diabetes quiz Flashcards
patho of DM
- involves insulin action or secretion defects, leading to elevated blood glucose levels
- Type 1 diabetes is characterized by the autoimmune destruction of beta cells, resulting in absolute insulin deficiency
- type 2 diabetes is primarily due to insulin resistance and progressive beta-cell dysfunction
patho of DKA
- caused by insulin deficiency and counter-regulatory hormone excess (such as glucagon, catecholamines, and cortisol)
- leads to hyperglycemia, increased lipolysis, and ketogenesis, resulting in ketonemia and metabolic acidosis. The excessive production of glucose and ketones overwhelms the body’s ability to compensate, leading to dehydration, electrolyte imbalances, and acidosis, which can be life-threatening without prompt treatment
Clinical Manifestations of Hypoglycemia
- Shaking, tremors
- sweating
- tachycardia, anxiety
- hunger
- confusion/difficulty concentrating
- dizziness or lightheadedness
- weakness, fatigue
- headache, blurred vision
Glycosylated hemoglobin (HbA1C) normal value
- non-diabetic: less than 5.7%
- diabetic: less than 7%
- indicator of pre-diabetes: 5.7% and 6.4%
- Indicators of diabetes: 6.5% or higher
goals for pts with DM
- glycemic control
- managing weight
- diet changes with an emphasis on whole grains, lean proteins, healthy fats, and fiber-rich foods. - Limit refined carbs and added sugars
- manage blood pressure and lipids
Microvascular complications
retinopathy, nephropathy, and neuropathy
Macrovascular complications
CAD, PAD, cerebrovascular disease
preventing microvascular complications
- Regular eye exams, kidney function monitoring (urine albumin test), and foot care.
- Strict blood sugar control and blood pressure management
preventing macrovascular complications
- monitoring blood pressure
- lower LDL cholesterol and triglycerides, raise HDL cholesterol
- low-dose aspirin
interventions for microvascular complications
- glycemic control
- Blood pressure management
lipid management, managing weight - eye exams
- Monitor renal function
- reduce sodium intake, monitor protein intake
- foot care, stop smoking, exercise
interventions for macrovascular complications
- glycemic control
- Blood pressure management
lipid management - Anti-platelet therapy - aspirin and clopidogrel
- stop smoking
- weight management, exercise
clinical manifestations of diabetic retinopathy
- Blurry/fluctuating vision
- Floaters (small dark spots or lines in vision)
- Impaired color vision
- Dark or empty areas in vision
- Vision loss (advanced)
initial interventions for a newly diagnosed patient with diabetes mellitus
- educate on cause and management
- glycemic control
- a balanced diet rich in whole grains, vegetables, lean proteins, and healthy fats while reducing refined sugars and processed foods
- regular exercise
- blood pressure and lipid management
- foot care, eye exams, monitoring kidney function
What risk factors predispose a patient to diabetes mellitus
- Genetics, ethnicity, age
- obesity, poor diet
- sedentary lifestyle
- hypertension
- dyslipidemia
- gestational diabetes
- polycystic ovary syndrome (PCOS)
- prediabetes
- smoking
What does the nurse need to remember about a patient with diabetes mellitus who has had a surgical procedure
- Monitor Blood Glucose Levels
- Adjust Medications: Insulin or oral hypoglycemic agents may need adjustments
- Prevent Hypoglycemia: Ensure that the patient receives appropriate nutrition and insulin doses
- Wound Healing: Diabetes can impair wound healing
- Infection Risk
- Hydration and Electrolyte Balance: Maintain proper hydration and electrolyte balance (dehydration can affect blood glucose control and kidney function)
- Monitor for DKA or HHS: Watch for signs of diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS), especially in patients with poor blood sugar control.
sick day management
- Check blood glucose levels every 2-4 hours during illness
- Continue insulin regimen
- Drink plenty of fluids to prevent dehydration
- small amounts of carbohydrate-containing foods
- Monitor for ketones
key features of somogyi phenomenon
- Hypoglycemia at Night
- Rebound Hyperglycemia
- Morning Hyperglycemia
clinical manifestations of Somogyi phenomenon
- Early morning hyperglycemia
- elevated fasting blood glucose
- symptoms of hypoglycemia during the night or early morning (sweating, shaking, headache)
Treatment for Somogyi phenomenon
- adjust insulin dosing
- have an evening snack
- frequent blood glucose monitoring
diabetic interventions
- Blood glucose monitoring
- oral meds and insulin
- diet changes (balanced diet, carb counting)
- exercise and weight management
- blood pressure and lipid management
- stop smoking
arterial ulcers: cause
poor blood flow (ischemia) from arterial insufficiency
arterial ulcers: location
toes, feet, heels, or ankles
arterial ulcers: appearance
- Punched-out appearance with well-defined edges.
- Pale or necrotic tissue at the base.
- Dry wound bed, often with minimal exudate.
- Shiny, thin skin with hair loss around the wound
arterial ulcers: symptoms
- pain at rest or at night
- cold feet and weak pulses
- delayed capillary refill
venous ulcers: cause
venous insufficiency
venous ulcers: location
lower legs around the inner ankle
venous ulcers: appearance
- Irregular shape with shallow or superficial wound beds
- Red, moist, and exudative with yellow fibrin or slough
- Edema around the ulcer site and brownish skin discoloration (hemosiderin staining)
venous ulcers: symptoms
- pain (increases with prolonged standing)
- swelling in legs (evening), - itching/heaviness in legs
diabetic ulcers: cause
diabetic neuropathy, poor circulation, and hyperglycemia
diabetic ulcers: location
plantar surfaces of the feet
diabetic ulcers: appearance
- Round or irregularly shaped with deep wound beds.
- Painless (due to neuropathy), with pink or red tissue and exudate.
- Calloused or thickened skin around the ulcer, possibly with surrounding edema
diabetic ulcers: symptoms
- painless (infection can cause pain)
- loss of sensation
