Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Care of Adult/Older Exam #3 (5701) > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Diabetes Mellitus is the leading cause of?

A
  • End-stage renal disease
  • Adult blindness
  • Nontraumatic lower limb amputations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diabetes is a major contributing factor for?

A
  • Heart disease (2-4x higher)

- Stroke (risk is 2-4x higer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Type 1 Diabetes Mellitus most often occurs in people what age?

A

younger than 40 years of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Classic symptoms of T1DM?

A
  • Polyuria (frequent urination)
  • Polydipsia (excessive thirst)
  • Polyphagia (excessive hunger)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Type 1 Diabetes Mellitus symptoms?

A
  • Rapid onset
  • Classic symptoms
    • Polyuria
    • Polydipsia)
    • Polyphagia
  • Weight loss
  • Weakness
  • Fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of Type 1

A

Insulin (REQUIRED)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type 2 Diabetes Mellitus Usually occurs in people what age?

A

over 35 years of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Risk Factors for Type 2 Diabetes Mellitus?

A
  • overweight
  • Family history
  • African American
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Major difference between type 1 & 2

A

Type 2: Pancreas continues to produce some endogenous insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Type 2 Diabetes Mellitus

A
  • Pancreas continues to produce some endogenous insulin

- Insulin produced is insufficient or is poorly utilized by tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hyperosmolar coma

A

caused by osmotic fluid/electrolyte loss from hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Symptoms of Type 2 Diabetes Mellitus?

A
  • Nonspecific symptoms
    • May have classic symptoms of type 1
  • Fatigue
  • Recurrent infection
  • Recurrent vaginal yeast or monilia infection
  • Prolonged wound healing
  • Visual changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diabetes Mellitus:Diagnostic Studies?

A
  • AIC ≥ 6.5%
  • Fasting plasma glucose level >126 mg/dL
  • Two-hour OGTT level ≥200 mg/dL when a glucose load of 75 g is used
  • Random or casual plasma glucose measurement ≥200 mg/dL plus symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diabetes Mellitus: Diagnostic Studies (Fasting plasma glucose level)

A

> 126 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diabetes Mellitus: Diagnostic Studies (Two-hour OGTT level)

A

≥200 mg/dL when a glucose load of 75 g is used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diabetes Mellitus: Diagnostic Studies (Random or casual plasma glucose measurement)

A

≥200 mg/dL plus symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

preferred method of diagnosis for Diabetes Mellitus?

A

The fasting plasma glucose (FPG) test, confirmed by repeat testing on another day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Prediabetes:

  • Fasting glucose levels
  • 2-Hour plasma glucose levels
  • AIC is in range of
A
  • 100 to 125 mg/dL
  • between 140 and 199 mg/dL
  • 5.7% to 6.4%.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Prediabetes:

1) symptoms
2) Teaching

A

1) Long-term damage already occurring
- Heart, blood vessels
- Usually present with no symptoms
2) diet, exercise, weight loss, and patient to watch for classic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Gestational Diabetes detected?

A

at 24 - 28 weeks of gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risk factors for Gestational Diabetes detected?

A
  • Obese
  • Advanced maternal age
  • Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When does Gestational Diabetes glucose levels usually return to normal?

A

6 weeks post partum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Therapy for Gestational Diabetes?

A

First nutritional, second insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Causes of Secondary Diabetes?

A
  • Cushings syndrome
  • Hyperthyroidism
  • Pancreatitis
  • Parenteral nutrition
  • Long term steroid treatments
  • Cystic fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Therapy for Secondary Diabetes?

A
  • Usually resolves when underlying condition is treated

- Usually treated with sliding scale insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Nutritional Therapy for diabetes (carbohydrates)?

A
  • Minimum of 130 g/day
  • Fruits, vegetables, whole grains, legumes, low-fat dairy
  • All benefit from including dietary fiber
  • Nutritive and nonnutritive sweeteners may be used in moderation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Nutritional Therapy for diabetes (Protein)?

A
  • Should make up 15% to 20% of total calories

- High-protein diets not recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Nutritional Therapy for diabetes (Alcohol)?

A
  • 1 drink/day for women; 2 drinks/day for men
  • Inhibits gluconeogenesis by liver and can cause severe hypoglycemia
  • Blood glucose levels must be monitored
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Nutritional Therapy for diabetes (Fats)?

A
  • Limit saturated fats to < 7% of total calories
  • Limit cholesterol to < 200 mg/day
  • Minimize trans fat
  • Healthy fats come from plants (Olives, nuts, avocados)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Amount of carbs per meal for a diabetic patient?

A

45-60g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Patient Teaching for a diabetic?

A
  • Insulin
    • Self-monitoring of blood glucose
    • Prep & admin
  • Exercise
    • At least 150 minutes/week aerobic
    • Strength training 2 days/week
  • Avoid Alcohol
  • Hygiene
  • Avoid Stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Exercise ________ insulin receptor sites and ________ blood glucose levels?

A
  • increases
  • lowers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Rapid-acting (bolus) insulin

A

Lispro, aspart, glulisine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Lispro

A
  • Rapid-acting (bolus) insulin
  • onset of action 15 minutes
  • Injected 0 to 15 minutes before meal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

aspart

A
  • Rapid-acting (bolus) insulin
  • onset of action 15 minutes
  • Injected 0 to 15 minutes before meal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

glulisine

A
  • Rapid-acting (bolus) insulin
  • onset of action 15 minutes
  • Injected 0 to 15 minutes before meal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Short-acting (bolus) Insulin

A

Regular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Regular insulin onset and time given?

A
  • Short-acting (bolus)
  • Injected 30 to 45 minutes before meal
  • Onset of action 30 to 60 minutes
39
Q

Intermediate Insulin?

A

NPH

40
Q

NPH

A
  • Intermediate insulin
  • Injected twice daily
  • 24 H coverage
  • cloudy, needs to be agitated (not shaken)
  • Must adhere to meal plan
41
Q

Long-acting Insulin?

A

Lantus, Glargine

42
Q

Lantus

A
  • Injected once a day at bedtime or in the morning
  • Released steadily and continuously
  • No peak action
  • Cannot be mixed with any other insulin or solution
43
Q

Glargine

A
  • Injected once a day at bedtime or in the morning
  • Released steadily and continuously
  • No peak action
  • Cannot be mixed with any other insulin or solution
44
Q

Administration of Insulin

A
  • Fastest absorption from abdomen, followed by arm, thigh, and buttock
  • Rotate injections
45
Q

Preferred site of injection for insulin?

A

abdomen

46
Q

Complications from Insulin Therapy?

A
  • Hypoglycemia
  • Allergic reaction
  • Infection at insertion site
  • Lipodystrophy-atrophy of sub q tissue
  • Somogyi effect-hypoglycemia
  • Dawn phenomenon
47
Q

Somogyi effect-hypoglycemia info?

A
  • 02-04am
  • May sleep through it
  • Provide HS snack, decrease insulin dose
48
Q

Dawn phenomenon-

A
  • hyperglycemia upon awakening
  • Have headache, night sweats, nightmares
  • Assess HS, BS and BS at 02-04am
  • Increase insulin dose or adjust times
49
Q

Inhaled Insulin?

A

Afrezza

50
Q

Afrezza

A
  • Rapid-acting inhaled insulin
  • Administered at beginning of each meal or within 20 minutes after starting a meal
  • Not a substitute for long-acting insulin
51
Q

Type 2 Oral Medications

A
  • Sulfonylureas (Amaryl)
  • Meglitinides (Prandin)
  • Biguanides (Metformin)
  • α-Glucosidase inhibitors (Precose)
  • Thiazolidinediones (Actos)
52
Q

Sulfonylureas

A
  • Glucotrol,
  • Glucotrol XL
  • glyburide (Micronase, DiaBeta, Glynase)
  • glimepiride (Amaryl).
53
Q

Meglitinides

A
  • repaglinide (Prandin)

- nateglinide (Starlix).

54
Q

Sulfonylureas and Meglitinides receptor sites are located?

A

pancreas

55
Q

biguanides and thiazolidinediones receptor sites are located?

A

adipose tissue and muscle

56
Q

Sulfonylureas and Meglitinides action?

A

increases insulin production

57
Q

biguanides and thiazolidinediones action in adipose tissue and muscle?

A 
Adipose tissue and muscle:
  - increases insulin uptake
  - decreases insulin resistance
Liver:
  - decreases glucose production
58
Q

α-Glucosidase inhibitors (Precose) action ?

A

delays absorption of starches in the stomach and small instestines

59
Q

DDP-4 Inhibitor action?

A
  • increases activity of incretins in the small intestine and stomach
  • decreases hepatic glucose production
60
Q

GLP-1 and amylin action?

A

decreases gastric emptying in the stomach and small intestine

61
Q

Complications-S/S of Hyperglycemia?

A
  • Increased urination
  • Increased appetite followed by lack of appetite
  • Weakness, fatigue
  • Blurred vision
  • Headache
  • N/V
  • May progress to DKA
62
Q

Complications-S/S of Hypoglycemia?

A
  • BG < 60 or 70 (varies)
  • Cold, Clammy skin
  • Numbness
  • Tachycardia
  • Headache, Nervous
    Dizzy, Slurred speech, Lethargy
  • May be a asymptomatic
63
Q

Causes of hyperglycemia?

A
  • Infection
  • Steroids
  • Too much food
  • Not enough medication
  • Stress
64
Q

Causes of hypoglycemia?

A
  • Alcohol
  • Not enough food
  • Too much exercise
  • Too much medication
  • Weight loss
65
Q

Tx of hyperglycemia?

A
  • Medication
  • Check BG frequently
  • Drink fluids
66
Q

Tx of hypoglycemia if alert and can swallow?

A
  • “Rule of 15”
  • Give 15-20 g of simple carb (juice followed by bread/crackers/peanut butter)
  • Recheck blood sugar 15 minutes after treatment
  • Repeat until blood sugar >70 mg/dL.
  • Patient should eat regularly scheduled meal/snack to prevent rebound hypoglycemia
  • Check blood sugar again 45 minutes after treatment
67
Q

Tx of hypoglycemia not alert enough to swallow (non-acute setting)?

A
  • Administer 1 mg of glucagon IM or subcutaneously
  • Side effect: Rebound hypoglycemia
  • Have patient ingest a complex carbohydrate after recovery (starchy veg, whole grain bread)
68
Q

Tx of hypoglycemia not alert enough to swallow (acute setting)?

A
  • 20 to 50 mL of 50% dextrose IV push

- Followed by a continuous infusion D5W

69
Q

Diabetic Ketoacidosis and Diabetic Coma are characterized by?

A
  • Hyperglycemia
  • Ketosis
  • Acidosis
  • Dehydration
  • mostly occurs in type 1
70
Q

Causes of DKA

A
  • Severe illness
  • Stress
  • Infection
  • Deficient pancreas
  • Inadequate insulin
  • Undiagnosed Type 1
  • Poor self-management or neglect
71
Q

DKA S/S early symptoms?

A

lethargy/weakness

72
Q

DKA S/S ?

A
  • Dehydration
  • Abdominal pain
  • Kussmaul respirations
73
Q

S/S of dehydration?

A
  • Poor skin turgor
  • Dry mucous membranes
  • Tachycardia
  • Orthostatic hypotension
74
Q

S/S of Kussmaul respirations?

A
  • Rapid deep breathing
  • Attempt to reverse metabolic acidosis
  • Sweet fruity odor
75
Q

DKA diagnostic results?

1) glucose
2) pH
3) HCO3
4) Ketones

A

1) > 250mg/dL
2) < 7.3
3) < 15 mEg/L
4) Moderate to large in urine

76
Q

DKA Complications

A
  • Renal failure
  • Comatose
  • Dehydration
  • Electrolyte imbalance
  • Acidosis
  • Death
77
Q

DKA Treatment?

A
  • Manage Airway
  • Correct fluid/electrolyte imbalance
    • IV infusion
      • Restore urine output
      • Raise blood pressure
      • 5% dextrose added
      • Prevent hypoglycemia
    • Potassium replacement (know K level before starting insulin gtt)
    • Sodium bicarbonate
78
Q

DKA insulin Tx therapy?

A

begin with a bolus followed by a drip

79
Q

Life threatening condition cause by severe hyperglycemia, but has enough insulin to prevent DKA?

A

Hyperosmolar Hyperglycemic syndrome (HHS)

80
Q

Hyperosmolar Hyperglycemic syndrome (HHS)

A
  • Life threatening condition cause by severe hyperglycemia, but has enough insulin to prevent DKA
  • Occurs in pts > 65
81
Q

Causes of HHS?

A

UTI, pneumonia, sepsis, acute illness, newly diagnosed type 2

82
Q

High blood glucose in HHS can result in?

A

Seizures, hemiparesis, aphasia

83
Q

Symptoms of HHS

A

May be asymptomatic with elevated blood sugar

84
Q

What is need for a diagnosis of HHS?

A
  • blood glucose > 600mg/dL
  • increase serum osmolality
  • absent or minimal ketones in serum and urine
85
Q

HHS Treatment?

A
  • Similar to DKA
  • Manage Airway
  • Correct fluid/electrolyte imbalance
86
Q

How often should blood glucose be monitored?

A

hourly

87
Q

Interventions for patients at home following acute illness, injury or surgery?

A
  • heck blood glucose every 4 hours
  • Report BG >300mg/dL x2
  • Continue to eat, increase non-caloric fluids
  • If unable to eat increase carb containing fluids
  • Continue to take insulin or oral medications
  • Notify MD if unable to keep food/fluids down
88
Q

Interventions for the hospitalized patient

following acute illness, injury or surgery?

A
  • IVF
  • IV insulin
  • Frequent blood glucose monitoring
  • If patient is unconscious monitor for sweating, tachycardia, tremors
89
Q

Chronic Complications of diabetes?

A
  • Cardiovascular disease
  • PAD
  • Diabetic retinopathy
  • Diabetic nephropathy
  • Diabetic neuropathy
  • infection
90
Q

T1DM pts should have dilated exam within _____ of onset and repeated _____?

A
  • 5 y/o

- annually

91
Q

What is the leading cause of ESRF?

A

diabetic nephropathy

92
Q

usually appears as red-yellow lesions, with atrophic skin that becomes shiny and transparent, revealing tiny blood vessels under the surface?

A

Necrobiosis Lipidoidica Diabeticorum

93
Q

High incidence of diabetes in what population?

A
  • Hispanics
  • American Indians
  • African Americans
  • Asians and Pacific Islanders

Care of Adult/Older Exam #3 (5701) (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions