Med Surg Exam 3

Question 1

Normal Glucose Regulation (alpha a & beta b)

Answer 1

Alpha a cells–> Glucagon –> Raise blood sugar levels

Beta b cells ==> insulin –> Lowers blood sugar

Question 2

Where is glucose stored?

Answer 2

Stored in the liver and muscles as glycogen or stored as fat

Question 3

Normal blood sugar range

Answer 3

80-120 mg/dL

Question 4

Symptoms of hyperglycemia

Answer 4

extreme thirst, hunger, excessive urination, blurry vision, slow healing wounds, drowsy, dry skin

Question 5

Hypoglycemia & causes

Answer 5

blood sugar below 70 mg/dL

May be caused by kidney, pituitary, liver disorders, some cancers, and sever malnourishment

Question 6

Symptoms of Hypoglycemia

Answer 6

blurry vision, irritable, shaky, anxiety, fatigue, hunger, fast hear beat, sweating, weakness

Question 7

What is Metabolic Syndrome & what can it lead to?

Answer 7

Increased bp, increased blood glucose, abnormal cholesterol, and central obesity and they are at risk for type 2 diabetes, heart disease, stroke

Question 8

Name 2 Rapid Acting insulins (onset, peak, duration)

Answer 8

Novolog & Humalog 15min; 1-3; 3-5 hours

Question 9

Which is the only insulin that can be administered via IV?

Answer 9

Regular insulin

Question 10

Name 2 short acting insulins (onset; peak; duration)

Answer 10

Humulin R & Novolin R - 30min;2-4hr;6-8hrs

Question 11

Name 3 intermediate acting

Answer 11

NPH - 1.5hr;4-12hr;24hr
Lente - 2.5hr;7-15hr;22hr
Ultralente - 4-6hr;8-20hr;28hr

Question 12

Name one long acting

Answer 12

Lantus - 2-4hr; no peak; 24hr

Question 13

Type 1 summary

Answer 13

• usually starts in childhood
• acute incident (i.e. DKA) is how they find out
• little or no insulin production

Question 14

Hyperglycemia 3 p’s

Answer 14

Polyuria, Polydypsia, Polyphagia

Question 15

Somogyi Phenomenon

Answer 15

BG drops between 2-3am

Tx- increase in bedtime snack and decrease dosage of intermediate-acting insulin like NPH

Question 16

Dawn Phenomenon

Answer 16

Results from a decrease in the tissue sensitivity to insulin that occurs between 5-8am (“pre-breakfast hyperglycemia”) cause by a release of nocturnal growth hormone
Tx-give NPH at 10pm

Question 17

Type II (NIDDM)

Answer 17

patients don’t have enough insulin or their insulin is no good

Question 18

Why don’t the wounds heal as easy for diabetic patients (primarily Type 2)?

Answer 18

Increase of glucose= Increase of bacteria -> Bacteria-friendly environment

Question 19

Type 2 diabetes diet

Answer 19

majority of calories should come from complex carbs; high fiber

Question 20

When should exercise be done?

Answer 20

Exercise when blood sugar is at its highest and try to exercise same time and amount daily since routine is very important for these patients

Question 21

Metformin

Answer 21

Decreases the rate of hepatic glucose production and changes the glucose uptake by tissues

Question 22

Which drugs stimilate the release of insulin from the pancreas?

Answer 22

-ides

Chlorpropamide, Glipizide, Glyburide

Question 23

Acarbose

Answer 23

Delay absorption of glucose from GI tract

Question 24

Pioglitazone

Answer 24

Increase glucose uptakes in muscles and decrease endogenous glucose production

Question 25

What is A1C?

Answer 25

a blood test of the glucose on hemoglobin; gives an average of what your BG has been over 3 months by calculating A1C –> should be <7%