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Med Surg 1 > Diabetes Mellitus > Flashcards

Diabetes Mellitus Flashcards

1
Q

Type 1 DM

A

Sudden onset at young age, thin body habitus, DKA common, autoantibodies present, little to no endogenous insulin.

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2
Q

Type 2 DM

A

Gradual onset at adult age, often obese, DKA rare, HHNS common.

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3
Q

Type 1

A

Body does not make insulin/beta cells damaged, so glucose can not be transported into cells. Body will burn ketones/fats instead.

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4
Q

Type 2

A

Body is resistant to insulin. There is enough to prevent the burning of ketones, and has trouble metabolizing carbs.

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5
Q

Glucose

A

Stored in liver as glycogen, can only enter cells with help of insulin.

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6
Q

Insulin

A

Hormone secreted by the beta cells of the pancreas in the Islets of Langerhans. Helps to lower blood sugar level.

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7
Q

Glucagon

A

Causes liver to turn glycogen into glucose to raise the blood sugar.

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8
Q

Hypoglycemia S&S

A

Less than 60. Sweaty, cold, clammy, light headed, confused, dizzy, double vision.

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9
Q

Hypoglycemia Interventions

A

Give patient simply carbs like hard candy, fruit juice, graham crackers, etc. If unconscious, Dr. will probably order IV D50.

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10
Q

Hyperglycemia S&S

A

The 3 P’s: Polyuria, Polyphagia, Polydipsia. May have fruity breath and glycosuria.

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11
Q

DKA

A

Seen in T1. No insulin so patient is burning up ketones which creates acid in the blood. Glucose can not enter into cells. Can cause metabolic acidosis, ketonuria, and is life-threatening.

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12
Q

HHNS

A

High blood sugar with no burning of ketones.

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13
Q

DKA S&S

A

High blood sugar, extreme thirst, Kussmaul respirations, fruity breath.

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14
Q

HHNS S&S

A

Dehydrated, thirsty, AMS, high blood sugar, fever, but no ketone issues.

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15
Q

Carb Intake

A

45-60% of daily diet.

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16
Q

Recommended Carbs

A

Grains, starchy vegetables (potatoes, corn), sweets (cookies, soda), dried beans, milk.

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17
Q

Fat Intake

A

Less than 20% of daily diet.

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18
Q

Recommended Fats

A

Avocados, olives, nuts. (Avoid saturated/trans fats and cholesterol)

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19
Q

Protein Intake

A

15-20% of daily diet.

20
Q

Recommended Proteins

A

Chicken, turkey, beans, egg whites, low fat cheese. (Avoid red meats)

21
Q

Recommended Exercise

A

Aerobics! (Cardio, walking, running swimming)

22
Q

Exercise Education

A

Check sugar before - if low, eat a snack. Carry simple carbs with you just in case. If sugar is higher than 250 with ketones in the urine = avoid exercise!

23
Q

Sulfonylureas

A

Most common oral diabetic medications. They end in “-ides”. Ex.) Glyburide, Glipizide, etc. They stimulate the beta cells to make more insulin. Do not drink any alcohol while taking! Can cause extreme hypoglycemia.

24
Q

Meglitinides

A

They end in “-glinide”. They stimulate the beta cells to make insulin. Take with first bite of food.

25
Q

Biguanides

A

Metformin (Glucophage). They decrease the liver’s stores of glucose! May cause diarrhea. Watch renal function.

26
Q

Alpha-glucoside Inhibitors

A

These lower blood sugar by breaking down starchy foods in the gut (starch blockers)! Take with first bite of food. Ex.) Precose, Glyset.

27
Q

Thiazolidinedione (TZDs)

A

Decreases glucose production in the liver. Watch liver and heart function, may have increased risk of MI. Ex.) Glitazone, Actos, Avandia.

28
Q

Dawn Phenomenon

A

Hyperglycemia during the “waking hours” (4-8am). Body prepares you to wake up by making extra glucose, but people with DM can’t handle extra sugar. So, can take night time dose of NPH to counteract hyperglycemia in the morning.

29
Q

Somogyi Effect

A

Hypoglycemia during the “sleeping hours” (2-3am). Body senses low blood sugar and makes cortisol/catecholamines to help raise blood sugar but people with DM can’t handle extra sugar = rebound hyperglycemia. Fix this by eating a bedtime snack or decrease the bedtime insulin dose.

30
Q

CV Complications of DM

A

Atherosclerosis can then lead to CAD, MI, strokes. HTN is most common complication of DM.

31
Q

Diabetic Retinopathy

A

High blood sugar damages your retina over time. The tiny vessels start to leak fluid which = retinal swelling = blurry vision. Can eventually lead to blindness.

32
Q

Diabetic Nephropathy

A

Thickening of basement membrane of glomeruli eventually impairs renal function. The first indication is microalbuminuria. Then leads to albuminuria, HTN, edema, & progressive renal insufficiency.

33
Q

Diabetic Neuropathy

A

Type of nerve damage due to chronic high blood sugar levels in body. Most often affects the legs and feet (peripheral). Can also effect the Autonomic Nervous System causing problems with your heart, GI, GU, etc.

34
Q

Aspirin Therapy

A

Recommended to help reduce complications from atherosclerosis (stroke, etc.).

35
Q

Surgical Intervention

A

May replace or transplant pancreas/pancreatic cells/beta cells. However, surgery alters self-management! High risk for infection, slow wound healing, hypoglycemia, etc.

36
Q

Rapid-Acting Insulin

A

Onset: 15 mins. Peak: 1 hour. Duration: 3 hours.

37
Q

Short-Acting Insulin

A

Onset: 30 mins. Peak: 2 hours. Duration: 8 hours.

38
Q

Intermediate-Acting Insulin

A

Onset: 2 hours. Peak: 8 hours. Duration: 16 hours.

39
Q

Long-Acting Insulin

A

Onset: 2 hours. Peak: none. Duration: 24 Hours.

40
Q

Rapid-Acting Insulins

A

Humalog, Novolog

41
Q

Short-Acting Insulin

A

Humulin-R, Novolin-R, all your regular insulins!

42
Q

Intermediate-Acting Insulin

A

NPH, Humulin-N, Novolin-N

43
Q

Long-Acting Insulin

A

Levemir, Lantus

44
Q

A1C for Dx

A

Greater than 6.5% = DM.

45
Q

Fasting Plasma Glucose for Dx

A

Greater than 126 = DM.

46
Q

Normal A1C

A

Less than 5.7%

47
Q

Nursing Diagnoses for DM

A

Lack of Knowledge. Hyperglycemia. Hypoglycemia. Risk for injury. Impaired peripheral neurovascular function.

Med Surg 1 (3 decks)

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