Diabetes4 Flashcards
When is exercise best done?
after meals
How long might the effects of exercise last on BG level?
up to 48 hours
When is exercise related hypoglycemia likely to occur?
when insulin or antidiabetic medication is peaking. if exercise is strenuous or prolonged and CHO is not replaced
When would you suggest to a diabetic patient who takes an antidiabetic agent, the most appropriate time to exercise?
one hour after eating a meal. after the ingestion of 15 grams of CHO every 45 minutes of activity the individual should consume another 15 gm of CHO
When should a type 1 diabetic avoid exercise?
BG greater than 300 without urine ketones present or if BG is greater than 250 with urine ketones present
What should a diabetic do about medications when sick?
continue as before unless otherwise advised by health care team, supplemental insulin doses may be required in type 1 DM
What should a diabetic do about blood sugar monitoring when sick?
increase freqency to every 4 hours, assess urine for presence of ketones especially during fevers and when BG is greater than 240mg/dl
What should a diabetic do about intake when sick?
continue CHO intake by substituting regular soda, regular jello, popsicles, or gatorade
small frequent meals
drinks adequate amount of fluids to prevent dehydration
When should a diabetic contact MD when sick?
keep good written records of BG and urine ketones as soon as they become sick so that they are prepared to relay info to MD, notfy if: BG is greater than 240, mod-large amount of ketones in the urine, unable to keep anything down
What can a diabetic do to prevent illness?
flu shot, handwashing
How often should diabetics monitor their BG?
after meals and before bed or every six hours
What shoud you do with the first drop of blood when testing BG?
Wipe away
What is an ideal BG before a meal?
60-100mg/dl
What is an acceptable blood glucose before a meal?
60-125mg/dl
What is an ideal BG 1 hour after a meal?
less than 160
What is an acceptable BG 1 hour after a meal?
less than 180mg/dl
What is an ideal BG 2 hours after meal?
less than 120mg/dl
What is an acceptable BG 2 hours after a meal?
less than 150mg/dl
Age 4-5 Diabetic Nursing Considerations
- helps pick foods based on likes and dislikes
- helps pick injection sites; pinches up skin; wipes skin
- collects blood or urine, watches parent do testing, colors test results on records
Age 6-7 Diabetic Nursing Considerations
- can tell if food has no sugar, some sugar or lots of sugar
- pushes plunger in after parent gives shot
- performs blood or urine test, records results, may need reminding, will need supervision
Age 8-9 Diabetic Nursing Considerations
- selects food based on exchanges
- gives own shots (at least one/day)
- does own blood test
Age 10-13 Diabetic Nursing Considerations
- knows diet plan
- rotates sites within a selected area, measures insulin
- looks for patterns in test results
Age 14+ Diabetic Nursing Considerations
- plans meals and snacks
- mixes two insulins in one syringe (if needed)
- suggests insulin changes based on test patterns
What BG would indicate diabetic ketoacidosis?
300-600mg/dl and a drop in pH less than 7.2
Symptoms of DKA
- BG 300-600mg/dl
- pH less than 7.2
- fruity smelling breath
- deep and rapid respirations (Kussmauls)
- polyuria
- polyphagia
- polydipsia
- symptoms of dehydration due to osmotic diuresis
Treatment DKA
- Fluid and electrolyte replacement
- IV- Regular Insulin (high alert med)
- Frequent monitoring of BG (every 30 minutes to 1 hour)
Hyperglycemia
Elevated levels of blood glucose
Reasons for hyperglycemia
- too much food
- too little or no diabetic medication
- stress
- inactivity
Assessment hyperglycemia
- polyuria
- polydipsia
- polyphagia
- weakness
- fatigue
- blurred vision
- dry skin
- hot
Treatment hyperglycemia
- Continue diabetic medication as ordered
- monitor BG levels
- force fluids
- consult physcian
