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Undeleted > Glucose > Flashcards

Glucose Flashcards

1
Q

Diabetes Mellitus

A

chronic, body is unable to use glucose as it should to produce energy

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2
Q

Type 1

A

unable to produce insulin- irreversible disorder of pancreatic beta islet cells (severe insulin deficiency)- altered macronutrient metabolism- dependent on exogenous insulin

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3
Q

Type 2

A

unable to use insulin- pancreas doesn’t produce enough (deficiency)- cells don’t use insulin properly (resistance) majority- dysfunction of liver: excess glucose released

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4
Q

insulin role

A
  • promotes uptake and storage of glucose from blood- promotes uptake and storage of glucose by other cellsminor- promotes fat deposition, amino acid transport- inhibits protein degradation
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5
Q

hyperglycemia pathophysiology

A

osmotic gradient shift - fluid from ICM -> ECM -> glomerular filtrateglucose > 180 mg/dl -> glucosuria, polyuria

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6
Q

diabetes clinical manifestations

A
  • frequent urination- increased thirst, appetite- decreased energy- vision disturbances- abdominal pain
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7
Q

alpha cells

A

glucagon: acts on liver to release glycogen, increases blood sugar

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8
Q

beta cells

A

insulin: decreases blood sugar

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9
Q

delta cells

A

somatostatin: stops glucagon and GH, decreases blood sugar

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10
Q

type 1 etiology

A

Human Leukocyte Antigen (HLA) system- identifies cells to immune system as self or non. Certain patterns indiate a susceptibility to Type 1 DMautoimmune process- islet cell antibodies, insulin antibodiesenvironmental factors-viruses

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11
Q

diabetic ketoacidosis

A

BIGGEST ISSUE.- often presenting symptom in children- moderate to life threatning- caused by metabolism of fats for energy (source #2 for energy; ketones released; body at extremely high glucose for extended period for this to happen)

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12
Q

DKA lab findings

A
  • hyperglycemia- glucosuria- ketonuria- metabolic acidosis/ketoacidosis
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13
Q

DKA s/s

A
  • kussmaul respirations (deep, rapid)- dehydration- acetone breath (sweet, fruity)- poor perfusion- impaired consciousnessi
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14
Q

illness/stress response + diabetics

A

check blood sugar, monitor to prevent DKA

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15
Q

nursing interventions for DKA

A
  • manage hyperglycemia(regular insulin, IV, 75 - 150 mg/dl/hr)- fluid and electrolyte(restore volume, maintain perfusion to brain/heart/kidneys)- education(reason for diagnosis, prevent further episodes)
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16
Q

Type 2 DM etiology

A
  • strong genetic basis exacerbated by environment factors including inactivity, weight gain, stress- most people overweight at time of diagnosis; weight loss can prevent/delay development- all age groups
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17
Q

Type 2: increased risks

A
  • overweight- parent/sibling with diabetes- 40+ yo- htn- African American, Latino, American Indian- diabetes during pregnancy- stress of illness, injury- had baby weighing more than 9 pounds at birth
18
Q

hyperglycemic-hyperosmolar state (HHS)

A

mainly type 2- blood sugars EXTREMELY high (up to 600 mg/dl)- body tries to rid excess by passing through urine- initially lots of UOP, becomes dark- very thirsty- if condition continues: severe dehydration -> seizures, coma, death

19
Q

nursing intervention of HHS

A

fluid therapy- replacement to increase blood volumemedical therapy- IV insulin after adequate fluid replacement. 50-70 mg/dL/hr

20
Q

management of DM

A

meds (insulin + PO)monitoringmeal planexercise planEDUCATION!

21
Q

medicinal management of Type 1

A

insulin: basal, rapid acting

22
Q

basal insulin

A

Levemir, Lantus (work up to 24 hours)

23
Q

rapid acting insulin

A

Novolog, Humalog (meal time and correction doses)

24
Q

medicinal management of Type 2

A

biguanides: Metformin (glucophage) - increases insulin sensitivity; decreases hepatic production of glucose from glycogen; decreases absorption of glucose from small intestinesulfonylureas: Glyburide, Glucotrol (glipizide) - directly stimulate pancreas to secret insulin

25
Q

monitoring management of diabetes

A
  • self-monitoring of blood glucose (SMBG)- HbA1C- urine testing for ketones
26
Q

HbA1C

A
  • glycoselated hemoglobin- reflects glycemic control for previous 3 months- target: 7% (American Diabetes Association), 6.5% (American Association of Clinical Endocrinologists)- normal: 6%
27
Q

A1C components

A

post-prandial glucose + fasting glucoseginormous table correlating blood sugar and A1C

28
Q

urine testing for ketones

A
  • when blood glucose is > 240 mg/dl - on sick daysKetones indicate that current insulin levels are not adequate; NO EXERCISE IF KETONES PRESENT
29
Q

meal plan management for diabetes

A
  • consistency in intake to match insulin regimen- adequate energy for growth, development- prevent longterm complications
30
Q

carbohydrates

A
  • main source of fuel- 4 calories per gram- almost 100% eaten turns into blood glucose- simple vs complex
31
Q

exercise management of diabetes

A
  • daily!- important to overall growth, development- extra snacks may be needed
32
Q

hypoglycemia s/s

A

COOL AND CLAMMY NEED SOME CANDYrapid onset- shaking- sweating, clammy- headache, dizzy- tachycardia- confusion, seizure, coma

33
Q

hypoglycemia causes

A
  • delayed/skipped meal/snack- too much med- too much/unexpected activity- drinking alcohol on empty stomach
34
Q

*hypoglycemia treatment

A

mild-moderate: 3 glucose tablets or fruit juice if BG < 60 whether or not s/s.- rest 15 minutes, recheck to make sure BG > 70severe: patient unresponsive; glucagon emergency kit

35
Q

hyperglycemia

A

WARM AND DRY, SUGAR’S HIGHgradual onset- frequent urination, ketonuria- lethargy, weakness- n/v/abdominal pain

36
Q

hyperglycemia treatement

A
  • adjust insulin- increase fluids- dietary changes- if signs of ketoacidosis: SEEK MEDICAL CARE
37
Q

diabetic retinopathy

A

recommend professional dilated eye examination once a year

38
Q

neuropathy and amputation: foot care

A
  • examine feet daily for discoloration, swelling, skin cracks, pain, numbness- hygiene- control water temperature- avoid going barefoot or shoes without socks- ask for help if reduction of visual acuity
39
Q

cardiovascular care for diabetics

A
  • higher risk for MI (leading cause of death for diabetics)- aggressive management of hyperglycemia, hypertension, hyperlipidemia- education: diet, exercise, med management
40
Q

diabetic nephropathy

A

annual testing for microalbuminuria recommended for Type 1 patients (5+ years long) and ALL Type 2

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