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Study > General Treatment of Diabetes > Flashcards

General Treatment of Diabetes Flashcards

1
Q

What should majority of calories come from?

A

Complex carbs, then fats, and lastly proteins

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2
Q

Carbs should be __% of diet?

A

45%

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3
Q

Fats should be ___% of diet?

A

30-40%

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4
Q

Proteins should be ___% of diet?

A

15-20%

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5
Q

Why are we worried about carbs?

A

Sugar destroys vessels just like fat

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6
Q

High fiber slows down ____ absorption in intestines, therefore eliminating sharp rise/fall in blood sugar

A

Glucose

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7
Q

Wait until blood sugar ____ to begin exercise

A

Normalizes

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8
Q

What should the client do pre-exercise to prevent hypoglycemia?

A

Eat a snak

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9
Q

Exercise when blood sugar is high or low?

A

Highest

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10
Q

T/F: Exercise same time and amount daily

A

T

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11
Q

Extreme blood sugar= ?

A

Vascular damage

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12
Q

Examples of complex carbs?

A

Fruits
Veg
Whole grains

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13
Q

Establish ___ with exercise

A

Routine

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14
Q

What type of diabetes get oral anti-diabetics and non-insulin injectables?

A

T2

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15
Q

Oral anti-diabetics and non-insulin injectables

Administered how?

A

Oral

SQ

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16
Q

Oral anti-diabetics and non-insulin injectables

How do they work-improve what 2 things?

A
  1. How body produces insulin

2. How body uses insulin and glucose

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17
Q

All oral anti-diabetics work to _____

A

Decrease amount of circulating glucose

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18
Q

What is the most widely used anti-diabetic?

A

Metformin

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19
Q

T/F: Metformin may be used for weight control in T2 diabetes

A

T

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20
Q

T/F: Metformin may be used with clients who have pre-diabetes

A

T

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21
Q

Why is metformin a favorite?

A

It reduces glucose production

Enhances how glucose enters cells

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22
Q

T/F: Metformin does not stimulate the release of insulin

A

T

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23
Q

Can you see hypoglycemia with metformin?

A

No!

Does not stimulate the release of more insulin!! It just reduces glucose production and helps the way glucose gets in a cell

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24
Q

If metformin is not controlling blood glucose, then what may be ordered?

A

Another anti-diabetic ….like Glargine (Lantus)

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25
Q

Clients undergoing surgery or any radiologic procedure that involves contrast dye should temporarily discontinue metformin. When can they resume?

A

48 hours after the procedure if kid function has returned and Cr is normal

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26
Q

How is insulin dose determined?

A

Initially based on body weight (average adult dose is 0.4-1 untis/kg/d)

27
Q

Insulin dose is adjusted until ___ is normal and until there is no more glucose or ___ in urine

A

Blood sugar, ketones

28
Q

Never give what insulin without food at bedside

A

Rapid acting

29
Q

Only insulin to give IV?

30
Q

T/F: Long acting has no peak and has steady control

31
Q

What color is regular insulin

32
Q

What color is NPH insulin

33
Q

When drawing up insulin, what do you draw up first?

A

Clear

Inject air to cloudy, inject air to clear, draw up clear, draw up cloudy

34
Q

All ____ are also clear and cannot be mixed with any other insulin or given IV

A

Long acting

35
Q

What is the standard insulin you give IV?

A

Reg

*rapid acting may also be given IV

36
Q

Plan is based on clients lifestyle, ___ and activity

A

Diet

Goal is to keep the before meal glucose near normal at 70-130 mg/dL

37
Q

The most common method of daily dosing insulin is ____

A

Basal bolus dosing

38
Q

The total daily dose of insulin with the basal/bolus method is a combination of what 2 insulins?

A

Long acting insulin

Rapid acting insulin

39
Q

How often to give long acting insulin?

A

Once a day

40
Q

How often to give rapid acting insulin?

A

Throughout day before meals in divided doses, and it covers the food eaten at meals

41
Q

Are snacks required with basal/bolus insulin dosing?

A

NO

*But clients must eat with a rapid acting insulin! So have food available

42
Q

When insulin is at its peak, the blood sugar is at its?

43
Q

Always monitor client on insulin for ____

A

Hypoglycemia

44
Q

What does HbA1c test do?

A

Gives an average of what your blood sugar has been over past 3-4 months

45
Q

Normal HbA1c?

A

Ideal goal: less than 7%

If it is more than 6.5% then that is diagnostic for diabetes

46
Q

What happens to your blood sugar when you are sick or stressed?

A

Increased

*normal pancreas can handle these fluctuations…Increase in blood sugar when sick or stressed is normal to help fight illness/stressor. ….If you are a diabetic who is sick, may have to increase insulin dose or DKA may occur!

47
Q

Diabetic illness — can lead to ?

48
Q

How to do rotation of site?

A

Within an area first

49
Q

Aspirate insulin?

A

No

Note: dont aspirate heparin and lovanox either `

50
Q

What is an alternative to daily insulin injections

A

Insulin infusion pumps

51
Q

Insulin infusion pumps

What insulin?

A

Rapid acting only

52
Q

Insulin infusion pumps help obtain better control. Receiving a basal level of insulin from the pump and boluses of additional insulin as needed with ___ or if they have an elevated ___

A

Meals; blood sugar

53
Q

Only insulin to give IV

54
Q

Only insulin to give via sq insulin infusion pump

A

Rapid acting

55
Q

S/s of hypoglycemia?

A 
Cold and clammy 
Confusion 
HA
Hunger 
Nausea
Nervous 
Shaking
Tachycardia
56
Q

If hypoglycemic, what should client do?

A

Eat simple carb (15g)

  • 4 oz juice or coke
  • 4 glucose tabs
57
Q

Snacks should be ___ grams of carbs

58
Q

Glucose absorption is delayed in foods with lots of __

59
Q

What is 15-15-15 rule?

A

15 g snack, wait 15 min and recheck, give 15 more grams of simple carb if blood sugar not up

60
Q

Once blood sugar is up, then get what?

A

Complex carb (protein, fat–Ex: PB crackers)

61
Q

You enter diabetics room and they are unconscious. What do we treat client like–hypo or hyperglycemic. Tx?

A

Hypoglycemic

Give D50W (need large bore, hard to push) 
*if no IV access, give injectable
62
Q

Preventing hypoglycemia?

A

Eat
Take insulin regularly
Know signs of hypoglycemia
Check blood sugar regularly

63
Q

What is hypoglycemia?

A

Blood sugar of 70 mg/dL or less

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