DM Flashcards
State the chronic complications of DM (at least 5)
Diabetic Retinopathy *
Diabetic Nephropathy *
Mood alteration*
Cardiovascular disease (CAD,Stroke, Hypertension) *
Peripheral vascular disease (feet)*
Increased susceptibility to infection
Visceral Neuropathy
Periodontal disease
Diagnostic Tests for DM
Glycosylated Haemoglobin — HbA1c (measures amount of glucose attached in haemoglobin and shows the avg glucose attached to haemoglobin over past 3 months)
Random plasma glucose (literally bgm)
Oral Glucose Tolerance Test (fasts for 8-14hrs overnight, 3ml of blood collected, drinks 75g of glucose water in 5mins, no smoking or eating , minimal strenuous activity, collect blood specimen 2hrs after )
Fasting plasma glucose (safe and common way to test for DM, requires to fast for 8-12hrs prior before withdrawing blood from a vein)
Urine Analysis (To test for increased glucose and ketones, which can indicate hyperglycaemia and ketosis and test for albumin, to detect early onset of kidney damage)
Fasting lipids (measures serum cholesterol and lipid levels identify those individuals at risk for CVS)
Acute complications of DM
Hyperglycaemia *
Hypoglycaemia *
Diabetic Ketoacidosis (DKA)
Hyperosmolar hyperglycemic state (HHS)
Persons with DM may experience relatively ____ef and _______ent episodes of ___________ as well as a____e complications of DKA and HHS.
Persons with DM may experience relatively brief and transient episodes of hyperglycaemia (the dawn and somogyi phenomenon) as well as acute complications of DKA and HHS
Dawn Phenomenon— rise in blood glucose between 4-8am
Somogyi Phenomenon—It’s a combination of hypoglycaemia during the night and a rebound morning rise in blood glucose to hyperglycaemic levels
This acute complication is common in people with T1DM and occasionally occurs in people with T2DM who are treated with certain OHGA.
Hypoglycaemia — results primarily from mismatch between insulin intake (eg. error in insulin dose), physical activity, and lack of carbohydrates (eg. omitting a meal)
Impaired skin integrity nursing intervention
Conduct _________e and ongoing a__________s:
- M____sk_____ assessment including f___ and a____ j____ ROM, b___e ab__________ies
- N________c assessment including s________ of Touch and P______, P____and T__________.
- V________r assessment including Lower-e________ p_____, C_______ r_____, Colour and T_________ of sk___
Conduct baseline and ongoing assessments:
- Musculoskeletal assessment including foot and ankle joint ROM, bone abnormalities
- Neurologic assessment including sensations of Touch and Position, Pain and Temperature
- Vascular assessment including Lower-extremity pulses, Capillary refill, Colour and Temperature of skin
Impaired skin integrity rationale:
The person with DM is at increased risk for s______ __________ and w________ as a result of d_________ s_________
The person with DM is at increased risk for skin breakdown and wounds as a result of decreased sensation
RISK OF INFECTION
NI:
Use and teach m________ H_____ H________.
R:
H_____ H________ is the single most e________ method for
preventing the s_______ of i________
NI:
Use and teach meticulous hand hygiene.
R:
Hand hygiene is the single most effective method for preventing the spread of infection.
RISK OF INFECTION
NI:
Monitor for manifestations of i_______ such as _________(give at least 1)
R: Early d_____sis and tr_________t of i________ can control their s_______ and decrease c__________s.
NI:
Monitor for manifestations of infection: Increased temperature, pain, malaise, swelling, redness, discharge, cough
R:
Early diagnosis and treatment of infections can control their severity and decrease complications.
RISK OF INFECTION
NI:
D_______ the importance of m________ s_____ c_____. Keep the skin c_____ and ____y, using l__________water and _____ soap.
R:
Clean, i_____ sk__ and m_______s m____anes are the f____ l____ of d____nse against i________.
NI:
Discuss the importance of meticulous skin care. Keep the skin clean and dry, using lukewarm water and mild soap.
R:
Clean, intact skin and mucous membranes are the first line of defense against infection
RISK OF INJURY
NI:
Assess f______ that i______se the r____ of i_____ such as ________ (give at least 1)
R: A kn________ b____ is n_______y to develop an i_________zed p_____n of care. The r____ of i_______ increases with the n______r of f______rs i_______d.
NI:
Assess factors that increase the risk of injury: Blurred vision, cataracts, hypoglycemia, hyperglycemia, joint immobility.
R: A knowledge base is necessary to develop an individualized plan of care. The risk of injury increases with the number of factors identified
RISK OF INJURY
NI:
Reduce en_________l h___ rds in the h_______are f______y, and teach the p_______about s_____ in the h_____and in the c_________y.
R:
presence of h______us en_________l factors i_______e the risk of f____ or other ac_____nts.
NI:
Reduce environmental hazards in the healthcare facility, and teach the patient about safety in the home and in the community.
R:
presence of hazardous environmental factors increase the risk of falls or other accidents
RISK OF INJURY
NI:
M________ for and t_____ the patient and family to recognize and treat the manifestations of h_________
R:
Severe h__________ causes a d__________ in the l______ of c_________s (LOC)
NI: Severe hypoglycemia causes a
decrease in the level of
consciousness
R: decrease in the level of
consciousness.
Deficit Knowledge
NI:
A______ the patient’s ps_____so_ial r________s, including e________l r_________s, s_______t r_________s, lifestyle, and c_________tion s____s
R: A c_________ive a________ent of st________s and we_________s is the f____ _____p in d__________ing an i__________zed p____.
NI:
Assess the patient’s psychosocial resources, including emotional resources, support resources, lifestyle, and communication skills
R: A comprehensive assessment of strengths and weaknesses is the first step in developing an individualized plan
Deficit Knowledge
NI:
Explore with the p_______ and f_____y the effects (a______l and per______d) of the d______sis and tr________t
R: Common fr________s ass_______d with DM are the d______ itself. Eff______ c_____g involves m________g a h_______ self-c_______t and s_______ing r_________s and han_____ e_________l st___s
NI:
Explore with the patient and family the effects (actual and perceived) of
the diagnosis and treatment
R: Common frustrations associated with DM are the disease itself. Effective coping involves maintaining a healthy self-concept and satisfying relationships and handling emotional stress
