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NUR 325 > NUR 325 Exam #2 > Flashcards

NUR 325 Exam #2 Flashcards

1
Q

What is glucose regulation?

A

the process of maintaining optimal blood glucose

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2
Q

euglycemia (definition & levels)

A

normal blood sugar levels

70-140 mg/dL

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3
Q

hyperglycemia (definition & levels)

A

high blood sugar levels

> 100 mg/dL fasting
140 mg/dL regular
180 mg/dL severe

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4
Q

hypoglycemia (definition & levels)

A

low blood sugar levels

< 70 mg/dL regular
< 50 mg/dL severe

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5
Q

S/S of hypoglycemia

A

-reduced cognition
-tremors
-diaphoresis
-weakness
-hunger
-headache
-irritability
-seizures

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6
Q

S/S of hyperglycemia

A

-polyuria (overproduction of urine)
-polydipsia (excessive thirst)
-dehydration
-fatigue
-fruity odor to breath
-kussmaul breathing (rapid, deep breathing)
-weight loss
-hunger
-poor wound healing

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7
Q

polyuria

A

overproduction of urine

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8
Q

polydipsia

A

excessive thirst

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9
Q

possible causes of hypoglycemia

A

-result of insufficient nutritional intake
-adverse reaction to medications
-excess exercise
-underlying disease

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10
Q

possible causes of hyperglycemia

A

-result of insufficient insulin production/secretion
-excessive counter regulatory hormone secretion
-deficient hormone signaling

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11
Q

hypoglycemia mental status

A

anxious, irritability, confusion, seizures, unconsciousness, coma

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12
Q

hyperglycemia mental status

A

can range from alert to confused and coma

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13
Q

hypogylcemia skin

A

diaphoresis, cool, clammy

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14
Q

hyperglycemia skin

A

warm, moist

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15
Q

hypoglycemia respiratory

A

no change in respirations

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16
Q

hyperglycemia respiratory

A

deep, rapid respirations

fruity, acetone scent to breath

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17
Q

hypoglycemia cardiac

A

tachycardia

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18
Q

hyperglycemia cardiac

A

tachycardia if dehydrated

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19
Q

are ketones present in hypo or hyperglycemia?

A

hyperglycemia

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20
Q

What is the A1C (aka HbA1c) test?

A

blood test that measures the average blood sugar levels over the past 3 months

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21
Q

What does a higher A1C mean?

A

greater risk for developing type 2 diabetes

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22
Q

A1C values

A

-Normal A1C: below 5.7%
-Pre-diabetes: 5.7% - 6.4%
-Diabetes: > 6.5%

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23
Q

long-term consequences of hypoglycemia

A

-repeated hypoglycemic episodes lowers the threshold that stimulated counter regulatory hormone
-death

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24
Q

long-term consequences of hyperglycemia

A

-organ disease due to microvascular damage
-retinopathy
-neuropathy
-macrovascular angiopathy
-hypertension

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25
Q

retinopathy

A

damage to blood vessels in retina

causes blindness and blurred vision

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26
Q

neuropathy

A

peripheral nerve damage to the brain and spinal cord

causes weakness, numbness, pain in hands and feet

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27
Q

macrovascular angiopathy

A

macrovascular = large vessels like arteries and veins

angiopathy = disease of the blood vessels

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28
Q

glucose regulation- diet

A

-low in saturated fats
-consistency in amount of food consumed
-regular meal times
-include omega 3 and fiber in diet to lower cholesterol

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29
Q

glucose regulation- exercise

A

physical activity lat least 3x a week = 150 minutes

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30
Q

Prevention/early recognition of type 2 DM

A

-screen pts with BMI over 25
-A1C test

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31
Q

pt & nursing interventions for hypoglycemia

A

-glucose tabs
-glucagon for unconscious patients
-eat full meals
-15/15 rule

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32
Q

what is the 15/15 rule?

A

eat 15g of carbs then check BG after 15 minutes

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33
Q

pt & nursing interventions for hyperglycemia

A

-oral hypoglycemic agents
-insulin
-change in lifestyle
-change in diet
-weight control
-education for self management

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34
Q

what are electrolytes?

A

minerals in the body that conduct electricity

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35
Q

What are the 4 minerals in the body?

A

potassium, sodium, calcium, magnesium

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36
Q

electrolyte function

A

-balancing water in the body
-balancing pH level
-moving waste out of body cells
-moving nutrients into body cells
-helping muscle/heart/nerve/brain function

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37
Q

what 2 groups are at high risk for impaired fluid and electrolyte balance?

A

infants and elderly

38
Q

why are infants at the highest risk for fluid and electrolyte imbalance?

A

-high metabolic rate
-immature kidneys
-more rapid RR
-proportionately greater body surface area

39
Q

why are elderly at risk for impaired fluid and electrolyte balance?

A

-thirst sensation blunt
-kidneys less able to respond to ADH
-impaired ability to conserve

40
Q

Risk factors for fluid and electrolyte imbalance

A

-vomiting
-diarrhea
-organ failure (liver, kidney, heart)
-unexplained nausea
-fatigue
-dizziness
-shortness of breath
-muscle cramping
-edema
-sudden changes in weight

41
Q

primary prevention - fluid and electrolyte imbalance

A

-pt teaching
-dietary measures
-fluid management

42
Q

secondary prevention - fluid and electrolyte imbalance

A

-screening for imbalances
-water replacement therapy
-electrolyte supplements
-pharmacology (diuretics, insulin, vasopressin- ADH)
-daily weight
-monitoring I/Os

43
Q

diffusion

A

-movement of solutes (electrolytes) from an area of high concentration to low concentration
-passive

44
Q

osmosis

A

-movement of water across a semi-permeable membrane from an area of low concentration to an area of high concentration
-active

45
Q

oral hypoglycemics vs insulin administration

A

-oral hypoglycemics are administered when pt DOES have function pancreas
-insulin is administered when client DOES NOT have functioning pancreas

46
Q

why are oral anti-diabetics not used for type 1 diabetes?

A

-oral anti-diabetic meds require a functioning pancreas, which type 1 diabetics do not have

47
Q

Why should patients with kidney failure, alcoholism, heart failure, or COPD not take metformin?

A

it can cause lactic acidosis in blood which can cause sepsis

48
Q

When should regular insulin be administered? Why?

A

It should be administered 30 minutes before mealtime to ensure the client will ingest some carbs for insulin to act on –> reduces risk of hypoglycemia

49
Q

How should the nurse administer insulins?

A

-alternate injection sites
-regular insulin before NPH
-second nurse check
-understand sliding scales

50
Q

_____ insulin before ____ insulin

A

regular before NPH

51
Q

When insulin reaches it’s ____ is when pt is most at risk for ________

A

peak, hypoglycemia

52
Q

insulin pumps are for which kind of insulin?

A

short acting

53
Q

What electrolyte imbalance may be caused/corrected by insulin? why?

A

hypokalemia, due to uptake of potassium from blood glucose

54
Q

Lispro insulin info

A

-Onset: 15-30 minutes
-Peak: 30 min - 3 hours
-Duration: 3-5 hours
-“meal-time” insulin
-subQ

55
Q

What kind of insulin is lispro?

A

rapid acting

56
Q

Humulin R (_____) insulin

A

regular

57
Q

What type of insulin is Humulin R?

A

short acting

58
Q

Humulin R info

A

-Onset: 30 minutes- 1 hour
-Peak: 1-5 hours
-Duration: 6-10 hours
-SubQ

59
Q

NPH Insulin aka ____ ____

A

Humulin N

60
Q

What type of insulin is NPH Insulin?

A

intermediate acting

61
Q

NPH insulin info

A

-Onset: 1-2 hours
-Peak: 4-14 hours
-Duration: 14-24 hours
-SubQ

62
Q

Glargine Insulin brand name

A

Lantus

63
Q

What type of insulin is glargine insulin?

A

long acting

64
Q

Lantus generic name

A

glargine insulin

65
Q

glargine insulin info

A

-onset: 1-4hr
-peak: none/steady
-duration: 24hrs
-SubQ injection

66
Q

hypertonic solution

A

-higher osmolality than blood
-draws water OUT of cells into ECF, cell = shrinks

67
Q

What should you monitor when giving a hypertonic solution?

A

BP, lung sounds, sodium levels

68
Q

Examples of hypertonic solutions

A

-3% saline
-D10W (10% dextrose in water)
-D5NS (5% dextrose in normal saline, 0.9%)
-D51/2NS (5% dextrose in half normal saline, 0.45% NS)

69
Q

hypotonic solution

A

-lower osmolality than blood
-moves water from ECF to ICF

70
Q

what should you monitor when giving hypotonic fluids?

A

changes in mentation

71
Q

examples of hypotonic fluids

A

-0.45% saline
-0.33% saline
-0.225% saline
-D5W (starts as isotonic but becomes hypotonic in body due to body metabolizing dextrose)

72
Q

isotonic fluids

A

-no movement between ECF and ICF

73
Q

examples of isotonic fluids

A

-NS, 0.9% saline
-LR (Lactated ringers)
-D5W, starts isotonic but becomes hypotonic in body)

74
Q

What’s in lactated ringers?

A

sodium, potassium, chloride, calcium, lactate

75
Q

what do lactated ringers do?

A

-expands ECF
-treats burns and GI losses
-contraindicated with liver dysfunction, hyperkalemia, and hypovolemia

(isotonic)

76
Q

Intracellular fluid (ICF)

A

fluid within cells, 2/3

77
Q

extracellular fluid (ECF)

A

fluid outside of cells, 1/3

contains interstitial fluid and intravascular fluid

78
Q

interstitial fluid

A

fluid around the cells

79
Q

sodium function

A

-supports the function of nerves and muscles
-helps maintain BP
-regulates body’s fluid balance

80
Q

potassium function

A

-helps with nerve and muscle cell function, especially muscles in the HEART

81
Q

What category does the medication Glipizide fall under?

A

sulfonylurea

82
Q

What category does the medication Repaglinide fall under?

A

meglitinide

83
Q

What category does the medication metformin fall under?

A

biguanide

84
Q

What category does the medication prioglitazone fall under?

A

thiazolidinedoines

85
Q

hypovolemia

A

too little fluid (ECV deficit)

86
Q

causes of hypovolemia

A

-polyuria
-prolonged vomiting
-prolonged diarrhea
-sweating
-dehydration

87
Q

symptoms of hypovolemia

A

-sudden weight loss
-skin tenting
-dry mucous membranes
-vascular underload –> rapid thready pulse, postural BP drop, HR increase, lightheadedness, flat neck veins when supine, syncope (fainting), shock

88
Q

what is the best treatment for hypovolemia?

A

isotonic fluids

89
Q

hypervolemia

A

too much fluid, ECV excess

90
Q

hypervolemia symptoms

A

-sudden weight gain
-edema
-vascular overload –> bounding pulse, distended neck when upright, dyspnea (difficulty breathing), pulmonary edema

91
Q

hypervolemia pt teaching

A

-reduce salt in diet
-monitor weight
-monitor fluids

92
Q

interventions for hypervolemia

A

-diuretic
-reduce fluid intake
-reduce salt in diet
-dialysis if severe

NUR 325 (3 decks)

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