Brainscape's Knowledge GenomeTM

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


See full index

NURS122 > interactive lecture diabetes > Flashcards

interactive lecture diabetes Flashcards

1
Q

what are diabetes the leading cause of

A

end-stage renal disease
adult blindness
lower limb amputations

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

theories for causation of diabetes mellitus

A

genetic
autoimmune
environmental: viral, obesity

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

normal insulin level

A

70-130 mg/dL

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

purpose of insulin

A

allows transport of glucose from blood stream into the cells cytoplasm

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

where are insulin released from in the pancreas

A

beta cells

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

which 4 regulatory hormones increase blood glucose levels to maintain normal bg lvls

A

glucagon
epinephrine
growth hormone
cortisol

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

what is gestational diabetes

A

develops during pregnancy detected around 24 - 28wks of gestation;
will return to normal 6 weeks postpartum

the high bg of mother will bring extra glucose to the baby -> causing the baby to gain weight

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

what is secondary diabetes and what can cause it

A

treatment of a medical condition that in turn cause increased bg

corticosteroids - prednisone
thiazides
Total parental nutrition (TPN)
pancreatic dx

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

3 requirements for diagnosis of prediabetes

A
  • IGT: 2 hr plasma glucose 140 -199
  • IFG: fasting glucose lvls >100 but <126
  • A1c lvls: 5.7-6.4%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the A1c levels for normal, prediabetes, and diabetes

A

normal: <= 5.6
prediabetes: 5.7-6.4
diabetes: 6.5+

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

what are the fasting blood sugar test (FPG) levels for normal, prediabetes, and diabetes

A

normal: <=100
prediabetes: 100-125
diabetes: >=126

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

what are the oral glucose tolerance test (OGTT) levels for normal, prediabetes, and diabetes

A

normal: <=140
prediabetes: 140-199
diabetes: >=200

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

Type 1 diabetes peak onset, and most often occurs in people how old

A

happens to people <30yrs old
peak onset 11-13 yrs old
autoimmune disease

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

classic symptoms of diabetes type 1

A

polyuria - frequent urination
polydipsia - extreme thirst
polyphagia - excessive hunger

ketoacidosis
weight loss
weakness/fatigue/blurred vision

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

etiology and pathophysiology of diabetes

A

pancreas produces insulin but either not enough or poorly used
can be prevented or delayed with weight loss & physical activity

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

4 major metabolic abnormalities of diabetes type 2

A
  1. insulin resistance
  2. pancreas decreased ability to produce insulin
  3. not enough insulin produced
  4. alteration in hormones and adipokines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

clinical manifestations of diabetes type 2

A

gradual onset with nonspecific symptoms
fatigue
recurrent infections/prolonged wound healing
visual changes

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

4 diagnostic studies for diabetes

A
  1. fasting plasma glucose lvl >126
  2. random plasma glucose >=200 mg/dL w/ symptoms
  3. 2hr OGTT >=200 mg/dl using glucose load 75G
  4. A1c>6.5% on 2 separate occasions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does A1c measure

A

the amount of glucose that gets attached to Hgb over the RBC lifespan 90-120 days

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

what is the ambulatory glucose profile (AGP)

A

summary of a pt’s daily glucose and insulin patterns over time

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

why use AGP or A1c

A

AGP is great for those prone to glycemic swings vs. A1c only show one snapshot

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

target range of bg for diabetics

A

70-180 at least 70% of the time with minimal hypo or hyperglycemia

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

who is exogenous insulin prescribed for

A

type 1 diabetes
type 2 who can’t control bg by other means

24
Q

fastest absorption rate of insulin injection locations

A

abdomen, back of arm, thigh, butt

25
Q

name 3 meds in class sulfonylureas

A

glipizide (Glucotrol), glimepiride (Amaryl), glyburide

26
Q

purpose of sulfonylureas

A

help pancreas make and secrete insulin for DM2
decreases A1C by 1-2%

27
Q

patient considerations for sulfonylureas

A

hypoglycemia - severe
GI: N&V, constipation

28
Q

drug in class biguanides

A

metformin

29
Q

purpose of metformin

A

Increases glucose tolerance by:

decrease glucose absorption in intestines
decrease hepatic glucose production
increase glucose uptake and usage
-> decrease A1c by 1.5-1.8% in DM2

30
Q

contraindications for metformin

A

renal failure,
liver dx,
severe infection

31
Q

considerations for metformin

A

hold 48hrs before invasive procedure such at cath lab
GI issues

32
Q

what 2 drugs go in the thiazolidinediones (TZDs) class

A

pioglitazone (Actos)
rosiglitazone (Avandia)

33
Q

purpose of thiazolidinediones

A

insulin ensitizers that decrease insulin resistance by inhibiting hepatic gluconeogenesis
reduce A1c 1.5%

34
Q

considerations for taking TZDs

A
  • fluid retention -> don’t use in CHF [may cause weight gain, edema]
  • weeks to months to work
  • start low dose, titrate q2-4wks
  • reduce effectiveness of oral contraceptives
  • liver function tests (LFTs)
35
Q

list the drug under DPP-4 inhibitors

A

sitagliptin (Januvia)

36
Q

how does sitagliptin work

A

increase incretins and increase GLP-1 levels (released in response to food and regulates insulin), thus increasing insulin secretion

lowers A1c 0.5-1%

few side effects

37
Q

what are the 2 incretin mimetics inj meds

A

exenatide (Byetta)
liraglutide (Victoza)

38
Q

how do incretin mimetics work

A

binds to GLP-1 receptors and slow down digestion of food -> glucose absorbed slower
can reduce appetite -> weight loss

39
Q

causes of DKA

A

hyperglycemia
dehydration
infection
mostly in DMtype1

40
Q

DKA signs and symptoms

A
  • 3Ps - polyurea, polydipsia, polyphagia
  • dehydration - -poor skin turgor, dry mucosa, tachycardia
  • orthostatic hypotension
  • Kussmaul’s respirations
  • acetone breath, fruity breath
41
Q

DKA labs - 4

A

bg >240-300
arterial blood pH <7.3
serum bicarbonate <15mEq/L
ketones in blood and urine

42
Q

DKA treatment

A
  • ensure airway/O2
  • IV NS 1/L until stable BP & urine output >30/hr
  • insulin bolus Regular IV 5-10units
  • then cont. insulin drip until bg around 250 1-2U/hr 0.5U/kg/hr, add D5W to prevent hypoglycemia
  • monitor bg q1-2hr
  • potassium (K) replacement
43
Q

what is hyperosmolar hyperglycemic syndrome (HHS) and treatment

A

occurs mostly in elderly >60yrs with DMtype2 - prolonged hyperglycemia >400 but no ketoacidosis because there is enough insulin
treat is similar to DKA

44
Q

what is considered hyperglycemia and symptoms

A

bg>200
3P’s
weight loss, visual changes
or asymptomatic

45
Q

causes of hyperglycemia

A
  • not enough basal insulin (overnight insulin)
  • dawn phenomenon & Somogyi effect
  • poor food choices
  • incorrect timing of insulin given
  • insulin resistance
  • illness/stress
46
Q

dawn phenomenon vs. Somogyi effect
how to tell difference

A

dawn phenomenon (our body produces cortisol and growth hormone to wake up but also effects bg)

Somogyi effect (hypoglycemia at night but hormones overcompensate to hyperglycemia)

check if bg is low around 2-3AM, if it’s low it’s Somogyi
if normal or high it’s dawn phenomenon

47
Q

how to avoid dawn phenomenon and Somogyi effect

A
  • avoid carbs at bedtime
  • have a low fat, high fiber dinner
  • use insulin pump at night, take insulin before bedtime instead of late afternoon
48
Q

what range of bg should diabetics be kept in

A

140-180 bg maintained
premeal bg <140
no higher than 180 after therapy

49
Q

common causes of hypoglycemia

A
  • meal delayed
  • insulin timing
  • excessive exercise
  • alcohol
50
Q

signs and symptoms of hypoglycemia

A
  • confusion/irritability
  • diaphoresis, tremors
  • hunger
  • weakness
  • visual disturbances
51
Q

hypoglycemia treatment

A

if ALERT and can swallow:
- 15-20g simple carbs, 4-6oz fruit juice, regular soft drink

avoid foods with fat: decrease absorption of sugar

recheck bg 15mins after until bg>70

if NOT awake:
- 1mg of glucagon IM/subQ (may cause rebound hypoglycemia)
- ingest complex carbs after recovery
- 20-50mls of D50W IVP

52
Q

factors that worsen and exacerbate chronic diabetes issues

A

obesity
smoking
hypertension
high fat intake
sedentary lifestyle

53
Q

areas mostly effected by chronic diabetes

A

eyes: retinopathy
kidneys: nephropathy
skin
erectile dysfunction
typically 10-20 yrs of diabetes

54
Q

most common cause of diabetic retinopathy

A

hyperglycemia leading to microvascular damage to the retina

55
Q

what to screen to prevent nephropathy

A

yearly screening of albumin in urine, serum creatinine

56
Q

what happens in nephropathy

A

damage to small blood vessels that supply the glomeruli, Main cause of end-stage renal disease

57
Q

how does diabetes effect the immune system

A
  • defect in mobilization of inflammatory cells
  • impairment of phagocytosis by neutrophils & monocytes
    —> more likely to get infections

NURS122 (28 decks)

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