Exam 3 ch 46 Flashcards
Know what diabetes type I is and what causes it
Destruction of beta calls
Know what diabetes type II is and what causes it
inadequate insulin and body’s inability to properly use
Know why a patient with type I diabetes would experience hunger, even though the patient is eating large amounts of food
cells can’t use blood glucose
Know why a patient with diabetes type I, is at risk for cardiovascular disorders
Increased fatty acids in liver
Know how/why “Hyperglycemia” occurs in a diabetic, related to glycogen stores
glycogen is converted to glucose in an attempt to nourish glucose-starved tissues
Know how a Nurse would respond to a patient with diabetes, who is having difficulty coping with the disease
Ask about their fears and concerns. open-ended questions
Know what a Hemoglobin A1c is and what it measures
shows glucose levels over the last 3 months. more accurate test
Know what a Nurse should do if a patient has a low fasting blood sugar at 6 AM in the morning
6-8oz of OJ and/ or feed them
Know what “diabetic ketoacidosis” is and what it results in
Life-threatening emergency caused by a relative deficiency or absolute deficiency (lack of insulin). Results in disorder of the metabolism of carbohydrates, fat and protein
- ketones are produced (fruity breath)
- early signs DKA: anorexia, H/A, fatigue
If a patient is admitted to a hospital with diabetic ketoacidosis, know what the patients vital signs would show
Elevated pulse (100Beats/M), elevated respirations (20 Breaths/M), Hypothermia (97.4 or lower),
Know how exercise would effect a type I diabetic, regarding the patient having hypoglycemia
exercise shortly after eating or snack before if BG is < 100
Know what a Nurse would teach on discharge planning, regarding exercise for a type I diabetic
Exercise at the same time and same intensity every day
If a Nurse is drawing up two different insulins into the same syringe, know the procedure for drawing two different insulins
Clear (regular) to cloudy (NPH)
Know the s/s of hypoglycemia
weakness, hunger, H/A, tachycardia, pallor, diaphoresis, tremors, anxiety, irritability
If a patient has a fasting blood glucose of 135, would the Nurse recommend testing for diabetes?
yes; normal BG= 70-120
If a patient was taking birth control pills and was on “Avandia”, what caution would the Nurse teach on
Avandia= oral anti-diabetic
-decreases BCP effectiveness, use another back up method
For a patient with type I diabetes, who is insulin dependent and is scheduled for a lab draw (to be NPO, prior to lab draw), what would the Nurse do with insulin dosage that is due for the patient
Hold insulin till after lab draw if NPO
If a patient admits to the Nurse that they are not compliant with their diabetic diet, how should the Nurse respond?
-open-ended questions.
Why are you not wanting to be compliant?
-Include healthy menu options
-figure out their past eating habits/diet, what they normally eat in 24 hrs.
How would a Nurse explain to a type I diabetic why their 7AM insulin was changed to: 70/30 premixed insulin. How would that medication change benefit the patient?
70(NPH)/30(reg)
decreases the risk of error when drawing up 2 insulins in one syringe. It’s easier to prepare
Know what a Nurse would include in a diabetes teaching plan regarding exercise?
regular exercise helps control blood glucose levels
Know what a patient diagnosed with endogenous hypoglycemia would have?
excessive secretions of insulin
Know when Humulin R insulin peaks
Humulin R = regular= peak:2hrs
Know what “Somogyi Phenomenon” is and what the patient will exhibit
Too much insulin can cause hyperglycemia (rebound hyperglycemia)
Know what “Hyperglycemic hyperosmolar non-ketotic syndrome (HHNS) is, and if caused by large amounts of glucose solutions IV, what would the patient exhibit?
Severe dehydration and hypernatremia
- HHNS=very high BG (800range)
- mortality up to 15%
- lack of effective insulin or defective use of insulin
- no ketones
