Brainscape's Knowledge GenomeTM

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


See full index

NRSG 200: Med Surg 3 > [Exam 4] Chapter 51 - Diabetes > Flashcards

[Exam 4] Chapter 51 - Diabetes Flashcards

1
Q

Diabetes: What is this?

A

Group of metabolic diseases characterized by increased levels of glucose in blood

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

Diabetes: What can cause this to occur?

A

Defects in insulin secretion, insulin is not as effective anymore, or combination of both.

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

Diabetes: What are the different types?

A

Type 1 and Type 2

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

Diabetes: What does Type 1 involve?

A

Beta Cells in the pancreas are destroyed.

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

Diabetes: What can cause Type 1 DM?

A

Can be genetic or autoimmune related.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diabetes: What happens when beta cells are desroyed?

A

Insulin production is reduced

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

Diabetes: What are Type 1 Diabetics treated with?

A

Insulin

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

Diabetes: What does insulin bind to?

A

REceptors on the cells and see an increase amount of glucose in the blood

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

Diabetes: What is basically occuring in Type 1 DM?

A

Body is not producing enough insulin to do its job

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

Diabetes: What is Type 2 DM?

A

Pancreas produces enough insulin, but cells aren’t responsive to insulin

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

Diabetes: What effect does insulin have on cells?

A

Is the key to cells. Opens it up so glucose can go from the blood into the cells; that is the energy.

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

Diabetes: insulin is secreted by what?

A

Beta cells in the pancreas

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

Diabetes: What is the purpose of glucose?

A

It gives energy to the muscle, liver, fat cells

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

Diabetes: What are some of the different actions of insulin?

A

Transport and metabolizes glucose for energy, stimulates storage of glucose in liver and muscle.

Tells liver to stop releasing glucose

Enhances storage of dietary fat and adipose tissue

Accelerates transport of amino acids into cells

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

Diabetes: Glucose is stored in the liver as what

A

Glycogen.

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

Diabetes: Insulin inhibits the breakdown of what

A

Stored glucose, protein, and fat. Important to know when body cannot get energy from glucose, it will start to break this down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diabetes: What happens if the liver needs to release glycogen from liver?

A

Will go through glycogenolysis to become glucose. Amino acids can also be converted during this step to become glucose

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

Diabetes: Where does energy come from when someone is in DKA and body doesn’t have enough energy?

A

It’ll start breaking down fatty acids and goes through ketogenesis. Releases ketone bodies to be used for body, heart, and brain.

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

Diabetes: Insulin is basically what?

A

The key that opens up the pathway , opens the door for glucose to enter the cell.

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

Diabetes: Risk factors for diabetes?

A

Family Hx
Obesity
Hypertension
Elevated Triglyceride Levels

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

Diabetes: Diabetes is the leading cause of what?

A

Non-traumatic amputations
Blindness
ESRD

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

Diabetes: What is the difference between Type 1DM and Type 2 DM?

A

Type 1: Pancreas fails to produce insulin

Type 2: Cells fail to respond to insulin correctly

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

Diabetes: What is having Type 1 DM bad?

A

Since pancreas isn’t producing insulin, you have glucose floating around in bloodstream. Can’t get into cells

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

DKA: This only occurs with who?

A

Those with Type 1 DM

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

DKA: What occurs in DKA?

A

There is not enough insulin this results in hyperglycemia, dehydration, and electrolyte loss along with acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

DKA: What do kidneys do here?

A

they try to excrete the excess glucose , and that is why there is dehydration and electrolyte imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

DKA: Why does the body go into acidosis?

A

Because the body is trying to break down fats for energy causing ketone bodies which leads to acidosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

DKA: Important for Diabetics to follow Sick Day Rules, which include what?

A

Take insulin as usual
Test glucose/ketones every 3-4 hours
Report elevated glucose
Take supplemental glucose ever 3-4 hours as needed
Sub soft foods if needed
Take liquids every 30- 1 hour to prevent dehydration

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

DKA: What are the three main causes of this?

A

Either decreased or missed doses of insulin

Illness/infection

Undiagnosed/untreated diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

DKA: What happens when patients are sick and they don’t eat enough food?

A

It could throw them into DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

DKA: How do you prevent this when sick?

A

Continue to take insulin

Check glucose levels/ketones every 3-4 hours

Be in contact with provider.

Sub foods for soft foods. Stick to meal plan.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

DKA - CMs: What are the first three main ones we may see?

A

Polyuri, Polydipsia, Fatigue

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

DKA - CMs: What are some other signs that they may have?

A

Hypotension due to volume depletion
Acidotic
Fruity Breath

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

DKA - CMs: What GI symptoms may they have?

A

Anorexia, N/V, abdominal pain

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

DKA - CMs: What is the hallmark sign of this?

A

Fruity breath due to buildup of ketones

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

DKA - CMs: How will their respiration’s be?

A

Kussmaul Respirations (deep, rapid breathing). they are in metabolic acidosis and are trying to breathe off the CO2.

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

DKA - CMs: Mental status can vary how?

A

Some can be in coma, or some can be alert.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

DKA - CMs: Assessment will focus on what?

A

The clinical manifestations. Assessing for dehydration, blood pressure, gi status, fruity breath, kuzzmal breathing.

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

DKA - Diagnostics: What will their glucose level be at?

A

300-800.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

DKA - Diagnostics: How will their abg levels be?

A

In metabolic acidosis

Will have decreased bicarb. pH will be less than 7.35.

Respiratory system may try to compensate for this

41
Q

DKA - Diagnostics: Urine test will reveal what?

A

Ketones present in the urine

42
Q

DKA - Diagnostics: Albumin and creatinine will be what?

A

Will both be increased

43
Q

DKA - Mx: What is the number one management way?

A

Rehydration. First start with normal saline.

44
Q

DKA - Mx: What will first be given for dehydration?

A

A bolus on normal saline, around 0.5 - 1L / hr over 2/3 hours.

45
Q

DKA - Mx: After the normal saline is given, what will then be given?

A

1/2 NS at 200-300 mL / hr. Have to keep an eye on glucose

46
Q

DKA - Mx: Why do you have to keep an eye on glucose as you rehydrate an individual?

A

BEcause as the glucose continues to be brought down, the glucose level will need to be switched once below 300

47
Q

DKA - Rehydration Mx: Once BS < 300, what will be given?

A

Will be switched to D5W and actually given a little bit of dextrose as well.

48
Q

DKA - Rehydration Mx: What electrolyte will be a big concern?

A

Potassium. Will usually see elevated potassium and will start to go down because patient is receiving a lot of fluids and insulin. Shifts potassium into cell.

49
Q

DKA - Rehydration Mx: What is a treatment of hyperkalemia?

A

Insulin

50
Q

DKA - Rehydration Mx: So while potassium is being corrected, what else is being corrected?

A

Metabolic Acidosis through insulin

51
Q

DKA - Mx: To ensure they are recovering, what must you do?

A

Get labs every 2-4 hours.

EKGs done more frequently.

Frequent monitoring.

52
Q

DKA - Mx: Why is the patient acidotic?

A

Because of the ketone bodies that have accumulated related to fat breakdown for energy.

53
Q

DKA - Mx: How will the patients acidosis be fixed?

A

Through Insulin IV drip. Will be getting glucose every hour.

54
Q

DKA - Mx: We wont give bicarb to correct acidosis to DKA patients why?

A

Because it will eventually correct itself normally

55
Q

DKA - Mx: When giving insulin, what must we keep in mind when we are hanging?

A

We must flush insulin because it tends to stick to the tubing. Make sure 50 mL are flushed through IV set because it will stick to tubing.

56
Q

Nickname for Hyperglycemic Hyperosmolar Syndrome?

A

HHS

57
Q

HHS: What is the official name of this?

A

Hyperglycemic Hyperosmolar Syndrome

58
Q

HHS: Sometimes referred to as HH NKS, which is what?

A

Non-Ketonic Syndrome

59
Q

HHS: This will typically affect what patient?

A

Those with Type 2 DM and older

60
Q

HHS: This is usually initiated by what?

A

Illness that raises the demand for insulin

61
Q

HHS: Why don’t you see acidosis with this?

A

Because there is not the ketosis that is going on. They still have insulin in circulation so they don’t develop acidosis.

62
Q

HHS: They will have an increase in what?

A

blood sugar, which causes the kidneys to try to get rid of all this extra sugar/glucose and see osmotic diuresis

63
Q

HHS: How long does this take to progress

A

This can progress over days to weeks

64
Q

HHS - CMs: What changes will start to occur?

A

Decreased blood pressure (hypotension)

Dehydration (bc of diuresis)

Tachycardia

Mental status varies (seizures)

65
Q

HHS - CMs: Decreased blood pressure and dehydration is coming from what

A

osmotic diuresis that happens because body is trying to get rid of excess glucose.

66
Q

HHS - Assessments: You will be looking at what glucose level?

A

Looking at glucose level of 600 - 1200

67
Q

HHS - Assessments: What will patient be assessed for?

A

Signs they are experiences so blood pressure and dehydration that matches with high glucose levels.

Elevated BUN / Creatinine.

68
Q

HHS - Mx: What three things cna be done to manage this?

A

Fluid replacement

Electrolyte correction

Insulin

69
Q

HHS - Mx: How long will this take to correct?

A

Usually 3-5 days, especially if theyre having AMS.

70
Q

HHS - Mx: Why will insulin be given?

A

To help get their blood sugar down

71
Q

Nursing Process - DKA and HHS: Assessment for both will focus on what?

A

Vital signs

Electrolytes

ABGs (DKA)

Mental status

72
Q

Nursing Process - DKA and HHS: Nursing Diagnosis will be what?

A

Fluid Volume Deficit

Fluid and Electrolyte Imbalance (Elevated K+ before tx)

Knowledge Deficit

Anxiety

Fear

73
Q

Nursing Process - DKA and HHS , Goals: You want to maintain what?

A

Fluid and electrolyte balance and having absence of complications

Self-CAre by decreasing anxiety.

74
Q

Nursing Process - DKA and HHS , Nursing Interventions: THis will line up with what and be what?

A

Nursing Diagnosis.

Maintain fluid and electrolyte balance,

Education to manage anxiety and fear.

75
Q

Nursing Process - DKA and HHS , Nursing Interventions: We should make sure to evaluate what?

A

Patient outcomes for our goals such as fluid and electrolyte balance and self care.

76
Q

Long-Term Comps of Diabetes: These can be split into what categories?

A

Macrovascular

Microvascular

77
Q

Long-Term Comps of Diabetes: Macrovascular changes include what?

A

Changes to medium/large blood vessels (Heart, Brain)

78
Q

Long-Term Comps of Diabetes: What are some diseases that can occur on macrovascular side?

A

CAD, Peripheral Vascular Disease, Cerebral Vascular Disease.

79
Q

Long-Term Comps of Diabetes: What is one of the bigest changes we can do for macrovascular changes?

A

Reduce risk factors , teach patients nutrition, exercise, smoking cessations, control blood pressure.

80
Q

Long-Term Comps of Diabetes: What event may occur on a macrovascular scale?

A

May see a stroke occur because large blood vessels were affected

81
Q

Long-Term Comps of Diabetes: Microvascular refers to what?

A

More of the capillary basement membrane thickening. Can see it happen with retina and kidney

82
Q

Long-Term Comps of Diabetes: What diseases occur on a microvascular scale?

A

Diabetic retinopathy and nephropathy

83
Q

Long-Term Comps of Diabetes: What occurs in diabetic retinopathy?

A

You have small blood vessels in the retina that begin to change. Causes vision changes.

84
Q

Long-Term Comps of Diabetes: What occurs in nephropathy?

A

Occurs when theres increased glucose levels which causes increased stress in kidney filtration allowing blood protein to leak into urine. Increases pressure and can lead to CKD, ESKD.

85
Q

Long-Term Comps of Diabetes: Why do those with uncontrolled diabetes end up with kidney problems?

A

Because of the increased strain that glucose causes on the kidneys

86
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What categories can this include?

A

Peripheral Neuropathy

Autonomic Neuropathies

87
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What is this?

A

Group of diseases that affects all types of nerves.

88
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What is the cause of this?

A

Can be due to increased glucose over years. Specific cause hasn’t been determined.

89
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What is peripheral neuropathy?

A

Affects the peripheral portion of the nerves in the lower extremity

90
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What will the patient usually describe with peripheral neuropathy?

A

Tingling, burning sensation

Decreased sensation

91
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: These patients are at big risk for what?

A

Injury

May have a foot injury that may be unnoticed. Can lead to further complications

92
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What is the best management that can be given to these patients?

A

Educate on how to control glucose levels, pain management

93
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What is often given for pain?

A

Gabapentins, because of tingling and burning sensatiosn can be unbearable.

94
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What are Autonomic Neuropathies?

A

DEals with cardiac, GI, Renal systems.

95
Q

Long-Term Comps of Diabetes - Diabetic Neuropathies: What problems may those with autonomic neuropathies have?

A

Silent Ischemia -> MI,

GI -> Delayed gastric emptying

Renal - Urinary Retention

96
Q

Long-Term Comps of Diabetes - Foot/Leg Probs: When you think of these patients, you think they are having what type of problems?

A

Some type of ulcers on the foot, or they star to have amputations and lose toes. Can start to go farther up the leg.

97
Q

Long-Term Comps of Diabetes - Foot/Leg Probs: It is important that these patients are taught what?

A

Foot care tips

98
Q

Long-Term Comps of Diabetes - Foot/Leg Probs: What foot care tips may be given?

A

Take care of DM
Inspect/wash feet daily
Keep skin soft/smooth
Smooth corns and calluses gently

Wear shoes and socks at all times

Protect feet from hold/cold

Keep blood flowing to feet (put feet up when sitting)

Consult with primary provider

NRSG 200: Med Surg 3 (46 decks)

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