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Med Surg > Glucose Regulation > Flashcards

Glucose Regulation Flashcards

1
Q

Fasting blood glucose

A

Drawn after client has been fasting at least 8 hours

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2
Q

Oral glucose test

A

Client fasts for 8-12 hours
Then given 75 g carbs orally
Blood drawn measures how body reacts to carb overload

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3
Q

Random glucose test

A

Random glucose

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4
Q

Hemoglobin A1c

A

Measures average of blood glucose levels over last 6-8 weeks

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5
Q

Fasting Glucose level no diabetes

A

less than 100

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6
Q

Fasting glucose level prediabetes

A

100-125

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7
Q

Fasting glucose level diabetes

A

126 or greater

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8
Q

Random glucose level diabetes

A

200 AND Signs of hyperglycemia

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9
Q

A1c level no diabetes

A

Less than 5.7%

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10
Q

A1c level prediabetes

A

5.7-6.4%

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11
Q

A1c level diabetes

A

6.5% or above

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12
Q

If the client has been diagnosed with diabetes. What should the nurse education about their A1c?

A

Target range is 7.0% for a client diagnosed with diabetes

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13
Q

My Plate method:

A

50% - non-starchy veggies (green leafy things)
25% - Starches (grains, pasta, or starchy veggies)
25% - low fat lean meats

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14
Q

Pt. BS is 90 an the client is getting ready to go for a jog. What should the nurse educate the client?

A

Eat a snack if your BS is on the low side to prevent hypoglycemia while exercising

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15
Q

The pt. is sick for a week and BS has dropped to 50. What education point should the nurse touch on?

A

You should take your long acting insulin even when you are sick.

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16
Q

True/False: It is okay for a diabetic pt to powder feet with cornstarch if they are sweaty.

A

True

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17
Q

True/False: It is okay for the diabetic pt. to wear plastic shoes like Crocs for protection

A

False: plastic shoes hold in more moisture

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18
Q

The pt. states that she will get sugar free fruit juice in order to stay hydrated on days she is sick. Nurse response:

A

You should get regular fluids such as gatorade, fruit juice that are high in carbs to replace electrolytes and keep BS norm

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19
Q

The nurse hears diabetic client who is sick at home say she has not eaten a full meal in the past 3 days. What should the nurse do?

A

Notify the provider immediately and tell pt. to seek Tx at ER

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20
Q

Diabetic seek Tx if ER if:

A 
Decreased LOC
Sick > 2 days
Temp > 102 for > 12hrs
Temp doesn't respond to meds
Increased RR
Can't tolerate fluids
BS > 240 consistently
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21
Q

Biguanides Ex.

A

Metformin

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22
Q

Precautions for Metformin

A

Can cause Renal impairment

**Do not give IV contrast within 48 hours of taking Metformin

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23
Q

Sulfonylureas Ex.

A

Glyburide (Glynase)

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24
Q

Glyburide precaution

A

Can cause hypoglycemia

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25
Q

Thiazolidinediones Ex.

A

Pioglitazone (Actos)

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26
Q

Pioglitazone precautions

A

Can cause Heart failure and liver toxicity

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27
Q

IV insulin is given in ____

A

IV insulin is given in Emergencies

28
Q

Ex of rapid acting insulin

A

Humalog/Lispro

29
Q

Ex. long acting insulin

A

Lantus
Glargine
Levemir/Detemir

30
Q

Ex. of short acting insulin

A

Regular/Novolin

31
Q

What is premixed insulin?

A

Mixed long and short acting insulins

32
Q

True/False: Premixed insulins do not have to be given with food

A

False, they have long and short acting insulin.

Short acting must be given with meals

33
Q

Premixed insulins must be given ___ ___

A

Premixed insulins must be given WITH FOOD

34
Q

Causes of Hyperglycemia

A 
Not producing enough or any insulin (Type 1)
Insulin resistance (Type 2)
35
Q

Causes of Hypoglycemia

A 
Too much insulin
Sickness
Sulfonylureas
Alcohol
Beta-blockers (mask symptoms)
36
Q

Dawn Phenomenon

A

Body naturally release a burst of hormones at 5-8 am that increase BS.
Pt. may have increase fasting BS in morning

37
Q

Somogyi Effect

A

Pt. take insulin before bed with have decreased BS then glucagon is released 2-3 am and result in higher than normal BS in morning
Tx: decrease insulin dose at night

38
Q

Hypoglycemia

A

BS < 70

39
Q

Hypoglycemia can cause ____

A

Seizures

40
Q

Priority safety when the nurse is caring for a client with BS of 55

A

Seizure precautions

41
Q

Tx for hypoglycemia

A 
15-15 rule
Eat 15 grams of carbs
Wait 15 min.
Recheck BS
Repeat until norm
42
Q

If pt. is unconscious and their BS is 25 what can the nurse do?

A

Give Glucagon or IV D50W

43
Q

Glucagon

A

IM - most common

IV or SQ

44
Q

D50W

A

Assess IV site before and after admin for extravasation

45
Q

DKA is a complication of which type of diabetes?

A

Type 1

46
Q

DKA produces ___

A

Ketones

47
Q

DKA BS usually gets above

A

DKA BS >250

48
Q

DKA will cause what electrolyte imbalance

A

Hyperkalemia

49
Q

DKA usually results in what acid/base imbalance

A

Metabolic acidosis

50
Q

What is the first action on Tx of DKA

A

Tx dehydration FIRST

51
Q

What is the priority action on Tx of DKA

A

Kill the sugar and get rid of ketones
Bs > 250 IV insulin
BS < 200 SQ insulin and D5W

52
Q

When treating a pt. with DKA the nurse administers IV insulin. What is her concerns with admining IV insulin

A

Hypoglycemia - switch to D5W when BS <200

Hypokalemia - Tx with K+ supplement

53
Q

HHS is a complication of what type of diabetes?

A

Type 2

54
Q

A pt. with HHS the nurse should expect to see BS over what?

A

> 600

55
Q

In HHS there is ___ insulin

A

In HHS that is SOME insulin

56
Q

In DKA there is __ insulin

A

In DKA there is NO insulin

57
Q

In HHS because of the high glucose levels in the blood the nurse knows the fluid in the body is flowing ___ the blood vessels

A

Fluid is flowing INTO the blood vessels - dehydrating the tissues

58
Q

Priority concerns and assessment for pt. in HHS

A

Mental status, seizures

59
Q

First action Tx fo HHS

A

Treat the dehydration FIRST

60
Q

Priority intervention for pt with HHS

A

Stabilize BS (SQ or IV)

61
Q

Causes of HHS

A

Illness

Infection

62
Q

Causes of DKA

A

Sepsis
Sickness
Stress/Surgery
Skipping insulin

63
Q

What kind of acid/base imbalance is a pt. with HHS most likely to be in?

A

Alkalosis

64
Q

What kind of respiration will a pt. with DKA exhibit?

A

Kussmauls

65
Q

True/False: HHS develops ketones

A

False, no ketones are present in HHS. Ketones are present in DKA

Med Surg (22 decks)

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