NURS 405 Week 6 Monday

Question 1

Dysfunction of the endocrine gland itself

Answer 1

Hyposecretion / Hypersecretion

Question 2

Dysfunction in feedback system

Answer 2

Fail to give proper feedback

May respond to inappropriate signals

Question 3

Dysfunction in transport of the hormone in blood

Answer 3

Hormone may be degraded at an alterted rate (too fast)

Hormone may be attacked (inactivated) by antibodies before it signals the target cell

Question 4

Dysfunction in the delivery of the hormone to the target tissue

Answer 4

Inadequate blood supply to the target tissue

Question 5

FBG levels

Answer 5

> 126 mg /dL –> diabetes
Fasting blood glucose after fasting for more than 8 hours
Avoid tea / coffee because caffeine mobilizes resources and puts nutrients in the blood
Caffeine lowers insulin sensitivity –> increase BG

Question 6

2 Hour BG < *** mg/dL following 75g OGTT

Answer 6

140 is the max for a person without diabetes

>200 –> diabetes

Question 7

A1C ideal level is?

What is A1C for diabetes dx?

Answer 7

5.7%
6.0 –> 126
6.5 –> 140 (>6.5 –> Diabetes)
7.0 –> 154
7.5 –> 169
10 –> 240

Question 8

Random BG for DM diagnosis

Answer 8

> 200 mg/dL

Question 9

Prediabetes Diagnostic Levels
FBG?
2 hour BG 75g OTTT
A1C

Answer 9

Any test value between normal values and values diagnostic of diabetes is considered to be indicative of prediabetes
FBG 100-125 mg/ dL
2 Hours 140-199 mg / dL
A1c- 5.7-6.4%

Question 10

Criteria for screening for diabetes or prediabetes in asymptomatic adults

Answer 10

• Overweight / Obese patients (BMI > 25 ) or BMI > 23 (Asians)
  Risk factors
• A1c > 5.7%
• 1st degree relative with DM
• High risk race: African American, Latino, Native American, Asian American, Pacific Islander
• Women w/ hx GDM or PCOS (polycystic ovarian syndrome)
• Hx CVD, HTN, dyslipidemia (HDL <35 mg/dL & trig >250 mg/dL)
• Physical inactivity
• Insulin resistance - acanthosis nigricans

Question 11

Signs of Hyperglycemia 3 Ps

Answer 11

Polyuria - increased urination
Polydipsia - increased thirst
Polyphagia - increased hunger

Question 12

Classic symptoms of hypoglycemia

Answer 12

Shakiness 
Dizziness
Lightheadedness
Hunger
Confusion
Irritability

Question 13

When should insulin therapy be initiated?

Answer 13

Persistent hyperglycemia > 180 BG. Target glucose range 140-180
More stringent goals 110-140 BG appropriate for selected patients if they can avoid hypoglycemia

Question 14

How often do you check BG when someone is on IV insulin?

Answer 14

Q 30mins - 2hrs

Question 15

What is the preferred treatment for noncritically ill hospitalized patients with poor oral intake or those who are taking nothing by mouth?

Answer 15

Basal insulin or basal plus bolus correction insulin regimen is the preferred treatment

Question 16

Preferred treatment for noncritically ill hospitalized patients with good nutritional intake?

Answer 16

Basal, prandial, and correction component

Question 17

What is strongly discouraged in a hospital setting in terms of insulin regimen?

Answer 17

Use of ONLY a sliding scale insulin regimen