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Nurs 270 > Diabetes Care Plan > Flashcards

Diabetes Care Plan Flashcards

1
Q

In hospital blood glucose target range

A

5-10 mmol/L

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2
Q

If clinicians fail to recognize adn treat hyperglycemia appropriately patients with diabetes are at risk for

A

-delayed wound healing
-surgical site infections
-hospital acquired infections
-mortality

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3
Q

1 in 5 patients in hospital have diabetes, what is the percentage of type 1 vs type 2

A

Type 2 - 90%

Type 1 - 10%

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4
Q

Hyperglycemia is defined as

A

Blood glucose levels above 10 mmol/L

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5
Q

What is BBIT

A

B- basal insulin
B- bonus insulin
I- insulin correction
T- titrate

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6
Q

Basal insulin

A

Covers the glucose, the liver makes around the clock

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7
Q

Bonus insulin

A

Covers the meal time carbohydrates

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8
Q

Insulin correction

A

Corrects the patients BG back into target range if it is high

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9
Q

Titrate

A

Every patient is different, the BG needs to be checked regularly and insulin doses adjusted every 1-3 days

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10
Q

Pancreas in normal physiology

A

Produces enzymes that digests fats, proteins, and carbohydrates in the food that is consumed

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11
Q

Pancreas endocrine function

A

Produces hormone: insulin (beta cells) and glucagon (alpha cells)

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12
Q

Beta cells

A

Sense glucose levels in the blood when BG rises
-secret insulin and inhibit glucagon

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13
Q

Alpha cells

A

Detect when BG is low
-insulin is inhibited, glucagon is secreted

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14
Q

Insulin

A

Helps cells in our body to take up glucose to be used for energy, or store excess glucose in form of glycogen

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15
Q

Glucagon

A

Increases amount of glucose in bloodstream
-stimulates liver to produce glucose
-breakdown of glycogen into glucose

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16
Q

Type 1 diabetes mellitus is caused by

A

Caused by destruction of insulin producing beta cells, from autoimmune process

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17
Q

Type 1 DM pancreas

A

Produces very little or no insulin since beta cells are destroyed
-so blood glucose rises

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18
Q

What happens in type 1 DM when body cannot break down glucose as an energy source?

A

The body breaks down fat, and produces ketones which are very acidic

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19
Q

High levels of ketones can lead to

A

Diabetic ketoacidosis

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20
Q

What do people with T1DM need to survive

A

-basal bonus insulin regimen

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21
Q

People with T1DM tend to be less

A

Insulin resistant

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22
Q

People with T1DM have a higher risk of

A

Developing severe hypoglycaemia

-where beta cells no longer work in conjunction with alpha cells that produce glucagon

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23
Q

Symptoms of hyperglycemia in T1DM

A

-fatigue
-frequent urination
-dehydration
-thirst
-weight loss despite hunger

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24
Q

T2DM is a

A

Progressive chronic disease

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25
Q

T2DM pancreas

A

The pancreas produces some insulin, but cells in the body fail tor respond to the insulin properly
-insulin resistance

26
Q

T2DM insulin resistance

A

Pancreas often cannot produce enough insulin to overcome this resistance without treatment

27
Q

T2DM have a lower risk of

A

Severe hypoglycaemia
-since the pancreas is still able to make glucagon

28
Q

What is different from T1DM hyperglycemia and T2DM hyperglycemia

A

Many people may be asymptomatic

29
Q

Initially when diagnosed with T2DM what is an important part of treatment?

A

Diet and exercise

30
Q

Basal insulin

A

Serves to suppress glucose and ketone production in periods of fasting
-relatively constant

31
Q

Basal insulin is produced by

A

Liver and to a lesser extent the kidneys

32
Q

Bolus insulin

A

After meals, insulin levels rise above the basal level in response to the increase in blood glucose from ingested and absorbed carbohydrate

33
Q

What is the 50/50 rule

A

Basal insulin accounts for about 50% of the total daily insulin secretion and remaining 50% is secreted as bolus insulin

34
Q

How often is basal insulin ordered to cover needs, and how long does the insulin act

A

Once or twice daily, and is a long/intermediate acting insulin

35
Q

Patients with __

A

May require basal insulin

36
Q

Bolus meal insulin length of action and when is it given

A

-short acting insulin
-given prior to meals

37
Q

Correction insulin length, and when is it given

A

-rapid, short acting insulin

-given to correct unanticipated hyperglycemia

38
Q

Correction insulin ensures

A

High glucose values are not left untreated

39
Q

Goal of basal

A

Replace the background insulin the body naturally makes with basal long acting insulin

40
Q

Goal of bolus

A

To replace natural mealtime insulin with bolus short acting insulin to cover carb intake

41
Q

Rapid acting insulin analogues (2)

A

Aspart and lisp r o

42
Q

Onset of aspart/lispro

A

Aspart - 10 to 15min

Lispro - 10 to 15min

43
Q

Peak of aspart and lispro

A

Aspart - 1 to 1.5h

Lispro - 1 to 2h

44
Q

Duration of aspart and lispro

A

Aspart - 3 to 5h

Lispro - 3.5 to 4.75h

45
Q

Short acting bolus insulin (1)

A

Regular

46
Q

Onset of regular

A

30min

47
Q

Peak of regular

A

2 to 3h

48
Q

Duration of regular

A

6.5h

49
Q

Basal intermediate acting insulin (1)

A

NPH

50
Q

Onset of NPH

A

1 to 3h

51
Q

Peak of NPH

A

5 to 8h

52
Q

Duration of NPH

A

Up to 18h

53
Q

Long lasting basal insulin (2)

A

Detemir and glargine

54
Q

Onset of detemir and glargine

A

Detemir - 90min

Glargine - 90min

55
Q

Peak of detemir and glargine

A

Detemir - not applicable

Glargine - not applicable

56
Q

Duration of detemir and glargine

A

Detemir - 16 to 24h

Glargine - 24h

57
Q

What color are long acting basal insulin

A

Clear

58
Q

What color is Intermediate acting insulin

A

Cloudy

59
Q

What color is bolus rapid acting insulin

A

Clear

60
Q

What color is Bolus short acting insulin

A

Clear

61
Q

Bolus can be

A

Rapid acting or short acting

62
Q

Basal can be

A

Intermediate acting or long acting

Nurs 270 (24 decks)

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