LESSON 1 Flashcards
A greek word means “to flow through”
Diabetes
Latinword which means “honeyed”
Mellitus
It is a chronic (long-lasting) health condition that affects how your body turns into energy.
Diabetes
It is thought to be caused by an autoimmune reaction (the body itself by mistake) that stops your body from making insulin.
Type 1 Diabetes
Usually diagnosed in children, teens, and young adults.
Type 1 Diabetes
FACTS:
* Total: 34.2 million people have ______
(10.5% of the US population)
* Diagnosed: 26.9 million people, including
26.8 million adults
* Undiagnosed: 7.3 million people (21.4%
are undiagnosed)
A. DIABETES
B. PREDIABETES
A. DIABETES
FACTS:
* Total: 88 million people aged 18 years or
older have _______(34.5% if the
adults US population)
* 65 years or older: 24.2 million people aged
65 years or older have _________
A. DIABETES
B. PREDIABETES
B. PREDIABETES
- Develops in pregnant women who have
never had diabetes. - The baby could be at higher risk for health
problems - Usually goes away after your baby is born
but increases your risk for type 2 diabetes
later in life
GESTATIONAL DIABETES
- Blood sugar levels are higher than
normal, but not high enough yet to be
diagnosed as type 2 diabetes - Risk for type 2 diabetes, heart disease and
stroke.
PREDIABETES
SYMPTOMS OF DIABETES
A
B
W
V
A
A
S
N
F
S
ALWAYS THIRSTY
BLURRY VISION
WOUNDS THAT WON’T HEAL
VAGINAL INFECTIONS
ALWAYS HUNGRY
ALWAYS TIRED
SEXUAL PROBLEMS
NUMBNESS OR TINGLING IN HANDS OR FEET
FREQUENT URINATION
SYSTEMIC WEIGHT LOSS
MEDICAL MANAGEMENT
1. Maintaining blood sugar level within the
desired normal level.
(Anti-diabetic drugs or oral hypoglycemic
agent (OHA); insulin)
2. Maintaining healthy blood lipid level
concentration.
3. Controlling blood pressure
4. Managing weight
5. Measures that can help to prevent or delay
previous diabetes complications.
A. DIABETES
B. MYOCARDIA INFARCTION
C. PEPTIC ULCER DISEASE
D. CHRONIC KIDNEY DISEASE
A. DIABETES
What is the normal value for fasting glucose test
Less than 100
What is the value of Prediabetes for fasting glucose test?
100-125
What is the value of Diabetes for fasting glucose test?
126 or higher
Give 3 NURSING MANAGEMENT for Diabetes
NURSING MANAGEMENT
* Review factors in glucose instability; and
educate the client about diet, exercise,
healthy lifestyle, and hyper or hypoglycemia
events.
o If the patient is admitted in the hospital,
nurses are assigned to conduct the
Random (anytime) glucose test through
pricking the patient early in the morning
and during the evening or depends on
the doctor’s prescription
o Nurses are responsible in providing the
medicines of the diabetic patients
o Nurses are also responsible for the diet of
the patient. Note if the patient finished
his food or not because it will affect the
patient’s blood glucose
o Nurses should monitor also other foods
the patient eat.
* Monitor VS; I&O and weight
o Nurses should monitor the vital
signs. Monitor the intake and output
especially the water consumed and urine
excretion of the patient. Monitor the
weight
* Discuss how client’s anti-diabetic medications
work
* Check injection sites periodically for client
administering insulin
o Check if the injection site already had
hematoma. If it happens, apply first aid.
* Educate about home glucose monitoring
o Nurses are responsible to educate
patients on how to use glucometer and
how to tally results
o Glucometer is not available before that is
why educating older people with
glucometer is necessary.
Give 3 NURSING MANAGEMENT for Diabetes
NURSING MANAGEMENT
* Review factors in glucose instability; and
educate the client about diet, exercise,
healthy lifestyle, and hyper or hypoglycemia
events.
o If the patient is admitted in the hospital,
nurses are assigned to conduct the
Random (anytime) glucose test through
pricking the patient early in the morning
and during the evening or depends on
the doctor’s prescription
o Nurses are responsible in providing the
medicines of the diabetic patients
o Nurses are also responsible for the diet of
the patient. Note if the patient finished
his food or not because it will affect the
patient’s blood glucose
o Nurses should monitor also other foods
the patient eat.
* Monitor VS; I&O and weight
o Nurses should monitor the vital
signs. Monitor the intake and output
especially the water consumed and urine
excretion of the patient. Monitor the
weight
* Discuss how client’s anti-diabetic medications
work
* Check injection sites periodically for client
administering insulin
o Check if the injection site already had
hematoma. If it happens, apply first aid.
* Educate about home glucose monitoring
o Nurses are responsible to educate
patients on how to use glucometer and
how to tally results
o Glucometer is not available before that is
why educating older people with
glucometer is necessary.
What is the DIETARY MANAGEMENT for DIABETES?
DIET:
* HIGH FIBER DIET
o Normal diet with fiber increased
o Give more whole grains, fruits, and
vegetables
- LOW FAT DIET
o Severely restricted fats allowed 10-15% of
TER
o All foods rich in fats are not allowed or
restricted
o Foods cooked by a method not requiring
the addition of fats - Especially if the patient has a high
cholesterol level in the blood, high
triglycerides, high LDL, and low HDL.
Patient is advised for a severely restricted
diet. Instead of giving 20-35% of TER for
fats, they are only allowed for 10-15% of
fats TER per day.
T or F.
Encourage rich desserts to to a diabetic patient.
FALSE
Give a food selection for diabetes
Give skimmed milk, lean meat, cereals, fruits,
and vegetables. Avoid fatty meats, rich
desserts, and fried foods.
o Avoid rich desserts because it can be
made with trans-fat or simple sugar or
added sugar or processed sugar or
refined sugar.
DIETARY MANAGEMENT OF DIABETES (T OR F)
The carbohydrates intake depends on the
metabolic needs, type of diabetes or degree of
glucose tolerance and individual preferences.
TRUE
The amount of carbohydrate ingested
has the most significant influence on
blood glucose levels after meals, the
more grams of carbohydrates
consumed, the greater the glycemic
response.
DIETARY MANAGEMENT OF DIABETES (T OR F)
Carbohydrates intake must
not be consistent at
meals and snacks to help reduce fluctuations
in blood glucose levels between meals
FALSE
Carbohydrates intake must be consistent at
meals and snacks to help reduce fluctuations
in blood glucose levels between meals
DIETARY MANAGEMENT FOR DIABETES
- The carbohydrates intake depends on the
metabolic needs, type of diabetes or degree of
glucose tolerance and individual preferences.
* The amount of carbohydrate ingested
has the most significant influence on
blood glucose levels after meals, the
more grams of carbohydrates
consumed, the greater the glycemic
response. - Carbohydrates intake must be consistent at
meals and snacks to help reduce fluctuations
in blood glucose levels between meals - Give carbohydrates foods that are low in GI
effects such as high in fiber foods like fresh
fruits, legumes, and whole grains. These foods
have a moderate effect on blood glucose. - Minimize foods and beverages with added
sugar and excessive use of fructose as a sugar
alternative. Because these are high in
glycemic index and has an adverse effect on
blood lipid levels. - Sugar alcohols are not recommended.
Because although sugar alcohols such as
sorbitol and mannitol have lower glycemic
effects than glucose, fructose or sucrose, but
their use has no significant long-term
improvement on glycemic control - Artificial sweeteners such as aspartame,
saccharin, and sucralose contain no digestible
carbohydrates and can be safely used in
place of sugar - Alcohol is w/ a daily limit of one drink for
women and two drinks for men. Alcohol can
cause hypoglycemia by interfering with
glucose production in the liver. Excessive
alcohol can worsen hyperglycemia and it can
also raise triglyceride levels - Should limit saturated fat intake to less than
7% of total kcal from fats. Should minimize
consumption of trans-fats and cholesterol to
less than 200mg/day. Because people with
diabetes are at high risk of developing
cardiovascular disease. Saturated fats
contribute to increased insulin resistance. - Give moderate protein of 10 to 15 % of resting
metabolic rate (RMR), give lean meat, fish,
and poultry to avoid muscle wasting. High
CHON intake is detrimental to kidney
function.
Myo means _______
MUSCLE
Cardia pertains to ______
HEART
tissue death d/t lack of blood
suppl
INFARCTION
More commonly known as a heart
attack
MYOCARDIA INFARCTION
- Most common form of coronary heart
disease (CHD) - Has multiple genetic and acquired risk
factors
MYOCARDIA INFARCTION
What are the diagnostics for MYOCARDIA INFARCTION?
o 12-lead ECG
o Echocardiogram
o Biochemical markers, like
o CKMB, troponin T and troponin I
Cardiac catheterization
Plaque buildup in arteries-atherosclerosis-plaque ruptures- thrombus formation in a coronary artery- cardiac ischemia- ?
MYOCARDIAL INFARCTION
SIGNS AND SYMPTOMS OF MI
A
P
S
C
H
D&L
N&V
R
- Angina (paninikip ng dibdib)
- Pain or discomfort in other areas (left
shoulder and arm, back, neck, jaw,
stomach) - Difficulty of breathing (and/or shortness of
breath) - Cold sweat (kahit malamig ang panahon
pinag pawisan sa malamig) - Heartburn (may have feeling of fullness or
indigestion) - Dizziness and lightheadedness
- Nausea and vomiting
- Rapid or irregular heartbeat
STATISTICS OF MI (T or F)
According to the WHO, the coronary
heart disease-related deaths in the
Philippines in 2018 reached 120,800 or
19.83% of total deaths
TRUE
STATISTICS OF MI (T or F)
In the United States, about 805, 000 have
a heart attack each year. Of these cases,
o 605,00 are a first attack
o 1 in 5 heart attacks is silent
TRUE
What are the 3 Medical Management for MI?
- Pharmacologic Therapy
- Cardiac Catheterization
- Coronary Angioplasty
What are under Pharmacologic Therapy?
I
I
A
F
T
A
- IV nitroglycerin
- IV morphine
- ACE inhibitors
- Fibrinolytics
- Thrombolytics
- Antihyperlipidemic
What are under the Coronary Angioplasty?
B
C
A
L
- Balloon angioplasty
- Coronary artery stent
- Atherectomy
- Laser angioplasty
NURSING MANAGEMENT FOR MI
- Assess for history of illnesses
- Monitor vital signs, especially blood pressure
and pulse rate - Administer medications, as ordered
- Priority during an attack: pain management
- Monitor pain: quantify the type,
characteristics, and intensity - Intravenous and oxygen therapy, as ordered
(especially if person is suffering from SOB) - Obtain diagnostics
- Assess for shortness of breath, dyspnea, or
crackles - Weigh the patient
- this is done especially if myocardial
infarction happen because of life style,
over weightiness or obesity - Provide opportunities for adequate rest
- Initiate cardiac rehabilitation
- cardiac rehabilitations are dietary
management, medical management,
weight management, smoking and
alcohol cessation, stress management
DIETARY MANAGEMENT FOR MI
Recommended diets:
* Low salt, low fat/low cholesterol and
high fiber
o doctors usually given is low
sodium or restricted diet and low
cholesterol diet
T OR F
Diagnosed with MI should Cut down salt (common table salt) intake
in your diet to avoid hypertension. Intake
should not exceed more than 2 to 2.5
grams a day
TRUE
MANAGEMENT FOR MI
- Cut down salt (common table salt) intake
in your diet to avoid hypertension. Intake
should not exceed more than 2 to 2.5
grams a day - Avoid food rich in cholesterol: ground nut
oil, butter, whole milk, eggs, lard (fats
derived from pig meat), tallow (fats
derived from goat or sheep mutton), oily
fish, meats and red meats, and all
nonvegetarian food contain cholesterol in
varied amount - Avoid non-vegetarian food especially red
meat - Increase intake of foods that contain
PUFA’s (polyunsaturated fatty acids):
flax/linseed oil is the richest source of
PUFA’s. Other oils that contain its
consumption should be limited. The
intake of oils should not exceed 20 grams
a day. - Sesame oil and almond oil hinders the
absorption of LDL (low-density
lipoproteins), so it is advisable to use,
replace other cooking oils by sesame oil - Increase your intake of water
- Take high fiber diet-whole grains, bran,
oat, green leafy vegetables etc. - Cut down the intake of sugar and other
sweeteners - Avoid fat-rich portions of flesh foods.
Instead have lean meat - Avoid fat-rich desserts and fried snacks
like cakes, pastries, pudding etc. - Instead of frying food boil, steam, grill or
roast food - Avoid coffee and caffeinated drinks
- Consume food rich in magnesium; - nuts
and sea food, green leafy vegetables, sea
plants like sea grapes, whole grains peas,
legumes and oil seeds - Increase intake of vitamin C, it maintains
the elasticity and integrity of the artery
walls. Eat citrus fruits, green leafy
vegetables. Eat vegetables – cabbage,
broccoli, tubers, potatoes, and sweet
potatoes - Avoid eating junk food – pizza, burgers
etc. - Reduce calcium intake (reduce but do not
completely avoid calcium as it is needed
for maintenance of our body): give milk
and sea food, nuts, green leafy
vegetables, whole grains, peas, legumes,
and oil seeds
* Calcium deposits are part of
artery-clogging plaque.
* They also contribute to stiffening
of the arteries and interfere with
the action of heart valves
DIETARY PLAN FOR MYOCARDIAL INFARCTION
What are the Best heart-friendly foods to eat?
- lots of fruits and vegetables
- skinless poultry
- fish
- plant-based oils such as olive oil
- lean meats
- nuts, beans, and legumes
- whole grains
- low-fat dairy products
What is the total energy requirement for MI?
1, 450 kilocalories
__________ is an excavated (hollowed-out area) that forms in the mucosa of the
stomach, in the pyiorus (the opening
between the stomach and duodenum), in
the duodenum or in the esophagus.
Peptic ulcer
T or F.
Erosion of a circumscribed area of mucosa is the cause of MI.
TRUE
This erosion may
extend as deeply as the muscle layers or
through the muscle to the peritoneum
(thin membrane that lines the inside of
the wall of the abdomen), may be
referred to as a gastric, duodenal, or
esophageal ulcer, depending on its
location. (Brunner & Suddarth, 2018).
STATISTICS (PEPTIC ULCER)
- Peptic ulcer disease affects
approximately 4.5 million Americans
annually, and it requires inpatient
hospitalization for an estimated 30 out of every 100 patients (Brunner & Suddarth,
2018). - According to the latest WHO data
published in 2018, Peptic Ulcer Disease
Deaths in the Philippines reached 6,283 or
1.03% of total deaths. The age adjusted
Death Rate is 9.69 per 100,000 of
population ranks Philippines #18 in the
world.
SIGNS AND SYMPTOMS OF PEPTIC ULCER
D
N
P
S
E
C
B
- Dull, gnawing pain or a burning sensation
in the mid-epigastrium or the back - Nausea
- Pyrosis vomiting (rare in uncomplicated;
usually symptom of complicated) - Sour eructation (burping)
- Epigastric tenderness or abdominal
distention - Constipation or diarrhea
- Bleeding (severe) (thru hematemesis or
melena)
SIGNS AND SYMPTOMS OF PERFORATION
S
V
C
E
- Sudden, severe upper abdominal pain
(persisting and increasing in intensity);
pain may be referred to the shoulders,
especially the right shoulder, because or
irritation of the phrenic nerve in the
diaphragm - Vomiting
- Collapse (fainting)
- Extremely tender and rigid (board like)
abdomen Hypotension and tachycardia,
indicating shock.
