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Health Challenges > Endocrine > Flashcards

Endocrine Flashcards

1
Q

80% of patients with DM will die from

A

Heart disease or stroke

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2
Q

Type 1 is _____% of cases

A

10

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3
Q

Type 2 is _____% of cases

A

90

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4
Q

That global prevalence is odisbetes is

A

9-10%, more prevalent is urban high income countries

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5
Q

Type 1
-Cause
-Onstet
-Risk factors
-Prevalence
-Treatment

A

-Cause
Absent or minimal insulin production
-Onstet
Often occurs in young but can happen at any age
-Risk factors
Environmental-virus, toxins
-Prevalence
-10% of cases
-Treatment
Insulin required for all

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6
Q

Type 2

-Cause
-Onstet
-Risk factors
-Prevalence
-Treatment

A

-Cause
Insulin resistance or decreased insulin production
-Onstet
Any age
-Risk factors
Obesity, irregular eating patterns, lack of exercise
-Prevalence
90% of cases
-Treatment
Insulin required for some

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7
Q

Four methods of diagnosis

A

-AIC => 6.5%
-Fasting CBG over 7
-Random or casual plasma glucose measurement over 11 + classic symptoms
-Two-hour OGTT level over 11.1 when a glucose load of 75g is used

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8
Q

Goals of collaborative care

A
  1. Promote well being
  2. Reduce symptoms
  3. Prevent acute complications (hyper/hypoglycaemia, DKA)
    -Delay long term complications
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9
Q

Accomplish this through

A

-Optimal glucose control
-Lifestyle modifications (nutritional therapy, exercise)

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10
Q

Cornerstones of treatment DM

A

-Nutritional therapy
-Exercise therapy
-Drug therapy
-Self monitoring glucose
-B/P monitoring
-Patient teaching

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11
Q

Nutritional therapy

A

-Cornerstone of care for person with diabetes
-Most challenging for many people
-Recommended that diabetes nurse educator and registered dietitian with diabetes experience should be members of the team

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12
Q

Rapid-acting insulin: Lisopro, aspart (clear) glusline.

A

Onset: 10-15 min
Peak: 60-90 min
Duration: 3-5hrs

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13
Q

Short acting: regular (clear), humulin R, Toronto, novolinge

A

Onset: 1-1/2 hr
Peak: 2-4hrs
Duration: 5-8hrs

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14
Q

Intermediate acting: Humlin N,NPH (cloudy)

A

Onset: 1-3 hrs
Peak: 6-8hrs
Duration: 12-16 hrs

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15
Q

Extended long acting insulin: Lantus, Levemir

A

Onset: 1-2hrs
Peak: none
Duration: 24+ hrs

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16
Q

Mixing insulin always draw up…

A

CLEAR before CLOUDY (short before long)

17
Q

cloudy insulins should always be…

A

gently agitated or rolled before drawing up

18
Q

multi dose insulin vials can be stored for up to…

A

-4 weeks at room temp
-Refrigerate unopened vials (avoid head or freezing)
-Insulin pens should not be refrigerated

19
Q

why not give insulin PO?

A

it would be inactivated by gastric juices

20
Q

what’s the only insulin that can be given IV?

A

Humulin R

21
Q

What 2 insulins cannot be mixed with other insulin

A

-Levemir and Lantus

22
Q

Order of fastest absorption

A

-abdomen
-arm
-thigh
-buttock

23
Q

Fixed combination insulins

A

-Humulin 30/70
-Novolin 30/70, 40/60, 50/50
-Novomix 30
-Humalog mix25
-Humalog mix50

24
Q

Sulphonylureas

A

Weight gain, hypoglycemia

25
Q

Nonsulphonylureas

A

N/V/D, hyppoglycemis, HA

26
Q

Biguanides

A

Edema, weight gain, CHF,

27
Q

α-Glucosidase inhibitors

A

GI upset, risk of lactic acidosis in patients with hepatic and renal impairment,

28
Q

Thiazolidinediones

A

URTI, sore throat, HA, diarrhea

29
Q

Dipeptidyl Peptidase 4 (DPP-4) Inhibitors

A

Less weight gain, decreased incidence of hypoglycemia compared to glyburide

30
Q

Incretin mimet ic -injectable (Byetta)

A

Flatulence, abd. pain, diarrhea

31
Q

Nursing considerations po Antihyperglycemics

A

Sulphonylureas – caution in persons with renal impairment and older adults

  1. Non-sulphonylureas – take 30 minutes before or right at meal time. Do not take if not eating

Biguanides – hold at time of procedure with IV dye and 48 hours post procedure

α-Glucosidase inhibitors - take with meal for best effect

Thiazolidinediones – do not use with insulin

Incretin mimetic -injectable (Byetta) – not indicated for use with insulin

32
Q

B blockers can…

A

mask symptoms of hypoglycemia and prolong hypoglycemic effect of insulin

33
Q

Thiazide and loop diuretics …

A

may potentiate hyperglycemia by inducing K loss

34
Q

Monitoring Blood Glucose

A

Self-monitoring of blood glucose (SMBG)
Enables patient to make self-management decisions regarding diet, exercise, and medication
Important for detecting episodic hyperglycemia and hypoglycemia
Patient training is crucial
Supplies immediate information about blood glucose levels

35
Q

What are key patient teaching points for individuals living with DM for RNs to emphasize?

A

Insulin therapy
Teaching proper administration
Effects of insulin
S and S of hyper/hypoglycemia
Self monitoring of glucose
Personal hygiene
Diligent skin and dental hygiene
Foot care/lower extremities
Medical ID and travel
Medic-alert

36
Q
A

Health Challenges (13 decks)

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