Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 301 - Exam 3 > Endocrine Alterations - Diabetes Mellitus > Flashcards

Endocrine Alterations - Diabetes Mellitus Flashcards

1
Q

What are the functions of insulin? (6)

A
  • Transports glucose for energy
  • Transports amino acids into cells
  • Stimulates fat storage
  • Stimulates storage of glucose as glycogen
  • Stimulates liver to stop realease of glucose
  • Inhibits breakdown of glucose, protein, and fat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe type I diabetes (2)

A
  • Decreased insulin production
  • Fasting hyperglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe type II diabetes (2)

A
  • Insulin resistance
  • Glucose intolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe gestational diabetes

A

Glucose intolerance with onset during pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the risk factors associated with gestational diabetes? (3)

A
  • Age > 25
  • Previous birth > 9 lb
  • Previous stillbirth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe latent autoimmune diabetes of adults (LADA)

A

Antibodies act against pancreas causing slow destruction of beta cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Latent autoimmune diabetes of adults (LADA) does not become insulin dependent in the initial ______ of disease onset

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Patients diagnosed with latent autoimmune diabetes of adults (LADA) are typically NOT ______

A

Obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What age is a risk factor of type I diabetes?

A

< 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What age is a risk factor of type II diabetes?

A

> 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What age is a risk factor of latent autoimmune diabetes of adults (LADA)?

A

> 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What HDL level is a risk factor of type II diabetes?

A

≤ 35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What triglyceride level is a risk factor of type II diabetes?

A

≥ 250

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the primary risk factor of LADA?

A

History of low birth weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A personal / family history of autoimmune diseases and hyperglycemia is an indication of ______

A

LADA / type I diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the manifestations of diabetes mellitus? (3)

A
  • Polyuria
  • Polydipsia
  • Polyphagia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Type I diabetes may have sudden ______

A

Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fasting glucose of ______ is an indication of diabetes

A

≥ 126

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Casual glucose of ______ is an indication of diabetes

A

≥ 200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the primary treatment goal for diabetic patients?

A

Hgb A1c < 7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hgb A1c < 5.7% is ______

A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hgb A1c from 5.7% - 6.4% is diagnosed as ______

A

Prediabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the test result that confirms presence of diabetes

A

≥ 6.5% on 2 separate tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Intensive therapy for diabetes must be initiated with ______

A

Caution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe the education topics for patients with diabetes (5)

A
  • Physical activity
  • Meal planning
  • Medications
  • Monitoring blood glucose
  • Self injections (type I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Describe the goals of nutritional therapy for diabetes (2)

A
  • Blood glucose levels in normal range
  • Consistent timing / amount of food eaten
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Meal planning for diabetic patients should be based on what factors? (3)

A
  • Usual preferences
  • Insulin patterns
  • Exercise patterns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Ideally, a person with diabetes should engage in regular ______

A

Exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the 5 components of diabetes management?

A
  • Exercise
  • Education
  • Monitoring
  • Nutritional therapy
  • Pharmacologic therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe the ideal meal composition for diabetic patients (2)

A
  • Carbohydrates: 50% - 60%
  • Fat: 20% - 30%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

When meal planning for diabetic patients, it is important to emphasize … (3)

A
  • Fiber
  • Whole grains
  • Non-animal protein (legumes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Combining what types of foods slows absorption and glycemic response?

A

Starchy foods with protein and fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

______ tend to have lower responses than cooked, chopped, or pureed foods

A

Raw or whole foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Eat ______ rather than juices; this decreases glycemic response because of fiber (slowing absorption)

A

Whole fruits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Foods with sugar may produce a lower response if eaten with foods that are ______

A

More readily absorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Define glycemic index

A

The speed at which foods increase blood glucose levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What other dietary concerns are associated with diabetes? (3)

A
  • Alcohol
  • Misleading food labels
  • Nutritive / non-nutritive sweeteners
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

______ blocks the production of glucose in the liver

A

Alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How does exercise lower blood glucose?

A

Increases uptake of glucose by body muscles

40
Q

Diabetic patients should AVOID exercise in what conditions? (2)

A
  • Blood glucose > 250
  • Ketones present in urine
41
Q

Exercising increases the secretion of … (3)

A
  • Glucagon
  • Growth hormone
  • Catecholamines
42
Q

What is primary contraindication for exercise in diabetics?

A

Ketones present in urine

43
Q

What should patients on exogenous insulin do prior moderate exercise?

A

Eat a 15 gram carbohydrate snack to prevent hypoglycemia

44
Q

What potential risk is associated with exercise for diabetic patients?

A

Post-exercise hypoglycemia - important to monitor blood glucose levels

45
Q

It is important for gerontologic diabetic patients to consider what factor regarding exercise?

A

Physical impairment

46
Q

Individualizing the treatment regimen of diabetes allows the patient to obtain …

A

Optimal blood glucose control

47
Q

What are the categories of insulin? (4)

A
  • Rapid-acting
  • Short-acting (regular)
  • Intermediate-acting (NPH)
  • Long-acting
48
Q

Which type of insulin has no peak?

A

Long acting

49
Q

Name an example of a rapid acting inhalation powder

A

Afrezza

50
Q

What are the 2 approaches to insulin therapy?

A
  • Conventional
  • Intensive
51
Q

Describe a conventional insulin regimen

A

Fixed schedule

52
Q

Describe an intensive insulin regimen (2)

A
  • More frequent injections
  • More flexible
53
Q

What is the onset of rapid-acting insulin?

A

15 - 30 minutes

54
Q

What is the peak of rapid-acting insulin?

A

1 - 2 hours

55
Q

What is the onset of short-acting insulin?

A

30 - 60 minutes

56
Q

What is the peak of short-acting insulin?

A

1 - 5 hours

57
Q

What is the onset of intermediate-acting insulin?

A

1 - 2 hours

58
Q

What is the peak of intermediate-acting insulin?

A

6 - 14 hours

59
Q

What is the onset of long-acting insulin?

A

1 - 2 hours

60
Q

What is the peak of long-acting insulin?

A

None

61
Q

What are the insulin delivery methods? (4)

A
  • SQ
  • Pens
  • Pumps
  • Jet injectors
62
Q

Describe insulin therapy by multiple daily injections (2)

A
  • Long-acting insulin once a day in morning / evening
  • Rapid-acting insulin before snacks / meals
63
Q

Rapid-acting insulin doses are adjusted based on …

A

Carbohydrate intake / blood glucose level

64
Q

Describe insulin therapy by continuous subcutaneous insulin infusion (2)

A
  • Rapid-acting insulin infused continuously through a pump
  • Boluses before meals
65
Q

What glucose level indicates hypoglycemia?

A

< 70

66
Q

When blood glucose drops, ______ is activated

A

Autonomic nervous system

67
Q

What are some possible causes of hypoglycemia? (2)

A
  • Mismatched timing of food and insulin peak
  • Mismatched oral hypoglycemic agents
68
Q

Hypoglycemia is more common in what type of diabetic patients?

A

Patients who take injectable insulin

69
Q

Manifestations of hypoglycemia mimic ______

A

Alcohol intoxication

70
Q

Describe the medical management at the first sign of hypoglycemia (2)

A
  • Check blood glucose level - if less than 70 begin treatment immediately
  • Follow “the rule of 15s”
71
Q

Describe the rule of 15s

A
  • Give patient 15 grams of quick-acting carbohydrates
  • Wait 15 minutes and test blood glucose
  • If unable to test, treat every 15 min until symptoms resolve
72
Q

What are some examples of foods used to provide 15 grams of quick-acting carbohydrates? (5)

A
  • Orange juice
  • Soda
  • Syrup
  • Jelly
  • Lifesavers
73
Q

Once glucose is stable, and next meal is more than 1 hour away …

A

Give patient additional carbohydrate AND protein / fat after symptoms subside (crackers with peanut butter or cheese)

74
Q

Immediately notify healthcare provider or emergency service if symptoms do NOT subside after ______

A

2 - 3 administrations of quick-acting carbohydrate

75
Q

Describe the nursing interventions for an unconscious hypoglycemic patient (2)

A
  • SQ / IM injection of 1 mg glucagon
  • IV administration of 20% - 50% glucose
76
Q

Describe monitoring for a sick diabetic patient (2)

A
  • Check blood glucose every 3 - 4 hours
  • Check urine for ketones every 3 - 4 hours
77
Q

Describe the oral intake for a sick diabetic patient

A

Fluids / soft foods 6 - 8 times a day

78
Q

What signs in a sick diabetic patient should be reported to the physician? (3)

A
  • Nausea / vomiting / diarrhea
  • Hypoglycemia / hyperglycemia
  • Presence of ketones in urine
79
Q

Diabetic ketoacidosis (DKA) occurs in patients with ______ diabetes

A

Type 1

80
Q

What is the cause of DKA?

A

Severe insulin deficiency

81
Q

DKA is characterized by …

A

3 metabolic derangements and dehydration

82
Q

What are the 3 metabolic derangements?

A
  • Hyperglycemia
  • Ketosis
  • Metabolic acidosis
83
Q

What manifestations of dehydration are associated with DKA? (4)

A
  • Tachycardia
  • Orthostatic hypotension
  • Poor turgor
  • Sunken eyes
84
Q

What are the manifestations of DKA? (4)

A
  • Polyuria
  • Polydipsia
  • Kussmaul respirations
  • Sweet / fruity breath
85
Q

Describe Kussmaul respirations

A

Rapid, deep breathing with dyspnea

86
Q

Blood glucose of ______ is associated with DKA

A

300 - 800

87
Q

Arterial blood pH of ______ is associated with DKA

A

< 7.30

88
Q

Bicarbonate of ______ is associated with DKA

A

< 16 mEq / L

89
Q

Describe the nursing interventions associated with DKA (5)

A
  • Oxygen (nasal cannula / non-rebreather)
  • 0.9% NSS until urine output is 30 - 60 mL / hr
  • Regular insulin drip
  • Sodium bicarbonate if severe acidosis
  • Dextrose if blood glucose is < 250
90
Q

What do ketones cause? (2)

A
  • Metabolic acidosis
  • Electrolyte depletion
91
Q

Describe what occurs in the end stages of DKA (5)

A
  • Vomiting
  • Hypovolemia
  • Shock
  • Renal failure
  • Death - if not treated
92
Q

What are the types of long-term complications associated with diabetes? (3)

A
  • Macrovascular
  • Microvascular
  • Neuropathic
93
Q

What are the types of macrovascular complications? (3)

A
  • CAD
  • CVD
  • PVD
94
Q

What are the types of microvascular complications? (3)

A
  • Microangiopathy
  • Retinopathy
  • Nephropathy
95
Q

What are the types of neuropathic complications? (3)

A
  • Peripheral neuropathy
  • Autonomic neuropathy
  • Sexual dysfunction

NURS 301 - Exam 3 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions