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N323 > Exam III--Diabetes > Flashcards

Exam III--Diabetes Flashcards

1
Q

Insulin needs ________ during pregnancy.

A

increase

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2
Q

Type II diabetics will likely need to take ______ while pregnant, even if they don’t take it normally.

A

insulin

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3
Q

All patients with type 1 diabetes require ________.

A

insulin

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4
Q

Describe the risks associated w/ mismanaged diabetes (gestational/DMI, DMII) during pregnancy

A

Fetal macrosomia:
-fetus gets too much sugar, fetus larger than normal
-High sugar → larger fetal pancreas/more insulin → more fat on fetus
-Higher risk of traumatic births, C sections

Immediate postpartum hypoglycemia:
-Baby is used to high-sugar environment, making lots of insulin at birth
-Baby will eventually adapt

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5
Q

The nurse is educating a client was newly diagnosed with Type II diabetes. The nurse will plan to teach the client all the following except: (Select all that Apply)

A) People with Type II diabetes only need to check their blood sugar if they think it is low.
B) Getting regular exercise can help decrease insulin resistance and can help lower blood sugar.
C) People with Type II diabetes will likely never need to use insulin.
D) You should get your eyes check every year.

A

A, D

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6
Q

Normal fasting and postprandial (2 hrs after eating) glucose levels

A

Fasting: 70-100
Postprandial: 100-140

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7
Q

Common causes of hypoglycemia include…

A

-insulin overdose
-sulfonylurea overdose
-after exercise

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8
Q

Both DMI and DMII have _________ and _______ factors

A

genetic and environmental

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9
Q

Describe the onset of DM-II

A

Insidious–often not detected until other side effects occur
-can also do lab testing of beta cell function

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10
Q

An A1C > 6.5, a fasting glucose >126, and a postprandial glucose >200 will likely lead to…

A

a diagnosis of DM

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11
Q

What is the response to a dx of Pre-diabetes?

A

-adjust risks–change diet, exercise
-other risk factors (age, obesity, HTN) –> Metformin

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12
Q

Describe the pathophysiology of gestational diabetes

A

Many factors, including: mom eating more, higher cortisol, placenta producing insulinase –> higher BG

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13
Q

Gestational diabetes is generally occurs in the _______ trimester and ends _______ ________. Screening occurs between __-__ weeks.

A

-second
-after delivery
-24-28

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14
Q

Describe the steps of the OGTT–what does it test?

A

-Gestational diabetes

Step one: BG drawn one hour after 50mg glucose drink. If BG >130, do step two

Step two: BG drawn at 1, 2, and 3 hours after chugging 100g glucose drink. If 2 of those BG > 130 –> gestational diabetes dx

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15
Q

High blood glucose in the first trimester is likely indicative of ______.

A

DMII

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16
Q

Eating __________ oils, _______ grains, limiting alcohol and not following a high-________ diet is recommended for DMII patients.

A

-vegetable oils
-whole grains
-not following high-protein

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17
Q

____ minutes of _______ __________ exercise each week is the recommended regimen for patients with type 2 diabetes

A

150 minutes of moderate resistance exercise each week

18
Q

Extra insulin should be __________.

A

refridgerated

19
Q

Metformin use, MOA, SFX
-cannot be taken with ___ _______.

A

-first line for DMII, and for pre-diabetes
-MOA: decreases hepatic glucose production
-cannot be taken with CT media
-SFX: weight loss

20
Q

Sulfonylurea use, MOA, side effects

A

-used for early stages of DMII
-MOA: stimulates beta cells
-SFX: hypoglycemia, nausea, heartburn, weight gain, sulfa cross-allergy

21
Q

Glinide use, MOA, considerations, side effects

A

-DMII
-MOA: briefly increases insulin production from pancreas
-take w/ food
-SFX: weight gain

22
Q

Glitazones MOA, side effects
-Do a careful ________ assessment b/c…

A

MOA: increased insulin receptors –> increased insulin re-uptake by cells
SFX: liver function, edema, weight gain, rhabdomyolysis
-do careful cardiac assessment b/c contraindicated w/ HF

23
Q

AG inhibitors MOA, side effects
-Must take with _______

A

-MOA: delay glucose absorption in small intestine
-SFX: GI issues (diarrhea, gas, pain)
-must take with food

24
Q

DPP-IV inhibitor MOA, SFX

A

-MOA: increases lifespan of incretin hormone
-SFX: URI, headache, diarrhea, ARF, pancreatitis, rhabdomyolysis

25
Q

Sglt2 inhibitors MOA, SFX
-_________ can decrease its effects

A

-MOA: increase glucose excretion in kidneys
-SFX: yeast infection, UTI
-Rifampin can decrease effects

26
Q

“-tide” drugs, or __________ mimetics MOA, SFX

A

-incretin
-MOA: mimic incretin hormones –> increases insulin, slows gastric emptying, increases satiety
-SFX: N/V, diarrhea, weight loss

27
Q

If a patient’s BG is over ____, they should call their provider–who might be worried about ____.

A

-300
-DKA

28
Q

Gestational diabetes is most common in what population(s)? It indicates higher risk of developing ______.

A

-mothers of color
-DMII

29
Q

Diabetic neuropathy symptoms are more common…

A

at night

30
Q

A monofilament screening tests the patient for _____________.

A

neuropathy

31
Q

Zostrix use, MOA, application considerations
-Typically takes ___ ________ to work

A

-Capsaicin cream for neuropathy
-MOA: depletes pain-mediating chemicals
-use gloves/cotton ball, avoid eyes-mouth-nose-open skin
-Typically takes 2 months to work

32
Q

Amitriptyline for neuropathy–MOA

A

increases serotonin levels (TCA antidepressant)

33
Q

Cymbalta for neuropathy–MOA

A

-MOA: inhibition of norepinephrine and serotonin receptors

34
Q

Gabapentin MOA
-starts working in __-__ weeks

A

MOA: decreases nociceptive transmitters
-starts working in 2-3 weeks

35
Q

Limited movement, foot ulcers, PAD, and infection are risks associated with _______ __________.

A

diabetic neuropathy

36
Q

__________ is the leading cause of adult blindness, end-stage renal disease, and lower limb amputation

A

Diabetes

37
Q

A fasting BG > ____ leads to a dx of DMII

A

126

38
Q

Lispro, aspart, glulisine onset, peak, duration

A

onset: 10-30 minutes
peak: 30 minutes - 3 hrs
duration: 3-5 hours

39
Q

Regular insulin onset, peak, and duration

A

onset: 30 - 60 minutes
peak: 2-5 hrs
duration: 5-8 hours

40
Q

NPH onset, peak, and duration

A

onset: 1.5-4 hrs
peak: 4-12 hours
duration: 12-18 hours

41
Q

Glargine, detemir, degludec onset, peak, and duration

A

onset: 1-4 hours
peak: none
duration: 16-24 hours

N323 (9 decks)

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