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adult health > EXAM 3 > Flashcards

EXAM 3 Flashcards

1
Q

PH is less than 7.3

A

diabetic ketoacidosis

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2
Q

Positive ketones (blood & urine)

A

diabetic ketoacidosis

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3
Q

blood glucose level greater than 300

A

diabetic ketoacidosis

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4
Q

what is considered hypoglycemic

A

less than 50

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5
Q

hormone secreting portion of pancreas

A

Islet of Langerhans

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6
Q

alpha cells produce and secrete

A

glucagon

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7
Q

beta cells produce and secrete

A

insulin

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8
Q

facilitates glucose transport

across cell membranes in most tissues

A

INSULIN

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9
Q

released in response to low blood sugar-opposes effects of insulin

A

Glucagon-released in response to low blood sugar-opposes effects of insulin

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10
Q

normal range of glucose range

A

70-120 mg/dl

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11
Q

two stress hormones are

A

cortisol and epinephrine

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12
Q

what is considered early diabetes

A

a1c is 5.7%-6.4%

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13
Q

early diabetes fasting glucose

A

greater than 100 but less than 126 ; fasting means not eating for 8-10 hours

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14
Q

target organs

A

eyes-diabetic neuropathy, glaucoma
nervous system
circulatory system- blood vessels
kidneys

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15
Q

leading cause of kidney failure

A

diabetes and hypertension

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16
Q

2 most complimentary diseases; occurring together increase the risk why people die

A

diabetes and hypertension

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17
Q

what do diabetic patients die from

A

die of heart issues

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18
Q

autoimmune disease

A

type 1

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19
Q

insulin producing cells of the pancrease

A

beta cells

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20
Q

has more signs of having diabetes; patients eventually get sick with dka

A

type 1

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21
Q

1 complaint for type 1

A

polyuria

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22
Q

5.8%

A

all your rbc.. only 5.8% of them are saturated with glucose

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23
Q

frosted flakes vs. corn flakes

A

all the frosted flakes are the cells saturated in glucose

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24
Q

average span of rbc

A

90-120 so 3 months ; a1c is considered within 3 months

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25
Q

greater than or equal to 126

A

diabetic fasting blood glucose

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26
Q

genetic + environmental; usually sudden onset

A

type 1

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27
Q

what will someone with type 1 come in with first

A

chronic hyperglycemic

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28
Q

higher blood glucose, higher urine output; water follows glucose

A

polyuria

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29
Q

kidney threshold for glucose

A

180; anything above that the kidneys will spill glucose in the urine

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30
Q

why are diabetics malaise and fatigue

A

glucose gives cells energy and If they dont have any then they have these symptoms

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31
Q

3 P’s of type 1

A

polyuria, polydipsia, polyphagia

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32
Q

metabolic syndrome

A 
hypertension >130/85
abdominal obesity >40 / >35
low HDL <40 / <50
impaired fasting glucose >110
elevated triglycerides >150

criteria for early diabetes

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33
Q

regular (onset, peak, duration)

A

30-60 minutes
2-4 hours
4-6 hours

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34
Q

lispro (humalog)

onset, peak, duration

A

5-15 minutes
0.5-1.5 hours
2-3 hours

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35
Q

aspart (novalog)

onset, peak, duration

A

10-20 minutes
1-3 hours
3-5 hours

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36
Q

insulin intermediate acting

A

lente

NPH

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37
Q

insulin short acting

A

regular, Iispro, aspart

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38
Q

NPH (onset, peak, duration)

A

2-4 HOURS
6-8 HOURS
10-18 HOURS

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39
Q

lente (onset, peak, duration)

A

2-4 HOURS
6-8 HOURS
10-18 HOURS

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40
Q

insulin long acting

A

Glargine (Lantus)

Ultralente (U)

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41
Q

Glargine (Lantus)

onset, peak, duration

A

4-8 hours
none
24+

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42
Q

Ultralente (U)

onset, peak, duration

A

4-6 hours
10-18 hours
18-36 hours

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43
Q

HumALOG Mix 75/25

A

5-15 minutes
1-12 hours
18 hours

44
Q

NovOLIN 70/30 or HumULIN 50 /50

A

0.5-1 hour
2-12 hours
18 hours

45
Q

normal a1c levels

A

less than 6.5%

46
Q

normal fasting glucose

A

70-126

47
Q

symptoms of dm plus a random plasma glucose

A

greater than 200

48
Q

glucose tolerance test

A

2 hour plasma glucose greater than 200

49
Q

2 fasting glucose levels

A

greater than 126

50
Q

the higher your number of glucose

A

the quicker chronic complications happen

51
Q

7 on the meter is

A

170

52
Q

the meter goes up by

A

35 points

53
Q

why is the peak most important

A

most at risk for hypoglycemia so you need to monitor your patient

54
Q

lantus has a decreased risk of hypoglycemia. why

A

because there is no peak

55
Q

what can you not mix with anything else

A

cannot mix lantus with anything in the same syringe

56
Q

why do you pull up regular insuLin before pulling up NPH

A

because you dont want to draw up long acting insulin in the short acting insulin because it is contaminated and could cause death

57
Q

insulin given IV

A

always regular insulin

58
Q

how is insulin given

A

sub -q so at 45 degree angle and DONT aspirate; person with not a lot of fat can have it at 45, person who is bigger can have it at a 90

59
Q

bumps dents in skin from repeated injections

A

Lipodystrophy

60
Q

fastest absorption of insulin

A

abdomen, arm, thigh, butt

61
Q

insulin and working out

A

avoid putting shot into the muscle that you are using because it may increase absorption

62
Q

what cells secrete insulin

A

beta cells located in the pancreas

63
Q

alpha cells

A

secrete glucagon

64
Q

why could a type 2 need insulin

A

if they have poor glucose control, bad diet, no exercise

65
Q

CHANGE THE INSULIN SITE for the pump

A

every 3 days for the pump

66
Q

oral insuline

A

only given to type 2 diabetics

67
Q

what to know about BIGUANIDES

A

first line used for dm
can cause renal damage
MONITOR CREATININE

68
Q

when a patient is on metformin and is getting contrast what do you do

A

hold the meds the day of and 48 hours after

69
Q

what do SULFONYLUREAS end in

A

ide; oral med

70
Q

major side effect of SULFONYLUREAS

A

hypoglycemia

71
Q

given orally and Lowers blood glucose by stimulating beta cells in pancreas to release insulin

A

Meglitinides

72
Q

whats important about Meglitinides

A

take 30 mins before each meal; do not take if meal is skipped ; cause hypoglycemia

73
Q

how much carbs do you need

A

130g/ day ; 45-65%

74
Q

fat

A

less than 7 %

75
Q

protein

A

15-20%; high protein is not recommended for these patients

76
Q

wbc

A

4-12,000

77
Q

hemoglobin male

A

13.0-18.0

78
Q

hemoglobin female

A

12.0-16.0

79
Q

hematocrit male

A

37-49%

80
Q

hematocrit female

A

36-46%

81
Q

platelets

A

150-400,000

82
Q

bun

A

10-20

83
Q

creatinine

A

0.6-1.2

84
Q

potassium

A

3.5-5.0

85
Q

sodium

A

135-145

86
Q

glucose fasting

A

70-100

87
Q

total cholesterol

A

<200

88
Q

treatment for hyperkalemia

A

regular insulin ; it drives potassium inside the cells

89
Q

only insulin given iv

A

regular

90
Q

why is potassium important

A

it can cause cardiac dysrhythmias

91
Q

anion gap

A

rough measure of acidosis ; resolves DKA ; blood sugar could be normal but if the anion gap is abnormal you’re still in dka

92
Q

anion gap elevated

A

means they are acidotic

93
Q

people w dka die from

A

acidosis

94
Q

when anion gap is within normal range

A

turn insulin off and consider acidosis has resolved

95
Q

hyperosmolar hyperglycemic syndrome

A

seen in patients with type 2 diabetes; dehydrated because glucose is high. some insulin production so they wont develop DKA

96
Q

hypoglycemia TIRED

A 
tachycardia 
irritability
restless
excessive hunger 
diaphoresis depression
97
Q

untreated hypoglycemia can cause

A

seizures and death

98
Q

what is considered hypoglycemia

A

less than 50

99
Q

can occur at any time but most often occurs at the peak of a medication

A

hypoglycemia

100
Q

treatment for hypoglycemia

A

glucagon and dextrose ; simple carb foods rule 15

101
Q 
Cool, clammy skin
Rapid heartbeat
Hunger 
Nervousness, tremor
Faintness, dizziness
Unsteady gait, slurred and/or incoherent speech 
Vision changes
Seizures, coma
Alc
Stroke
A

hypoglycemic

102
Q

whats important in treating hypoglycemic

A

giving them glucose but even when its normal, continue to monitor because they could fall right back into hypoglycemic after your short acting sugars

103
Q

slide 53

A

concept map

104
Q

check if patient is experiencing nephropathy

A

check protein in the urine

105
Q

anything higher than 240

A

go see the doctor because its too high

adult health (10 decks)

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