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Med/Surg > Diabetes Nursing Care and Management > Flashcards

Diabetes Nursing Care and Management Flashcards

1
Q

Hypergylcemia caused by defect in insulin secretion or insulin action or both

A

Diabetes

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2
Q

beta cells produce

A

hormones

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3
Q

Glycemic control reduces

A

complications

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4
Q

CVD

A

Coronary vascular disease

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5
Q

90% of cases are type _____

A

Type 2

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6
Q

Transports & Metabolizes glucose for energy in the cells

A

Insulin

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7
Q

Stimulates storage of glucose in the liver as glycogen

A

Insulin

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8
Q

Signals the liver to stop producing glucose

A

Insulin

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9
Q

Assists with the storage of fat into adipose cells

A

Insulin

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10
Q

Accelerates the transport of amino acids into the cells

A

Insulin

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11
Q

Prevents the breakdown of stored glucose, fat, and protein

A

Insulin

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12
Q

Sugar breaks down ______ first then _____ then ______

A

Sugar breaks down glucose first then fat then protein

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13
Q

Is a protein sparing hormone

A

Insulin

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14
Q

Primarily a disease of insulin deficiency

A

Type 1 Diabetes

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15
Q

Insulin producing beta cells (pancreas) are destroyed by genetic, immunologic, and environmental factors.

A

Type 1 Diabetes

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16
Q

Results in decreased to absent insulin production, unchecked glucose production by the liver, and hyperglycemia.

A

Type 1 Diabetes

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17
Q

Affects 5% of adults with diabetes

A

Type 1 Diabetes

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18
Q

Primarily a disease of INSULIN RESTIANCE and/or Impaired insulin secretion

A

Type 2 Diabetes

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19
Q

Slow, progressive glucose intolerance may go undetected for years.

A

Type 2 Diabetes

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20
Q

Autoimmune disease attacks pancreatic cells at a later age

A

Latent Autoimmune Diabetes of Adults (LADA)

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21
Q

Condition where blood sugars begin to increase, putting person at future diabetes

A

Pre-Diabetes / Impaired Glucose Tolerance

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22
Q

Believed to be an autoimmune reaction to insulin

A

Type 1 diabetes

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23
Q

Some viruses can trigger an autoimmune response leading to

A

Type 1 diabetes

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24
Q

Body still produces insulin but is resistant or impaired secretion

A

Type 2 diabetes

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25
Q

gestational diabetes testing is done at

A

24-28 weeks

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26
Q

diabetes can be postponed with

A

diet and exercise

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27
Q

What factors increase blood sugar in the body?

A

Sedentary lifestyle, excessive sugar in diet, stress (cortisol released), or medications

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28
Q

What decreases blood sugar in the body?

A

Insulin, exercise, diet, and medications

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29
Q

Synthroid
Glucocorticoids
Cortisol
Epinephrine
Growth hormone
Birth control pills
GLUCAGON

A

INCREASE BLOOD GLUCOSE

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30
Q

INSULIN
Oral diabetic meds
Beta blockers
Alcohol

A

Decreases blood glucose

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31
Q

during meals, insulin ____

A

goes up

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32
Q

Hormone secreted by Beta cells of Islets of Langerhans (Pancreas)

A

Insulin

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33
Q

After 8-12 hrs without food, the liver begins to form glucose from the

A

breakdown of proteins and fats (gluconeogenesis)

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34
Q

Pancreas also has alpha cells secreting glucogon to break up ______ stores in liver

A

glycogen

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35
Q

normal fasting range

A

70-120

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36
Q

hypoglycemia range

A

<70

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37
Q

hyperglycemia range

A

> 120

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38
Q

Number where excess glucose spills from blood into urine

A

180-200

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39
Q

Occurs because water follows glucose and polyuria and polydipsia occur.

A

Osmotic diuresis

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40
Q

Hormone made in the intestine that assists in releasing insulin

A

GLP

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41
Q

Three “Ps”

A

Polyuria
Polydipsia
Polyphagia

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42
Q

Polyphagia

A

Excessive hunger or increased appetite

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43
Q

In type 1 diabetes, because of no insulin the body uses ____ and ____ to survive

A

body fat and protein

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44
Q

RBC lifespan

A

120 days

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45
Q

Normal A1C

A

5-5.7

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46
Q

Glycosylated Hemoglobin Test

A

A1C

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47
Q

Normal, non-diabetic A1C

A

between 5.0 – 5.7

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48
Q

Controlled diabetic A1C is .

A

6.4 or less

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49
Q

Diagnosing diabetes

A

An A1C of ≥6.5 on 2 separate days

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50
Q

A low to negative C-peptide blood test indicates

A

Type 1 or insulin deficiency

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51
Q

C peptide is formed when

A

insulin is produced

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52
Q

If C-peptide is zero, patient has

A

Type 1 diabetes

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53
Q

If C-peptide is present, patient has

A

Type 2 diabetes

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54
Q

One of the strongest factors of Type 2

A

Obesity: BMI>25

55
Q

Considered to be a risk for diabetes & included under Type 2

A

HDL < 40-50

56
Q

3 examples of BASIC SKILL information a new diabetic would need

A

Diet
Exercise
Monitor blood sugar

57
Q

Onset usually abrupt with flu-like for several days until Ketoacidosis / coma

A

Type 1

58
Q

Fasting blood glucose above normal (>300)

A

Type 1

59
Q

S/S can be gradual and subtle

A

Type 2

60
Q

What findings are similar in BOTH Type 1 and Type 2?

A

Hunger, tired, high Hbg, vision problems, slow to heal

61
Q

Bedtime blood glucose should be between

A

100 – 140 mg/dL

62
Q

Type 1: Dependent on insulin for life…

Insulin is calculated to “cover” (or account for) the total amount of

A

carbohydrates in a meal needed to be taken up

63
Q

Healthy diet:

Carbohydrates should be

A

50-60%; emphasis on whole grains

64
Q

Healthy diet:

Fats should be

A

limit saturated fats to 10% and <300 mg cholesterol

65
Q

Healthy diet:

Proteins should be

A

Non-animal sources of protein (lower fat: legumes, whole grains), and increase fiber. Protein 15-20%

66
Q

Combining starchy foods with protein and fat slows

A

absorption and glycemic response

67
Q

Raw or whole foods tend to have ______ than cooked, chopped, or puree foods

A

lower responses

68
Q

The diet focuses on carbohydrates, with the goal of eating foods that produce a steady rise in blood sugar instead of the spike in blood sugar created by eating foods that are quickly digested

A

Glycemic index Diet

69
Q

High GI foods score

A

70 or higher

70
Q

Medium GI food score

A

56-69

71
Q

Low GI food score

A

55 and under

72
Q

How can alcohol affect blood sugar?

A

Alcohol can increase or decrease sugar

73
Q

Humalog; Novolog Peak

A

30m-2h

74
Q

an insulin that’s twice the concentration of Humalog U-100.

A

Humalog U-200

75
Q

Insulin with 5 times as much insulin in the same volume

A

Humulin R U-500

76
Q

Humulin/Novolin R peak

A

2-4 hrs

77
Q

Short acting insulin

A

Humulin/Novolin R

78
Q

Fast acting insulin

A

Humalog, novalog

79
Q

Intermediate-acting insulin

A

Humulin or Novolin N

80
Q

Humulin or Novolin N peak

A

over 8 hrs

81
Q

Insulin where food does not need to be taken immediately

A

Humulin or Novolin N

82
Q

Insulin where food needs to be taken within 30 minutes

A

Humulin, Novolin R

83
Q

Insulin that is planned with meals

A

Humalog, Novolog

84
Q

Long acting insulin

A

Glargine (LANTUS):

85
Q

Glargine (LANTUS) peak

A

no peak

86
Q

Only type of insulin that can be given through IV

A

“Regular” - Humulin/Novolin R

87
Q

Insulin injections must be 1 inch away from

A

Previous injection site

88
Q

Do not use same injection site more than once within

A

2 weeks

89
Q

What happens when you DO NOT ROTATE sites?

A

Scar tissue builds

90
Q

Avoid injecting insulin in body area that

A

is about to be exercised

91
Q

Insulin storage temp

A

below 86F

92
Q

Insulin pens do not need

A

refrigeration

93
Q

Safety requirements= 2 nurses should

A

check before insulin is given

94
Q

Closest thing to a functioning pancreas

A

insulin pump

95
Q

Insulin pump site must be changed every

A

q48-72h

96
Q

insulin pump can use _____ type of insulin

A

reg or rapid

97
Q

insulin sensor tells pump _____

A

how much insulin to deliver

98
Q

inhaled insulin needs

A

insulin injections to supplement

99
Q

Type 2 oral hypoglycemic med that must be skipped if meal is skipped

A

Sulfonylureas

100
Q

Oral hypoglycemic taken before a meal

A

Meglitinides

101
Q

Drug that must be held for 48hrs before and after IV contrast dye (CAT Scan) because it can cause kidney damage

A

Glucophage (metformin)

102
Q

Type 2 Meds: Oral Hypoglycemics that is contraindicated for CHF and heart disease Black Box Warning

A

Tthiazolidinediones (TZD)

103
Q

Type 2 Meds: Oral Hypoglycemics

“Starch Blockers”

A

Alpha glucosidase inhibitors

104
Q

GLP-1 inhibits glucagon by

A

alpha cells and increases insulin, also inhibits appetite

105
Q

Drugs that mimic GLP-1

A

Drugs that mimic this are:
(Exenatide) Byetta & (Liraglutide)Victosa
(dulaglutide) Trulicity

106
Q

GLP-1 medication is contraindicated for

A

breastfeeding women

107
Q

Medication that blocks the enzyme that breaks down the GLP1

A

Dpp4

108
Q

DPP4 meds

A

Sitagliptin (Januvia)
Saxagliptin ( Onglyza)

109
Q

Pramlintide ( Symlin) = synthetic

A

amylin

110
Q

Peptide hormone secreted with insulin by beta cells

A

Amylin

111
Q

Blocks glucose reabsorption from kidney= more glucose loss from kidney into urine

A

SGLT-2 Inhibitors

112
Q

SGLT-2 Inhibitors drug

A

Invokana ( canaglifloxozin)

113
Q

Which is more dangerous, too high or too low glucose?

A

Too low

114
Q

basal insulin is given pre-op even in ______ pts preop/postop

A

NPO

115
Q

LDL should be:

A

<100

116
Q

HDL should be: >40 (w) >50 (m)

A

> 40 (w) >50 (m)

117
Q

Triglycerides should be:

A

<150

118
Q

Type 1 diabetic should only exercise when blood sugar =

A

<250 & negative urine ketones

119
Q

Type 1 who exercise can go into

A

hyperglycemia

120
Q

3am hypoglycemia due to body over reacting to bedtime meal:

A

Somogyi

121
Q

Morning hyperglycemia

A

Dawn phenomenon

122
Q

If patient is sweating or acting erratic,

A

give them a snack to raise glucose

123
Q

Signs and symptoms of Hypoglycemia:

A

Feeling shaky
Tired
Sweaty
Confused / Irritable
Blurred vision
Behavior change or nothing at all!!!

124
Q

Always follow glucose treatment (juice, candies, etc) with

A

a protein based snack

125
Q

Treatment for Severe Hypoglycemia <50

A

Give glucose by mouth (or IV/IM if unconscious)

126
Q

Hot & Dry=

A

Sugar is HIGH

127
Q

Treatment for hyperglycemia with Blood Sugars >180:

A

Insulin

Decrease food

Increase fluids

128
Q

Dehydration causes osmotic diuresis

A

↑ in kidney labs BUN & Creatinine

129
Q

What are KETONES???

A

the byproduct of fat breakdown

130
Q

Diabetic Ketoacidosis

A

Blood becomes acidic

131
Q

High mortality rate of 8-20%

A

Hyperglycemic, Hyperosmolar State (HHS): type 2

132
Q

C-peptide in type 1

A

Zero

133
Q

C-peptide in type 2

A

Is present

Med/Surg (17 decks)

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