Diabetes Nursing Care and Management Flashcards
1
Q
Hypergylcemia caused by defect in insulin secretion or insulin action or both
A
Diabetes
2
Q
beta cells produce
A
hormones
3
Q
Glycemic control reduces
A
complications
4
Q
CVD
A
Coronary vascular disease
5
Q
90% of cases are type _____
A
Type 2
6
Q
Transports & Metabolizes glucose for energy in the cells
A
Insulin
7
Q
Stimulates storage of glucose in the liver as glycogen
A
Insulin
8
Q
Signals the liver to stop producing glucose
A
Insulin
9
Q
Assists with the storage of fat into adipose cells
A
Insulin
10
Q
Accelerates the transport of amino acids into the cells
A
Insulin
11
Q
Prevents the breakdown of stored glucose, fat, and protein
A
Insulin
12
Q
Sugar breaks down ______ first then _____ then ______
A
Sugar breaks down glucose first then fat then protein
13
Q
Is a protein sparing hormone
A
Insulin
14
Q
Primarily a disease of insulin deficiency
A
Type 1 Diabetes
15
Q
Insulin producing beta cells (pancreas) are destroyed by genetic, immunologic, and environmental factors.
A
Type 1 Diabetes
16
Q
Results in decreased to absent insulin production, unchecked glucose production by the liver, and hyperglycemia.
A
Type 1 Diabetes
17
Q
Affects 5% of adults with diabetes
A
Type 1 Diabetes
18
Q
Primarily a disease of INSULIN RESTIANCE and/or Impaired insulin secretion
A
Type 2 Diabetes
19
Q
Slow, progressive glucose intolerance may go undetected for years.
A
Type 2 Diabetes
20
Q
Autoimmune disease attacks pancreatic cells at a later age
A
Latent Autoimmune Diabetes of Adults (LADA)
21
Q
Condition where blood sugars begin to increase, putting person at future diabetes
A
Pre-Diabetes / Impaired Glucose Tolerance
22
Q
Believed to be an autoimmune reaction to insulin
A
Type 1 diabetes
23
Q
Some viruses can trigger an autoimmune response leading to
A
Type 1 diabetes
24
Q
Body still produces insulin but is resistant or impaired secretion
A
Type 2 diabetes
25
gestational diabetes testing is done at
24-28 weeks
26
diabetes can be postponed with
diet and exercise
27
What factors increase blood sugar in the body?
Sedentary lifestyle, excessive sugar in diet, stress (cortisol released), or medications
28
What decreases blood sugar in the body?
Insulin, exercise, diet, and medications
29
Synthroid
Glucocorticoids
Cortisol
Epinephrine
Growth hormone
Birth control pills
GLUCAGON
INCREASE BLOOD GLUCOSE
30
INSULIN
Oral diabetic meds
Beta blockers
Alcohol
Decreases blood glucose
31
during meals, insulin ____
goes up
32
Hormone secreted by Beta cells of Islets of Langerhans (Pancreas)
Insulin
33
After 8-12 hrs without food, the liver begins to form glucose from the
breakdown of proteins and fats (gluconeogenesis)
34
Pancreas also has alpha cells secreting glucogon to break up ______ stores in liver
glycogen
35
normal fasting range
70-120
36
hypoglycemia range
<70
37
hyperglycemia range
>120
38
Number where excess glucose spills from blood into urine
180-200
39
Occurs because water follows glucose and polyuria and polydipsia occur.
Osmotic diuresis
40
Hormone made in the intestine that assists in releasing insulin
GLP
41
Three “Ps”
Polyuria
Polydipsia
Polyphagia
42
Polyphagia
Excessive hunger or increased appetite
43
In type 1 diabetes, because of no insulin the body uses ____ and ____ to survive
body fat and protein
44
RBC lifespan
120 days
45
Normal A1C
5-5.7
46
Glycosylated Hemoglobin Test
A1C
47
Normal, non-diabetic A1C
between 5.0 – 5.7
48
Controlled diabetic A1C is .
6.4 or less
49
Diagnosing diabetes
An A1C of ≥6.5 on 2 separate days
50
A low to negative C-peptide blood test indicates
Type 1 or insulin deficiency
51
C peptide is formed when
insulin is produced
52
If C-peptide is zero, patient has
Type 1 diabetes
53
If C-peptide is present, patient has
Type 2 diabetes
54
One of the strongest factors of Type 2
Obesity: BMI>25
55
Considered to be a risk for diabetes & included under Type 2
HDL < 40-50
56
3 examples of BASIC SKILL information a new diabetic would need
Diet
Exercise
Monitor blood sugar
57
Onset usually abrupt with flu-like for several days until Ketoacidosis / coma
Type 1
58
Fasting blood glucose above normal (>300)
Type 1
59
S/S can be gradual and subtle
Type 2
60
What findings are similar in BOTH Type 1 and Type 2?
Hunger, tired, high Hbg, vision problems, slow to heal
61
Bedtime blood glucose should be between
100 – 140 mg/dL
62
Type 1: Dependent on insulin for life…
Insulin is calculated to “cover” (or account for) the total amount of
carbohydrates in a meal needed to be taken up
63
Healthy diet:
Carbohydrates should be
50-60%; emphasis on whole grains
64
Healthy diet:
Fats should be
limit saturated fats to 10% and <300 mg cholesterol
65
Healthy diet:
Proteins should be
Non-animal sources of protein (lower fat: legumes, whole grains), and increase fiber. Protein 15-20%
66
Combining starchy foods with protein and fat slows
absorption and glycemic response
67
Raw or whole foods tend to have ______ than cooked, chopped, or puree foods
lower responses
68
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
Glycemic index Diet
69
High GI foods score
70 or higher
70
Medium GI food score
56-69
71
Low GI food score
55 and under
72
How can alcohol affect blood sugar?
Alcohol can increase or decrease sugar
73
Humalog; Novolog Peak
30m-2h
74
an insulin that’s twice the concentration of Humalog U-100.
Humalog U-200
75
Insulin with 5 times as much insulin in the same volume
Humulin R U-500
76
Humulin/Novolin R peak
2-4 hrs
77
Short acting insulin
Humulin/Novolin R
78
Fast acting insulin
Humalog, novalog
79
Intermediate-acting insulin
Humulin or Novolin N
80
Humulin or Novolin N peak
over 8 hrs
81
Insulin where food does not need to be taken immediately
Humulin or Novolin N
82
Insulin where food needs to be taken within 30 minutes
Humulin, Novolin R
83
Insulin that is planned with meals
Humalog, Novolog
84
Long acting insulin
Glargine (LANTUS):
85
Glargine (LANTUS) peak
no peak
86
Only type of insulin that can be given through IV
"Regular" - Humulin/Novolin R
87
Insulin injections must be 1 inch away from
Previous injection site
88
Do not use same injection site more than once within
2 weeks
89
What happens when you DO NOT ROTATE sites?
Scar tissue builds
90
Avoid injecting insulin in body area that
is about to be exercised
91
Insulin storage temp
below 86F
92
Insulin pens do not need
refrigeration
93
Safety requirements= 2 nurses should
check before insulin is given
94
Closest thing to a functioning pancreas
insulin pump
95
Insulin pump site must be changed every
q48-72h
96
insulin pump can use _____ type of insulin
reg or rapid
97
insulin sensor tells pump _____
how much insulin to deliver
98
inhaled insulin needs
insulin injections to supplement
99
Type 2 oral hypoglycemic med that must be skipped if meal is skipped
Sulfonylureas
100
Oral hypoglycemic taken before a meal
Meglitinides
101
Drug that must be held for 48hrs before and after IV contrast dye (CAT Scan) because it can cause kidney damage
Glucophage (metformin)
102
Type 2 Meds: Oral Hypoglycemics that is contraindicated for CHF and heart disease *Black Box Warning*
Tthiazolidinediones (TZD)
103
Type 2 Meds: Oral Hypoglycemics
"Starch Blockers"
Alpha glucosidase inhibitors
104
GLP-1 inhibits glucagon by
alpha cells and increases insulin, also inhibits appetite
105
Drugs that mimic GLP-1
Drugs that mimic this are:
(Exenatide) Byetta & (Liraglutide)Victosa
(dulaglutide) Trulicity
106
GLP-1 medication is contraindicated for
breastfeeding women
107
Medication that blocks the enzyme that breaks down the GLP1
Dpp4
108
DPP4 meds
Sitagliptin (Januvia)
Saxagliptin ( Onglyza)
109
Pramlintide ( Symlin) = synthetic
amylin
110
Peptide hormone secreted with insulin by beta cells
Amylin
111
Blocks glucose reabsorption from kidney= more glucose loss from kidney into urine
SGLT-2 Inhibitors
112
SGLT-2 Inhibitors drug
Invokana ( canaglifloxozin)
113
Which is more dangerous, too high or too low glucose?
Too low
114
basal insulin is given pre-op even in ______ pts preop/postop
NPO
115
LDL should be:
<100
116
HDL should be: >40 (w) >50 (m)
>40 (w) >50 (m)
117
Triglycerides should be:
<150
118
Type 1 diabetic should only exercise when blood sugar =
<250 & negative urine ketones
119
Type 1 who exercise can go into
hyperglycemia
120
3am hypoglycemia due to body over reacting to bedtime meal:
Somogyi
121
Morning hyperglycemia
Dawn phenomenon
122
If patient is sweating or acting erratic,
give them a snack to raise glucose
123
Signs and symptoms of Hypoglycemia:
Feeling shaky
Tired
Sweaty
Confused / Irritable
Blurred vision
Behavior change or nothing at all!!!
124
Always follow glucose treatment (juice, candies, etc) with
a protein based snack
125
Treatment for Severe Hypoglycemia <50
Give glucose by mouth (or IV/IM if unconscious)
126
Hot & Dry=
Sugar is HIGH
127
Treatment for hyperglycemia with Blood Sugars >180:
Insulin
Decrease food
Increase fluids
128
Dehydration causes osmotic diuresis
↑ in kidney labs BUN & Creatinine
129
What are KETONES???
the byproduct of fat breakdown
130
Diabetic Ketoacidosis
Blood becomes acidic
131
High mortality rate of 8-20%
Hyperglycemic, Hyperosmolar State (HHS): type 2
132
C-peptide in type 1
Zero
133
C-peptide in type 2
Is present
