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Assessment & Diagnosis Final > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Is smoking a risk factor for diabetes?

A

Yes

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2
Q

Is DKA more common in type I or type II DM?

A

Type I

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3
Q

Is HHS more common in type I or type II DM?

A

Type II

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4
Q

What is the patho of type I?

A

B cell destruction leading to absolute insulin deficiency

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5
Q

What is patho of type II?

A

Insulin resistance

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6
Q

A1c above what is diagnostic for diabetes?

A

6.5% or above

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7
Q

Fasting FSBG above what is diagnostic for diabetes?

A

Above 126

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8
Q

Random FSBG above what is diagnostic for diabates?

A

Above 200

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9
Q

Prediabetes is what A1c?

A

5.7-6.4

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10
Q

Fasting FSBG of what indicates prediabetes?

A

100-124

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11
Q

FSBG above what at 2 hours postprandial is diagnostic for diabetes?

A

Above 200

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12
Q

A1c can be falsely high in what pt?

A

Anemic pts

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13
Q

What is average age of onset of DMII?

A

Above age 40

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14
Q

Blood sugar tends to be higher on presentation in DMI or II?

A

DMI

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15
Q

DMII patients typically gain or lose weight?

A

Gain

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16
Q

DMI or DMII can present asymptomatic?

A

DMII

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17
Q

How does diabetes cause dehydration?

A

Osmotic diuresis

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18
Q

Diabetes can cause what kind of shock?

A

Hypovolemic shock

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19
Q

Blood pressure should be maintained below what in outpt DM?

A

Below 130/80

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20
Q

What is A1c goal in DM overall?

A

Below 7%

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21
Q

What is A1c goal in younger, healthier pts?

A

6-6.5

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22
Q

How is blood sugar generally controlled inpatient?

A

With insulin, not oral agents

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23
Q

What is the A1c goal for older pts?

A

7.5-8

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24
Q

What three things should blood sugar control be based on?

A

Basal needs, prandial (nutritional) needs, correctional needs (for elevated BS)

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25
Q

What are the three main types of insulin?

A

Long acting, regular and fast acting

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26
Q

Does insulin differ in how much or how rapidly it reduces BS?

A

How fast (they all reduce BS by the same amount if given in the same dose)

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27
Q

When should you check BS when giving insulin?

A

Before pt eats

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28
Q

ICU critically ill pt should have BS between what?

A

140-180

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29
Q

What is non ICU target BS?

A

140-180

30
Q

Does a DMI pt always need basal insulin?

A

Yes

31
Q

Should NPO pt get basal insulin?

A

Yes

32
Q

Should NPO pt get nutritional insulin?

A

No

33
Q

Should diabetic pts get oral agents while in the hospital?

A

No

34
Q

If pt diet controlled at home, what kind of insulin should you write for?

A

Correctional insulin

35
Q

Should a pt who is diet controlled at home be started on basal insulin?

A

No, unless their BS is not controlled with correctional insulin

36
Q

If you are on an insulin drip should you also be on dextrose?

A

Yes

37
Q

Should a pt be NPO while on an insulin drip?

A

Yes

38
Q

Does a type I diabetic always need basal insulin?

A

Yes

39
Q

What is a normal a1C?

A

Less than 5.7%

40
Q

What happens to volume status in DM?

A

You can have osmotic diuresis which leads to dehydration/shock

41
Q

Can you ever have a Type I diabetic not on insulin?

A

No

42
Q

Can Type I diabetic have insulin held if they are NPO?

A

No

43
Q

Is insulin or oral agents safer while hospitalized?

A

Insulin is safer

44
Q

What three types of insulin should an inpatient be on?

A

Basal, nutritional, correctional

45
Q

How long before a meal is aspart given?

A

10 mins

46
Q

How long before a meal is regular insulin givem?

A

30 mins

47
Q

At what time of day is NPH given?

A

Morning and night

48
Q

How often is glargine given?

A

Once daily

49
Q

Should NPH or glargine be given timed with meals?

A

No

50
Q

Should sliding scale ever be used alone?

A

No

51
Q

When starting a pt on insulin what type should you add first?

A

Correctional insulin

52
Q

Should Type I diabetic always have basal insulin?

A

Yes

53
Q

Does basal dose of insulin take into account how much a pt is eating?

A

No

54
Q

Basal insulin accounts for what % of daily insulin requirement?

A

50%

55
Q

What is the nutritional dose of insulin based on?

A

Amount of carbs patient is eating

56
Q

If a pt is diet controlled at home, what type of insulin do you start with and based on what?

A

Correctional insulin based on BMI

57
Q

If pt is diet controlled at home and on correctional insulin already but has pre-meal FSBG of above 150, what do you add and what do you base this on?

A

Nutritional insulin based on carb counting

58
Q

If pt is diet controlled at home and on correctional insulin in hospital but has random FSBG above 150, what should you do?

A

Add basal insulin at 0.1 units/kg

59
Q

If pt is on basal dose of insulin at home and well-controlled, what percent should you decrease by when they are hospitalized?

A

70-80%

60
Q

A pt on insulin at home should have nutritional insulin (aspart) based on what?

A

Carb counting or appetite

61
Q

What should you do with NPH basal insulin if pt NPO?

A

Give 1/2 dose

62
Q

What should you do with basal lantus or glargine if pt NPO?

A

Can give full dose

63
Q

Should nutritional insulin be given if pt is NPO?

A

No

64
Q

How often and when to give correctional insulin if ptt NPO?

A

Q4 hours if BG > 150

65
Q

If you have a pt on an insulin drip, do they always need a source of dextrose?

A

Yes

66
Q

If dextrose is interrupted during insulin drip, how often should you check BS?

A

Q 30 mins

67
Q

Can a pt on an insulin drip eat?

A

No

68
Q

BS less than what in the hospital is considered hypoglycemic?

A

70

69
Q

If pt is hypoglycemic and NPO what should you do?

A

Give D50

70
Q

If pt is hypoglycemic and able to swallow/alert what should you do?

A

Give 15-20 grams of carbs

Assessment & Diagnosis Final (6 decks)

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