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EPCC Nursing Foundations > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

Type 1 Diabetes requires ___________

A

Insulin
5-10% of cases
Type 1 pts are usually younger

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2
Q

Type 2 the body _________ insulin

A

Makes insulin
90-95% of cases are type 2
Can be prevented to delayed
Usually type 2 pts are overweight and older

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3
Q

Lab tests used in the dx of diabetes

A

Fasting blood sugar
Casual (random) blood sugar
Glycated hemoglobin (HbgA1C)
Urine examinations to look for glucose, protein, ketones

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4
Q

A fasting blood sugar is collected when? and what is the diagnostic criteria for type 1 diabetes?

A

Usually 8 hours (no calories) and
greater than or equal to 126 mg/ mL

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5
Q

A casual or random blood sugar is collected because of what indication and what is the diagnostic criteria for type 1 diabetes?

A

It can be collected anytime and it requires symptoms
greater than or equal to 200 mg/ mL
The pt will be showing classic symptoms of hyperglycemia or hyperglycemia

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6
Q

Glycated Hemoglobin (HgbA1C) lab value diagnostic criteria for type 1 diabetes?

A

greater than or equal to 6.5%
Average blood sugar over than last 3-4 months
HgbA1C value without diabetes: 4 - 5.6%
HgbA1C that indicates a high chance of diabetes: 5.7 - 6.4%
[we like to keep the pt below 7% (150)]

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7
Q

Deficits in insulin can cause:

A

non traumatic amputation
cause CVD (which can kill you)
leading cause of blindness
can hospitalize you

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8
Q

How can you manage diabetes?

A

Exercise
Nutrition
Pharmacologic tx
Education
Monitoring - SMBG (self monitoring blood glucose) - capillary blood

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9
Q

The normal range of HgbA1C is?

A

4.0% - 5.5%

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10
Q

A HgbA1C elevated lab value reflects what?

A

Hyperglycemia in people with diabetes

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11
Q

What is the cause of type 2 diabetes?

A

The body is not properly processing sugar into energy.
The body is failing to use insulin correctly.
The pancreas is failing to make enough insulin.

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12
Q

What are the risk factors for type 2 diabetes/

A

40+ years old
Physically active less than 3x a week (sedentary lifestyle)
Family hx
High BP
Overweight

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13
Q

The primary defecet of type 2 diabetes is that insulin is___________ and __________

A

insulin is resistant and insulin is inappropriately secreted (wrong time wrong amount)

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14
Q

What is the cause of type 1 diabetes?

A

The pancreas is producing little to no insulin.
Auto immune because the beta cells in the pancreas is

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15
Q

What is the primary defect in type 1 diabetic pts?

A

the loss of pancreatic beta cells

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16
Q

Type 1 diabetes has an _______ onset

A

abrupt (before 15 years)

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17
Q

Type 2 diabetes has a ________ onset

A

gradual

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18
Q

What are the risk factors for type 1 diabetes?

A

Childhood and adolescent ages
Negative family hx
Weight loss
Blurry vision
Increased frequency in infections
Fatigue

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19
Q

Signs and symptoms for type 1 diabetes

A

Polyurea (increased urination)
Polydypsia (increased thirst)
Polyphagia (increased hunger)

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20
Q

The body composition of a pt with type 1 diabetes is?

A

thin
undernourished

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21
Q

The body composition of a pt with type 2 diabetes is?

A

obese

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22
Q

What causes type 2 diabetes?

A

Its unknown, but strong family and genetic association is a risk factor

23
Q

Describe insulin levels ins type 1 diabetic pts?

A

Reduced early in the disease and completely absent later

24
Q

Describe insulin HgbA1C / fasting levels in type 2 diabetic pts?

A

Levels may be low (3.0%// < 80) (indicating deficiency)
Levels may be normal (4.0 - 5.6% // 80 - 100)
Levels may be high (5.7 - 6.4% // 101 -125 ) (indicating resistance)

25
Q

What is the tx for type 1 diabetic pts?

A

insulin replacement with strict diet control

26
Q

What is the tx for type 2 diabetic pts?

A

Oral antidiabetic or non-insulin injectable agent and or insulin
BUT ALWAYS in combination with a reduced calorie diet and appropriate exercise

27
Q

What are characteristics of blood glucose levels in type 1 diabetic pts?

A

levels fluctuate widely in response to infection (when you get sick BG increases [stress, infection, illness], you need insulin the most when you are sick)
levels fluctuate during exercise
+changes in caloric (food makes levels increase and between meals BG drops) and insulin dose

28
Q

What are the characteristics of BG levels in type 2 diabetic pts?

A

Levels are more stable

29
Q

What are the symptoms of type 2 diabetes?

A

may be asymptomatic

30
Q

Describe the characteristics of ketosis in type 1 diabetic pts?

A

It is common especially when insulin dosage is insufficient
(missed or reduced insulin dose, not adhering to a schedule, insulin pump failure)

31
Q

What is DKA (diabetic ketoacidosis)?

A

Relative or absolute (severe) insulin deficiency

32
Q

What causes DKA?

A

Severe insulin deficiency
Hyperglycemia

33
Q

What are the s/s of ketoacidosis or DKA?

A

Dehydration
Deep labored respirations
Glucose 300 - 800
Fruity breath due to ketones
n/v/a
abd pain
weakness
head ache

34
Q

What is hypoglycemia?

A

BG levels are below normal
Low *(3.0%// < 80) (indicating deficiency)
There is not enough glucose to make ATP (energy)

35
Q

When a pt notices that their BG levels are decreasing (hypoglycemia) what needs to happen?

A

We want the pt to eat or drink something like:
Apple juice
milk
hard candy
protein (cheese)
starch snack (crackers)
soda
because we dont want their BG to become dangerously low

36
Q

What is the minimum CHO that should be given to a pt whose BG levels are dropping?

A

15 gm

37
Q

At the hospital, this is the tx if the pts BG levels are dangerously low and the pt cant eat or drink anything because they are unresponsive

A

FIRST check their BG and then give glucagon (D50 {dextrose 50})

38
Q

What is hyperglycemia?

A

High BG levels in the blood
high (5.7 - 6.4% // 101 -125 ) (indicating resistance)
The goal is to get the glucose out of the blood and into the cells (which will lover the BG level)

39
Q

How do you know if a pts BG is droping?

A

Mild Sx due to SNS surge in epi and nor-epi
Cold and clammy (get some candy)
Sweating
Pale
Confusion
Irritability
Tachycardia
Tremors
Hunger

40
Q

What happens to a pt when their BG levels are severely low?

A

Loss of consciousness
Seizures
Trouble arousing
Disoriented

41
Q

What happens to a pt when their BG levels are moderately low?

A

Their brain is not getting enough glucose
Head ache
Light headed
Slurred speech
Double vision
Drowsy

42
Q

Hypoglycemia is considered an insulin ________

A

RXN

43
Q

What are the s/s of hyperglycemia?

A

Polyurea
Polydipsia (fluid loss due to osmotic diuresis)
Polyphagia
Fatigue
Weakness
Sudden vision changes
Tingling or numbness ins hands or feet
Dry skin
Slow healing wounds

44
Q

Hyperglycemia is caused by

A

too little insulin or liver increasing the production of glucose

45
Q

HypOglycemia is caused by

A

too much insulin or too little food

46
Q

Insulin onset means

A

the insulin is working during this time

47
Q

Insulin peak means? and what is the risk during this time?

A

where problems occur and the nurse needs to assess the pt

48
Q

Lispro and Aspart are rapid acting insulins. What is the onset, and peak?

A

10 -30 min onset
30 min - 3 hours peaks

49
Q

What is the onset and peak of regular insulin (slower acting)

A

30 min - 60 min onset
2 - 3 hours peak

50
Q

Intermediate duration insulin (NPH) has an onset and peak when?

A

60 - 120 min onset
6 -14 hour

51
Q

Long duration and ultra long duration insulin have an onset and peak when?

A

60 - 70 min onset
60 min onset
NO PEAK

52
Q

List the oral antidiabetic agents for type 2 diabetes

A

Metformin
Glipizide
Repaglinide
Pioglitazone
Acarbose

53
Q

List the non-insulin injectable drugs for type 2 diabetes

A

Exenatide
Pramlitide

EPCC Nursing Foundations (43 decks)

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