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Sasha: Module 10 Endocrine Clincial Assessment > Lecture > Flashcards

Lecture Flashcards

1
Q

4 things to remember with diabetes

A
  1. Diabetes care team: members and roles
  2. Diabetes basics
  3. Components of diabetes care plan
  4. Helping patients cope with diabetes
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2
Q

A good diabetes care takes a team…

A 
Patient
Physician : Primary Care Physician , Endocrinologist
Nurse (RN, NP, LPN)
Physician assistant
Medical assistant
Other office staff members
Family and friends
Certified diabetes educator
Registered dietitian
Ophthalmologist
Foot doctor
Pharmacist
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3
Q

beta cells of pancreas produce no insulin

A

Type 1:

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4
Q

beta cells produce insufficient insulin and body does not use insulin effectively

A

Type 2:

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5
Q

diabetes diagnosed during pregnancy

A

Gestational

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6
Q

general category that includes diabetic related to other causes (eg. genetic disorder or pancreatic disease)

A

other forms of diabetes

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7
Q

Carbohydrates are metabolized into glucose during digestion

Glucose enters bloodstream

Rising blood glucose level causes beta cells in the pancreas to release insulin

Insulin moves glucose from blood into the cells, where it is used for engery

Carbohydrates increase blood glucose levels; insulin decreases blood glucose levels

A

How Food Turns into Energy:

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8
Q

________ makes little or no insulin or the body cannot use the insulin that is in the body

A

Pancreas

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9
Q

____ can’t get in the cell so it stays in the blood causing hypoglycemia

A

glucose

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10
Q

Glucose can’t get into cells, so it stays in the

_______

A

blood

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11
Q

Blood glucose levels increase, resulting in_________

A

hyperglycemia

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12
Q 
Family history of diabetes
High-risk ethnic population
Excessive body weight
High blood pressure
Physical inactivity
A

Risk Factors.. Type 2 Diabetes

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13
Q

A1C 6.5% or higher: A1C: over a 3 month span

Fasting blood sugar 126 mg/dL or higher

2-hour blood glucose 200mg.dL or higher during oral glucose tolerance test

Classic: symptoms of high blood sugar or hyperglycemia crisis and blood sugar over 200 or higher on a random blood glucose test

A

Criteria for Diagnosis of Diabetes…

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14
Q

A1C 5.1

A

prediabetes

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15
Q 
Urinating often 
Being thirsty or hungry more often than usual
Unusual weight loss
Tired more often than usual
Numb or tingling hands or feet
Cuts or bruises slow to heal
Blurry vision
Irritability
A

Signs and Symptoms:

of diabetes

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16
Q

Patients need to understand:
The basics of diabetes

How to incorporate a meal plan into their lifestyle

How to incorporate physical activity into their lifestyle

How to take medicines

How to check their blood sugar

How to prevent, detect and manage diabetes-related problems

What strategies they can use to make health-related changes

How to deal with psychosocial issues (depression can cause diabetes or diabetes can cause depression

A

Developing a Diabetes Care Plan:

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17
Q

Help patients to understand that they need to …

want a variety of healthy foods

eat meals and snacks at regular times

check food labels for calories, CHO, fat, sodium, cholesterol, protein, and fiber

watch portion sizes, especially of CHO foods.

A

The Basics of a Meal Plan…

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18
Q

Motivate patient by informing them about the benefits

  • -> Improved blood glucose control
  • ->Reduced risk of CV disease
  • -> Weight loss
  • -> Improved well being

Provide a physical activity prescription

  • -> At least 150 minutes (2.5 hours) per week of moderate-intensity aerobic activity
  • -> In absence of contraindications, 2 session per week of resistance exercise
A

The basics of physical activity plan…

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19
Q 
Check blood sugar before and at regular intervals during activity
Wear or carry medical ID
Carry food or meals
Check you feet
A1C
Home monitoring of blood sugar
Checking both A1C and blood sugar helps assess diabetes control
Higher the A1C more related to fasting
Over 9% is more post meal
A

Checkinging Both A1C and Blood Sugar is Important…

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20
Q

Reflects average blood sugar for the past few months

If at goal they would check it 2 a year

A

AIC

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21
Q

Provides instant feedback or current blood sugar level

A

home glucose monitoring

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22
Q

when do we check blood sugars

A

At bedtime and after
waking up

Before meals

1 to 2 hours after meals

In the middle of the night

Advise patient to track readings in a blood sugar diary

23
Q

What Are the Goals for Blood Sugar and A1C?

A

Blood glucose parameters

  • ->A1C
  • ->Preprandial glucose
24
Q

What Are the ABC’s?

A

A: A1C
B: Blood glucose
C:Cholesterol

25
Q

A Sample Diabetes Care Schedule

Every 3 months:

A

Regular office visit
A1 C test ( if blood sugar is not stable)
Check: Blood pressure, Weight, Feet

26
Q

A Sample Diabetes Care Schedule

Every 6 months:

A

A1C blood sugar is stable

Dental exam

27
Q

A Sample Diabetes Care Schedule

Every year:

A

Physical Exam
Comprehensive foot exam
Check: Lipid profile, Kidneys, Eyes
Flu shot/ pneumonia shots

28
Q

Teaching Patient to Recognize Signs and Symptoms of High Blood Sugar
(3)

A
  1. Thirst or hunger
  2. Passing more urine than usual
  3. Feeling tired
29
Q

Check blood sugar

A

Following meal, physical activity and medicine plans

Call doctor or nurse if blood sugar is high and they don’t know why

Note high blood sugar readings in diary along with factors that may have contributed so that the can discuss

missed the rest of this slide

30
Q

causes of Hypoglycemia

A

Too little food or CHO
Skipping or delaying meals
Being more active than usual
Taking too much insulin

31
Q

signs and symptoms of hypoglycemia

A 
Hunger
Anger/irritable
Nausea
Lightheadedness
Shakiness
Tiredness
Clammy/sweaty pale skin
32
Q

Rule of 15

A

Eat or drink something with 15 grams of carbohydrates, such as:

  • -> 0.5 cup of regular juice (4 ounces)
  • -> 0.5 cup of regular soda
  • -> Candy like pack of skittles: 5 to 6 hard candies
  • -> 3 or 4 glucose tabs

Check blood sugar again 15 min

If blood sugar is still low, eat or drink another 15 grams of CHO

33
Q

tell you patient when they should be checking their

A

blood sugars and urine ketones

34
Q

Advice patient to stay motivated they do not need to be perfect

help them to identify obstacles that may be preventing them from taking the best possible care of themselves

Advise them to make sure that they have support

Encourage them to stay in close touch with the diabetes care team.

A

Helping Patients Cope with Diabetes Burnout

35
Q

Hoffman said: Know what lab values and test values for diabetes: go with ADA recommendation

A

so i will add this once i find it

36
Q

Why meals matter in diabetes

A 
Be a part of diabetes care plan
Blood sugar is affected by
What we eat
How much we eat
When we eat
37
Q

Your meal plan should consider

A

Culture
Lifestyle
Food likes and dislikes
Budget

38
Q

80/20 rule

A

eat healthy 80% of the time; other 20% they can eat what they want

39
Q

Carbohydrate counting

A

more flexible meal plan

40
Q

It’s important to…

Eat at regular times
Match amount eaten with activity level
Count carbohydrates (carbs)

A

Planning Healthy Meals

41
Q 
Lots of vegetables and fruits
Whole-grain foods
Fish 2 to 3 times a week
Lean cuts of beef and pork
Non fat dairy products
More liquid fats than solid fats (Limit grantinitie)
A

healthy food choices

42
Q

One of the main components of meals

The main kind of food that raises blood sugar levels

Simple (sugar) or complex (starchy foods)

A

Carbohydrates

43
Q

The 3 Main Types of Carbohydrates

A

Starches (or complex carbs): fructose, fruit, lactose, milk

Sugars (simple carbohydrates) : honey, agave nectar,

Fiber

*****All 3 types raise blood sugar, but they do so at different rates

44
Q

Foods that contain the most carbs

A 
Starches (for example, bread)
Starchy vegetables
Fruits and fruit juices
Milk and yogurt 
Sweets and other sugary foods
45
Q

Foods that don’t contain cards

A

Meats and eggs

Fats and oils

46
Q

Lack enzymes to break down fiber → should eat 25 to 30 a day

Adding fiber to the diet should be gradual

A

sugars

47
Q

Check serving size, information on the label is based on the serving size

See how many grams of carb are in each serving

Decide whether the food fits in the plan.

Don’t forget to count the carbs in your dinks

A

find something that works for you

reading the label

48
Q

Calorie counting:

what are you looking at on the label (6)

A 
Harmful fats:
Saturated fat
Trans fat
Healthier fats
Monosaccharides
Polyunsaturated fat
49
Q

Eating out: Tips that can help

A

Split dinner in half

If you don’t know what’s in a dish, ask…..

50
Q

The 10 diabetes superfoods

some reason only have 5 written.. so five me 5

A 
Beans
Dark green leafy veges
Citrus fruits
Sweet potatoes
Berries
51
Q

Cornerstones 4 care:

A

Patient support program

52
Q

60-65g per day of carbs

A

Males

53
Q

45-60g per day of carbs

A

Women

Sasha: Module 10 Endocrine Clincial Assessment (1 decks)

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