Diabetes & Thyroid Review Flashcards
1
Q
T1D
A
- Complete lack of insulin in body
- Autoimmune
- Genetic component
2
Q
T2D
A
- Insulin resistance
- Metabolic syndrome (hypertension, obesity etc)
- Acquired illness
3
Q
Symptoms of Diabetes
A
- Neurocognitive - dizziness/confusion
- Polydipsia
- Weight - loss
- Hungry
- Polyuria
4
Q
Complications - Hyperglycemia
A
- Glucose damages vessels
- Atherosclerosis & poor perfusion
- Damages many body systems including nervous
5
Q
Occular Complications
A
- Damage to micro-vessels in eye
- Blindness, blurred vision
6
Q
Cardiac Complications
A
- Atherosclerosis
- Increased risk of MI, CAD, stroke, HTN
7
Q
Renal Complications
A
- Damage to nephrons
- Increased risk of chronic kidney disease
- Neuropathy in bladder
- Neurogenic bladder, UTI
8
Q
Vascular Complications
A
- Peripheral vascular disease
- Peripheral neuropathy
- Poor wound healing
- Numbness feet/hands
- Falls risk
- Mobility
- Foot ulcers
9
Q
Immune System Complications
A
- Impaired perfusion - limits movement of immune cells to infection sites
- High blood glucose is breeding ground for infection
- Decreased neutrophil synthesis
- Risk of septic shock
10
Q
Integumentary Complications
A
- Impaired wound healing
- Impaired immunity
11
Q
Critical BG Levels
A
<2.8mmol/L
>20mmol/L
12
Q
Normal Levels
A
- Random <7.7mmol/L
- Fasting 4.0-7.0mmol/L
- HbA1C <6.5%
13
Q
Diabetic Levels
A
- Random >11.1mmol/L
- Fasting >7.0mmol/L
- HbA1C > 6.5%
14
Q
Hemoglobin A1C (HbA1C)
A
- Amount of glucose attached to Hb
- Reflects average serum glucose level over previous 2-3 months
- High = poor control of diabetes
15
Q
Acute Hypoglycemia
A
- Too much insulin/oral antihyperglycemic agents
- Inadequate food intake
- Excessive physical activity
16
Q
Autonomic (Neurogenic) S&S
A
- Trembling
- Palpitations
- Sweating anxiety
- Hunger
- Nausea
- Tingling
17
Q
Neuroglycopenic S&S - elderly/very severe hypoglycemia
A
- Poor concentration
- Confusion
- Weakness
- Drowsiness
- Vision changes
- Speech issues
- Headache
- Dizziness
18
Q
Mild Hypoglycemia
A
- Autonomic symptoms
- Able to self-treat
- 2.8-4.0mmol/L
19
Q
Moderate Hypoglycemia
A
- Autonomic & neuroglycopenic symptoms
- Ability to self-treat
- 2.8-4.0mmol/L
20
Q
Severe Hypoglycemia
A
- Autonomic & neuroglycopenic symptoms
- <2.8mmol/L
- Unconsciousness may occur
21
Q
Mild-Moderate Hypoglycemia Treatment
A
- Oral ingestion of 15g of carbs
- Retest BG in 15 mins
- Re-treat with another 15g of carbs if BG levels remain <4.0mmol/L
22
Q
Severe Hypoglycemia Treatment - Conscious
A
- Oral ingestion of 20g carbs
- Retest BG in 15 mins
- Re-treat if BG level remains <4.0mmol/L
23
Q
Severe Hypoglycemia Treatment - Unconscious
A
- IV access (Pre-established) IV push D5W (20-50mL) over 1-3 mins
- No IV access - SC/IM glucagon 1mg
24
Q
Diabetic Keto Acidosis
A
- T1D hyperglycemia emergency
- > 13.9mmol/L
25
Hyperglycemic Hyperosmolar Syndrome
- T2D hyperglycemia emergency
- >33mmol/L
26
Early Hyperglycemia Signs
- Tiredness
- Polyurea, dehydration
- Polydipsia
27
Rapid Insulin
- Onset 15mins
- Peak 30-90mins
- Duration 3-4hrs
28
Short Acting Insulin
- Peak 2-3 hrs
- Duration 4-6 hrs
- 20-30mins before meal
29
Intermediate Insulin
- Peak 4-12 hrs
- Duration 16-20hrs
- Post meal
30
Long Acting Insulin
- No peak
- Duration >24 hrs
- Basal dose
31
Metformin Side Effects
- Stomach pain
- GI upset
- Gas
- Bloating
- N/V/D
- Constipation
32
Metformin Function
Treat hyperglycaemia, lower blood glucose
33
Metformin Considerations
- Hypoglycemia risk
- Monitor ALT/AST - hepatotoxic
- Hold before contrast dye
- Contraindicated eGFR <30
34
Glyburide Function
Treat hyperglycaemia, lower blood glucose
35
Glyburide Side Effects
- GI upset
- Skin reactions - sunscreen
- Weight gain
36
Glyburide Nursing Considerations
- Hypoglycemia risk
- Avoid EtOH
- Reduce alcohol intake
- Caution with heart failure/MI
37
Rosiglitazone/Pioglitazone Function
Treat hyperglycaemia, lower blood glucose
38
Rosiglitazone Side Effects
- Weight gain
- Edema
- Macular edema
- Heart failure
39
Rosiglitazone Nursing Considerations
- Hypoglycemia risk
- Hepatotoxic risk
- Bladder cancer risk - genetic origin
40
Acarbose Function
Treat hyperglycaemia, lower blood glucose
41
Acarbose Side Effects
- Gas
- Diarrhea
- Bloating
- Stomach pain
- GI upset
- NV
42
Acarbose Nursing Considerations
- Hypoglycemia risk
- Avoid in clients with GI issues (IBS, Crohn's)
43
Levothyroxine (Synthroid) Function
Hypothyroidism treatment
44
Levothyroxine Side Effects
- Fever/hot flashes
- Sweating
- Nervousness
- Irritability
- NVD
- Headache
- Insomnia
45
Levothyroxine Nursing Considerations
- Monitor toxicity
- Risk of hyperthyroidism
- Tachycardia, chest pain, palpations
- Take in morning without food
- Avoid calcium & iron
- Avoid fluctuations in thyroid levels
46
Hyperthyroidism Treatment
- Oral iodine
- Destroys thyroid hormone
- Attaches to hormone & helps excrete
