1. Dehydration

2. Hypoglycemia - try and stay as active as possible b/c glucose goes up when sick,

29
Q

What are the 3 Acute Complications of Diabetes?

A

Low Blood Glucose in T1 or T2 diabetic. (aka: insulin shock, insulin reaction, hypoglycemic shock or hypoglycemic all means glucose is low)

Causes of Hypoglycemia

  • not enough food
  • Too much insulin ( primary cause =brain damage)
  • Too much excercise
30
Q

What is the primary cause of Hypoglycemia?

A

Too much insulin= primary cause =brain damage can destroy their life.

31
Q

What are the signs and symptoms of Hypoglycemia coma?

A

” Drunk and In Shock”

DRUNK

  • staggering gait
  • slurred speech
  • impaired judgement
  • delayed reaction
  • Labile
  • Obnoxious and belligerent

SHOCK

  • Decreased BP
  • Tachycardia
  • Tachyhepnia
  • Skin- cold, pale, clammy
  • Mottled, patchy, extremities.

Therefore for hypoglycemia SATA questions pick drunk and shock answers.

32
Q

Treatment for Hypoglycemia includes?

A

Administration of Rapidly Metabolizable Carbohydrates
i.e sugars. Juice, Regular Pop, Chewed up candy, milk, Honey, Jam, icing.

The ideal combination of foods is 1 sugar with 1 starch or 1 protein.

  • O.J. and crackers
  • Apple juice and Slice of Turkey
  • Skim milk = sugar and protien
33
Q

What do you give a hypoglycemic Pt. thats unconscious?

A

Glucagon I.M. ( if at home) or Dextrose I.V. ( if in hospital)

34
Q

Define Diabetic Keto acidosis (DKA)

A

1 cause of DKA is Acute Viral Respiratory infection within the last 2 weeks. After Pt. recovers initially in 3-5 days from virus, but then start going down hill fast and develop DKA and become lethargic.

Only T1 get DKA

To much food, To much medication, To much exercise are all causes of increased glucose - DKA

Remember if the Pt. has DKA symptoms always ask if they have had a viral infection in the last 2 weeks, the stress of the illness can cause the glucose to increase therefore they burn fats for fuel and get into a negative situation.

35
Q

Signs and Symptoms of DKA

A

Dehydration
Ketones in blood, Kaussmauls, K+ increase.
Acidotic, Acetone (fruit breath), Anorexia.

36
Q

Treatment for DKA includes?

A

Tx. for dehydration and increased sugars includes:

  1. Hydrate - give fast rate I.V. fluids 200 ml/hr with regular insulin and D5 or NS.
  2. Tx. Low blood glucose T1 is same as T2
  3. High blood glucose in T2 AKA: HHNK = DEHYDRATION.
    whenever you see Hyperosmolar, Hyperglycemic, Non-Ketotic THINK T2 and DEHYDRATION.
    - Skin low H20, hot flush, Dry
    - FVD # 1 diagnoses
    - Fluid replacement # Tx
37
Q

Which one out of DKA and HHNK is insulin most important?

A

DKA

38
Q

Which one out of DKA and HHNK is more life threatening

A

HHNK - but DKA is higher priority in a ER b/c DKA shows signs and symptoms quick where as HHNK shows signs often when its to late.

39
Q

What are the long term complications of DKA?

A
  1. Poor tissue perfusion

2. Peripheral Nephropathy

40
Q

Which lab test is the best indicator of long term glucose control?

A

Hemoglobin HAIC - Glycosatin hemoglobin.

41
Q

What #’s do you want to see in a Hemoglobin HAIC teat?

A

Below 6 = in control
Above 8 = out of control
7 = on the boarder - need a wrk up, assessment, may have an infection.

MK REVIEW (16 decks)

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