Endocrine: 2

Question 1

glycosylated hemoglobin (hbA1c): blood test; gives an average of what your blood sugar has been over the past ____

Answer 1

3 months

Question 2

illness= think (diabetes)

Answer 2

DKA

Question 3

should you aspirate insulin?

Answer 3

NO , to reduce the trauma of the skin

Question 4

insulin infusion pump:

-only ____insulin is used in infusion pump.

Answer 4

alternate to insulin injections

rapid acting

Question 5

____ is the only insulin that can be given in IV fluid as an intravenous infusion.

____ is the only insulin that can be given via SQ insulin infusion pump. insulin infusion pump are small computerized device worn by the client that provide both a ____ dosing of rapid-acting insulin and on-demand (bolud) dosing.

Answer 5

regular insulin

rapid acting insulin

continuous

Question 6

s/s of hypoglycemia

Answer 6

cool
clamy
confusion
HA
nervous
increase pulse
shaky
nausea

Question 7

if hypogylcemic, what should client do?
glucose absorbtion is delayed in food with lots of __.
once the blood sugar is up, what should they do?

Answer 7

eat simple sugar
fat
eat complex carb and protein

Question 8

what is important about d5w?

Answer 8

hard to push, if you have a choice you need a large bore IV

Question 9

for prevention of hypoglycemia, teach the client to

Answer 9

eat
take insulin regular
know sign of hypoglycemia
check blood sugar regularly

Question 10

hypoglycemia is a glucose level of ____

Answer 10

70 or less

Question 11

diabetic ketoacidosis:

Answer 11

anything that increases blood sugar can throw a client into DKA (illness, infection, skipping insulin)

• DKA may be the first sign of type 1
• have all the usual s/s of type 1
• patho: absent or inadequate insulin–blood sugar goes sky high–polyuria,polydipsia,polyphagia– fat breakdown(acidosis)–kussmaul’s respiration (trying to blow off co2 to compensate for the met. acidosis), also, as the client becomes more acidotic, the LOC does DOWN!

Question 12

treatment for DKA

Answer 12

• find the cause
• hourly blood sugar and potassium level
• IV insulin (insulin decreases glucose and potassium by driving them out of the vascular space into the cell)
• ECG
• ABGs
• IVFs–start with NS.. then when the blood sugar gets down to about 300, switch to d5w to prevent throwing the client into hypoglycemia
• anticipate that the physician will want to add potassium to the iv solution at some point

Question 13

HHNK or HHS is…

Answer 13

Hyperosmolar hyperglycemic nonketosis or hyperglycemic hyperosmolar state

• looks like dka, but no acidosis
• making just enough insulin so they are not breaking down fat. no fat breakdown…no acidosis, no ketones…no acidosis
• no fruity breath odor
• no kussmauls respirations

Question 14

DKA happens in ___ whereas HHNK (HHS) happens in ___.

Answer 14

type 1

type 2

Question 15

DKA and HHNK are both hyperosmolar state caused by ____ and ____, but there is no ____ with HHNK.

Answer 15

hyperglycemia
dehydration
acidosis

Question 16

what is gastroparesis?

Answer 16

stomach empyting is delayed so there is an increased risk for aspiration

Question 17

what is the complications of diabetes?

Answer 17

DKA
HHNK (HHS)
vascular problems
neuropathy
increased risk for infection