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MS exam 2 > metabolism/diabetes > Flashcards

metabolism/diabetes Flashcards

1
Q

type 1 diabetes

A

autoimmune
genetic
insulin dependent
diagnosed as children and young adults
no cure/prevention

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2
Q

type 1 diabetes s/s

A

weight loos
fatigue
DKA
PPP
weakness
blurred vision

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3
Q

DKA

A

caused by hyperglycemia and ketosis
more common in type 1

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4
Q

DKA related to

A

illness
infection
wrong insulin dose
undiagnosed type 1
noncompliance
lack of education

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5
Q

DKA s/s

A

dehydration (dry)
lethargy/weakness
tachycardia
abd pain
orthostatic hypotension
n/v
fruity breath
hypokalemia
decreased GFR (90-120 normal)
cerebral edema

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6
Q

DKA treatment

A

admin K+, fluids, insulin
O2, breath sounds
assess LOC
I+Os

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7
Q

type 2 diabetes

A

due to poor diet
insulin resistant
modifiable factors
diagnosed over 40 yrs
managed w/ lifestyle changes/ meds

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8
Q

type 2 diabetes risk factors

A

family history
obesity
sedentary lifestyle
hypertension
over 45 yrs

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9
Q

type 2 diabetes s/s

A

PPP
recurrent infections
fatigue
slow wound healing
vision changes
HHS
weight gain

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10
Q

HHS hyperosmolar hyperglycemic syndrome

A

hyperglycemia without ketosis
leads to dehydration and altered mental status

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11
Q

hyperosmolar hyperglycemic syndrome related to

A

type 2 diabetes
usually elderly pt
starts w infection or undiagnosed DM

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12
Q

hyperosmolar hyperglycemic syndrome s/s

A

inadequate fluid intake
mental depression
cognitive impairment
polyuria
coma
seizures
extremely high glucose over 600
gradual onset

resembles CVA

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13
Q

hyperosmolar hyperglycemic syndrome treatment

A

admin IV fluids, insulin drio
monitor VS, labs, I+Os

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14
Q

chronic complications of diabetes

A

chronic angiopathy

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15
Q

chronic angiopathy

A

blood vessel damage due to hyperglycemia

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16
Q

risk factors of chronic angiopathy

A

smoking
obesity
hypertension
sedentary lifestyle

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17
Q

chronic angiopathy treatment

A

yearly screenings
treatment of hypertension & dyslipidemia (wt loss, diet, stop smoking)

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18
Q

microvascular complications of diabetes

A

eyes, nerves, kidney, periodontal disease

retinopathy - leading cause of blindness
nephropathy - leading cause end stage renal disease
neuropathy nerve damage

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19
Q

proliferative retinopathy

A

more severe - leads to blindness, cataracts, glaucoma

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20
Q

nonproliferative retinopathy

A

mild vision loss, more common
Tx: yearly eye exams
maintain healthy glucose lvl
corticosteroid injections

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21
Q

sensory neuropathy

A

loss of sensation (itching, burning, tingling)
feeling numb
related to foot ulcers
Tx: pain management, meds

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22
Q

autonomic neuropathy

A

damage to ANS
delays food absorption
urinary retention
hypoglycemia
Tx: urinary training Q3hr, ASA’s

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23
Q

macrovascular complications of diabetes

A

stroke, MI, atherosclerosis, CVD(heart), CVA(cerebral), PVD (peripheral)

insulin resistance develops CVD

24
Q

collaborative care of pt w diabetes

A

check for ketones in urine
accucheck q4hr when sick
avoid eye dr apps w high blood sugar levels

25
Q

diabetic plan of care

A

accuchecks
yealry eye exams
kidney fx/ urine monitoring
diet changes (carb counting 45-60g, avoid alcohol and fats)
mild exercise (150mins/wk)

26
Q

foot care for diabetic

A

wash feet and examine daily
pat dry, keep between toes dry
yrly podiatry visits
no heating pads/tight fitting clothes

27
Q

sick day management of diabetic pt

A

NEVER stop insulin
check glucose q4hrs
check urine for ketones if over 250

28
Q

somogyi effect

A

hypoglycemia at night d/t overdose
rebound hyperglycemia when waking up

check glucose from 2-4am
decrease daytime insulin or give bedtime snack
SOMO is LOW

29
Q

dawn phenomenon

A

not enough insulin during day causes hyperglycemia
increase daytime insulin
HIGH FOR THE DAWN

30
Q

s/s hypoglycemia

A

under 70 mg/dL
COLD AND CLAMMY NEED SOME CANDY
seizures
diaphoresis
palpitations
LOC changes
PPP
stupor
pallor

31
Q

causes of hypoglycemia

A

not eating enough
too much insulin
over exercise

32
Q

treatment of hypoglycemia

A

give 15g crab q15mins till glucose over 70

1mg glucagon - can cause nausea

33
Q

s/s hyperglycemia

A

HOT AND DRY, SUGAR IS HIGH
dehydration
fatigue
fruity breath
kussmals
weight loss
poor wound healing
PPP

34
Q

hyperglycemia causes

A

not enough insulin
poor food choices
stress
growth hormone
illness/surgery

35
Q

hyperglycemia treatment

A

administer insulin

36
Q

always carry ____ incase of hypoglycemia

A

glucose tabs/glucagon

37
Q

hyperglycemia leads to

A

decreased immune response

38
Q

what do beta blockers mask

A

s/s of hypoglycemia

39
Q

primary prevention of diabetes

A

exercise
PCP visits
good nutrition (no sugar/bad fats)

40
Q

secondary prevention of diabetes

A

fasting glucose
HgbA1C
oral glucose tolerance test
random glucose level

41
Q

fasting glucose

A

greater than 126 is diabetes

normal 74-106

42
Q

HgbA1C

A

greater than 6.5% is diabetes

normal is 5.7%

43
Q

oral glucose tolerance test

A

2hr lvl of over 200mg/dL

44
Q

random glucose level

A

over 200mg/dL with 3 P’s

45
Q

rapid acting insulins

A

lispro, aspart, glulisine

give within 15 mins of meals

46
Q

short acting insulins

A

regular insulin
30-45 mins after meals

can be IV push, watch for hypoglycemia

47
Q

regular/intermediate insulin

A

NPH
CLOUDY can be mixed with short/rapid (clear) insulin

48
Q

long acting insulin

A

glargine, detemir, degludec
ALL day/ no peak

less risk for hypoglycemia
do not mix glargine or detemir with any other insulin

49
Q

inhaled insulin

A

afrezza
combo w long acting in type 1
bronchospasm and throat irritation

50
Q

basal bolus method

A

basal NPH & long acting
bolus short & rapid acting

51
Q

how to store insulin

A

avoid sunlight
unopened stored in fridge
label vials w date and time
roll syringe in palm
2 insulins/syringe good for 1 wk
1 insulin/syringe good for 30 days

52
Q

biguanides

A

metformin - type 2
decreases glucose prod.
s/s: headache, weakness, dizzy/drowsy, n/v/gi, metallic taste. lactic acidosis

TAKE with food, no alcohol, no kidney/liver/heart issues

hold 24-48hrs before contrast medium procedure

53
Q

sulfonylureas

A

glimepiride, glipizide, glyburide
increases insulin prod.
s/s: hypoglycemia, headache, weakness, dizzy/drowsy, photosensitivity, hepatotoxicity

30 mins before means, skip if meal is skipped, no alcohol

54
Q

meglitinides

A

nateglinide, repaglinide
increases insulin prod.
less likely to cause hypoglycemia
s/s: headache, weakness, pancreatitis, weight gain
take 30 mins before meals, skip if skipped meal

55
Q

glitazones

A

pioglitazone, rosiglitazone
insulin sensitizer
bad side effects, rarely used
s/s: sinusitis, pharyngitis
complications: MI, bladder cancer, worsening HF

56
Q

amylin analogs

A

non insulin injectable agents
type 1
given before meals, never in arm
hypoglycemia 3hrs post admin.
causes decreased appetite

MS exam 2 (9 decks)

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