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MS exam 2 (final) > metabolism/diabetes (final) > Flashcards

metabolism/diabetes (final) 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
diabetic plan of care
accuchecks yealry eye exams kidney fx/ urine monitoring diet changes (carb counting 45-60g, avoid alcohol and fats) mild exercise (150mins/wk)
26
foot care for diabetic
wash feet and examine daily pat dry, keep between toes dry yrly podiatry visits no heating pads/tight fitting clothes
27
sick day management of diabetic pt
NEVER stop insulin check glucose q4hrs check urine for ketones if over 250
28
somogyi effect
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
dawn phenomenon
not enough insulin during day causes hyperglycemia increase daytime insulin HIGH FOR THE DAWN
30
s/s hypoglycemia
under 70 mg/dL COLD AND CLAMMY NEED SOME CANDY seizures diaphoresis palpitations LOC changes PPP stupor pallor
31
causes of hypoglycemia
not eating enough too much insulin over exercise
32
treatment of hypoglycemia
give 15g crab q15mins till glucose over 70 1mg glucagon - can cause nausea
33
s/s hyperglycemia
HOT AND DRY, SUGAR IS HIGH dehydration fatigue fruity breath kussmals weight loss poor wound healing PPP
34
hyperglycemia causes
not enough insulin poor food choices stress growth hormone illness/surgery
35
hyperglycemia treatment
administer insulin
36
always carry ____ incase of hypoglycemia
glucose tabs/glucagon
37
hyperglycemia leads to
decreased immune response
38
what do beta blockers mask
s/s of hypoglycemia
39
primary prevention of diabetes
exercise PCP visits good nutrition (no sugar/bad fats)
40
secondary prevention of diabetes
fasting glucose HgbA1C oral glucose tolerance test random glucose level
41
fasting glucose
greater than 126 is diabetes normal 74-106
42
HgbA1C
greater than 6.5% is diabetes normal is 5.7%
43
oral glucose tolerance test
2hr lvl of over 200mg/dL
44
random glucose level
over 200mg/dL with 3 P's
45
rapid acting insulins
lispro, aspart, glulisine give within 15 mins of meals
46
short acting insulins
regular insulin 30-45 mins after meals can be IV push, watch for hypoglycemia
47
regular/intermediate insulin
NPH CLOUDY can be mixed with short/rapid (clear) insulin
48
long acting insulin
glargine, detemir, degludec ALL day/ no peak less risk for hypoglycemia do not mix glargine or detemir with any other insulin
49
inhaled insulin
afrezza combo w long acting in type 1 bronchospasm and throat irritation
50
basal bolus method
basal NPH & long acting bolus short & rapid acting
51
how to store insulin
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
biguanides
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
sulfonylureas
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
meglitinides
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
glitazones
pioglitazone, rosiglitazone insulin sensitizer bad side effects, rarely used s/s: sinusitis, pharyngitis complications: MI, bladder cancer, worsening HF
56
amylin analogs
non insulin injectable agents type 1 given before meals, never in arm hypoglycemia 3hrs post admin. causes decreased appetite

MS exam 2 (final) (9 decks)

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