Med. Surge 3 - exam Flashcards
study for 1st exam
which describes HHS in DM type 2?
a blood glucose of >600-1000; the patient is going through total dehydration because water is leaving the cells to thin the blood of glucose; No ketones because insulin is still being produced
What is a fasting plasma glucose?
-to help diagnose diabetes
-this is a BG >126
Which describes non-pharmacologic treatment of type 1 diabetes?
-diet “my plate” guidelines; a protein, carb and veggie - this will slow absorption + the glycemic response
-stop/no smoking
-exercise
What is causing an arrhythmia in a uncontrolled diabetic patient?
high blood sugar
which of these describes A Fib?
missing P waves and irregular QRS complexes
What cardiac arrhythmias result from uncontrolled diabetes?
-A Fib
- A Flutter
-V Tach
-V Fib
Which describes V Fib?
(crazy) multiple QRS’s
If your patient is in V Tach or V Fib, what are you doing about it?
-CPR/ code cart
-Lidocaine + Amiodarone
When your diabetic patient is having an arrhythmia due to high blood sugar, what are we doing to help this patient?
-check their blood sugar
-hang normal saline - this is going to thin the blood to “get rid” of the excess sugar
-then give insulin, because you don’t want their sugar to drop too quickly
(all with dr.’s orders)
What are you going to do for a patient that is experiencing SVT?
-have the patient bare down to vagal themselves
-bag of ice to “put them into shock” and bring HR down
-ADENOSINE
What should be taught to your diabetic patient about their blood glucose related to stress?
-their blood sugar may increase
-physical activity and exercise are very important
What medication would you give to patient in sinus bradycardia?
ATROPINE
-this is a HR <60
What are you going to give your type 1 diabetic patient who is currently hypoglycemic?
-glucagon
-dextrose in water (this will also rehydrate them)
Why does a diabetic patient develop microalbuminuria? (protein in the urine)
this is caused by blood vessel damage in the kidneys; if their blood glucose isn’t brought down this may facilitate a need for dialysis
which describes peripheral neuropathy?
tingling and numbness
What are some s+s of DKA?
-kussmal respirations
-ketones present in the urine
-fruity breath
-blurred vision
-altered mental status
which of these describes kussmal respirations?
deep and labored
describe the SOMOGYI effect.
elevated blood sugar in the morning; when blood sugar is low the body releases glucagon (from its stores) + epinephrine, the liver turns that glucagon into glucose.
-this process is trying to counter regulate and bring the blood sugar up, but it can result in a period of high blood sugar following this
How can a patient try to avoid the SOMOGYI effect in the morning?
by having a snack at bedtime w/ their insulin
describe the dawn phenomenon.
this is when hormones, (cortisol + growth hormone) that your body is naturally producing, causing an increase in your blood sugar in the morning, and your body isn’t producing enough insulin to control the glucose level.
how can a patient try to avoid the dawn phenomenon in the morning?
-changing their insulin dose and adding a carbohydrate into their bedtime routine
what are some things we need to educate diabetic patients about when they’re leaving the hospital?
-diet + exercise
-proper foot care etc.
What describes a continuous glucose monitor (CGM)?
this is continuously monitoring the patients glucose levels, make sure to monitor for hypo and hyperglycemia
which describes PVD wounds?
they are irregular shaped wounds
