Diabetes Mellitus Management Flashcards
Hyperglycemia
Elevated blood glucose levels
What are the characteristics of hyperglycemia?
Polyuria, polyphagia, nausea, fatigue, and blurred vision.
Hypoglycemia
Low blood glucose.
What are the characteristics of hypoglycemia?
Characterized by pallor, tremor, diaphoresis (sweating), palpations, hunger, visual disturbances, weakness, paresthesias, confusion, agitation, coma, and death.
Diabetic ketoacidosis (DKA) is
A complication most common if pt that have type 1 diabetes, is categorized by hyperglycemia, ketones in the urine, increased respiratory rate and fruity breath odor.
Ketoacidosis
Abnormally high concentration of ketones in the blood and urine. Typically, greater than 300mg/dl. A medical emergency.
Hyperglycemic-hyperosmolar state (HHS)
A coma. A medical emergency, more common in pt that have type 2 diabetes. Characterized by severe hyperglycemia, only slight or no ketosis and profound dehydration.
Polyphagia
Excessive hunger
Polydipsia
excessive thirst
Polyuria
Excessive urine output
What are the chronic complications of diabetes?
Macrovascular complications- including coronary artery disease, cerebrovascular accident, and peripheral vascular disease. Microvascular complications- including retinopathy, neuropathy, and nephropathy.
Infections- of the skin, urinary tract, and vagina.
Neuropathy
Any kidney disease
Sulfonylureas
(Oral) Class of antihyperglycemic agents that stimulate the release of insulin from pancreatic islets.
Thiazolidinediones
(Oral) Increases the cellular response to insulin by decreasing insulin resistance.
Meglitinides (glinides)
(Oral) Works by increasing insulin secretion by the beta cells of the pancreas
Biguanides
(Oral) Works by reducing haptic glucose production while increasing insulin action on muscle glucose intake.
Examples include Metformin
Alpha-glucosidase inhibitors
(Oral) Works by delaying carbohydrate digestion.
Dipeptidyl peptidase-4 (DPP-4) inhibitors
(Oral) Works by augmenting naturally occurring incretin hormones
Rapid-acting insulin
Examples: Lispro (Humalog), Aspart (Novolog), Glulisine (Apidra)
Onset: 15-30 minutes
Peak: 30-150 minutes
Duration: 3-6 hours
Use: Taken just before or after meals to control blood sugar spikes.
Short-acting insulin
Examples: Regular (Humulin R, Novolin R)
Onset: 30 minutes to 1 hour
Peak: 1-5 hours
Duration: 5-10 hours
Use: Taken 30 minutes before meals.
Intermediate-acting insulin
Examples: NPH (Humulin N, Novolin N)
Onset: 1-2 hours
Peak: 6-14 hours
Duration: 16-24 hours
Use: Often used once or twice a day to provide basal insulin coverage.
Long-actin insulin
Examples: Glargine (Lantus, Basaglar), Detemir (Levemir), Degludec (Tresiba)
Onset: 1-2 hours
Peak: 12-24
Duration: Up to 24 hours or more
Use: Provides steady insulin levels throughout the day and night.
What is type 1 diabetes mellitus?
Previously called insulin dependednt. It involves the complete destruction of the beta cells. Beta cells produce insulin.
What is type 2 diabetes mellitus?
Insulin resistance and impaired insulin secretion. The pancreas is producing insulin but not enough to sustain the body.
What is gestational diabetes mellitus?
Diabetes that manifests during pregnancy.
What is the proper technique for measuring blood glucose?
Introduce self
Identify client using two identifiers
Verify orders
Gather supplies
Perform hand hygiene
Inform pt with task
Don clean gloves
Prepare the glucose monitor for use
Turn on glucometer
Verify and Insert test strips.
Inspect fingertip
choose a spot on lateral side of finger tip
Clean finger tip using anticeptic
Gently massage finger for blood flow
Place the injector firmly again side of fingertip
Press button to release to pierce skin
Gently squeeze pt fingertip util a drop of blood forms.
Wipe away first drop with cotton blood
Hold test strip and allow adequate amount of blood to enter test strip.
The reading will appear on glucometer screen. Make sure pts finger stops bleeding.
Note results turn off monitor and dispose of supplies
Interpret blood glucose levels
Fasting Blood Glucose Levels
Normal: 74 to 106 mg/dL
Prediabetes: 106 to 125 mg/dL
Diabetes: 126 mg/dL
Random Blood Glucose Levels
Normal: Less than 140 mg/dL
Prediabetes: 140 to 199 mg/dL
Diabetes: 200 mg/dL or higher
Assess client data- such as glucose levels, vitals signs, and Laboratory values before administering insulin
Compare and contrast the various types of insulin
Key Differences
Onset: Rapid-acting insulins start working the fastest, while long-acting insulins take longer to start but provide a steady level of insulin.
Peak: Rapid- and short-acting insulins have a pronounced peak, while long-acting insulins have minimal or no peak.
Duration: Long-acting insulins last the longest, providing basal coverage, while rapid-acting insulins are short-lived and used for mealtime control.
What are the appropriate timelines for administering insulin?
After mixing a long term and short term 5 minutes.
Compare and Contrast the various insulin delivery methods
Insulin pens - prefilled cartridges, most convenient for pt that need one type of insulin at a time. A disposable needle is attached for each injection.
Insulin pumps - For a pt who has type 1 and needs continuous insulin replacement. Or for type 2 who are insulin dependent.
What are the appropriate interventions for managing hypoglycemia and hyperglycemia?
When a pt is experiencing hypoglycemia they need glucagon. When a pt is experiencing hyperglycemia they need insulin.
What indicates that a client who has diabetes needs teaching?
Poor diet and exercise
Following misconceptions
Inconsistent monitoring
Missed dosage of medications
