med surg Diabetes Flashcards
what is the pathologic cause of type 1 DM?
destruction of beta cells
what organ releases glucagon?
liver
what does beta cells do?
secretes insulin
what pH disorder is associated with DKA?
metabolic acidosis
what is breaking down in metabolic acidosis
fat
what is the pathologic cause of type 2 DM
insulin resistance
impaired insulin secretion
overworked beta cells
what 2 physical characteristics are of a type 2 DM patient that is not a characteristic of type 1 DM
obesity and age
which type of diabetes is genetic
both
t/f weight loss can cure diabetes
false
a patients lab on a routine exam revealed a fasting blood sugar = 140. whats an appropriate intervention for this patient?
consider repeating FBS, order HgbA1c, start SBGM, education about diabetes
what serum lab provides the most accurate representation of blood sugar control?
HgbA1c
what urinalysis finding is an indicator that blood sugar is not well controlled?
ketonuria
what are normal blood sugar values for fasting, postprandial, and HgbA1c?
FBG < 126
postprandial BG < 200
HgbA1c <6.5%
a newly diagnosed type 2 DM tells the nurse he doesn’t want to buy insulin he can just use his wife’s because she is diabetic. What 2 things indicate he needs education?
he is type 2 and needs oral most likely
don’t use meds not prescribed to you
when teaching a patient about injecting insulin what site should he avoid if he exercises daily?
arms/ legs bc with exercise, certain parts of the body may absorb insulin more quickly
if BS is < 80 prior to exercise, what should you teach a patient to do?
eat a snack before exercise
name a statement that indicates the patient understands the importance of foot care
” i need to check my feet every day for a cut and/or infection”
what is the ADA recommendation for % of fat/pro/carb per meal?
pro 10-20% (4 cal/g)
fat 20-30% (9 cal/g)
carb 50-60% (4 cal/g)
when educating patient about type 2 diabetes what should you discuss? (4 things to teach)
BS monitoring
medication therapy
diet/exercise
complications
what is important to tell patients when taking Alpha-Glucosidase inhibitors
must take with first bite of meal
what class of oral anti-diabetic agents is contraindicated with ETOH use and CKI (chronic kidney insufficiency)?
biguanides
what is basal insulin dosing mean and what is its peak?
its a 24 hour dose with no peak
a patient has been ordered 15 u NPH insulin in addition to 10 u Novolog R insulin to be given with meals. Which should you draw up first?
Novolog R - clear to cloudy
what type of insulin should be used with the sliding scale formula and what is the formula
short acting insulin
(BG-100)/30
a type 2 DM has been changed from Metformin (biguanide) to litaglutide glucagon-like peptide 1 agonist (or GLP-1). what is important to tell the patient about his new medication regimen?
this new med is a daily injection and not an oral med
name 4 organs that can be affected by DM
heart
eyes
kidneys
feet
what ocular pathological condition occurs with DM
diabetic retinopathy
what are the macrovascular complications associated with uncontrolled diabetes
CAD (coronary artery disease)
CVA
PVD
what are the microvascular complications associated with uncontrolled diabetes
retinopathy
nephropathy
t/f - greater than 50% of amputations are performed on DM patients
true
name all the things a diabetic must do
take insulin (t1) or oral (t2)
cholesterol med
baby aspirin
ACE or ARB
HgbA1c test every 3 mo
podiatrist every 3 mo
check feet everyday
ophthalmologist every year
EKG every year
Neurologist every year