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Patient Centered Care > Patient Centered Care > Flashcards

Patient Centered Care Flashcards

1
Q

Diabetes mellitus:

A

is a chronic multisystem disease characterized by hyperglycemia related to abnormal insulin production, impaired insulin utilizations or both. (7th leading cause of death in the U.S)

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2
Q

Long term complications of diabetes includes:

A

adult blindness, end stage renal disease, and non traumatic lower limb amputations. It is also a major contributor to heart disease and stroke.

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3
Q

More than half of adults with diabetes have

A

hypertension(HIGH Blood pressure)and high cholesterol levels

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4
Q

The current theory’s of the cause of diabetes includes:

A

genetic, autoimmune, and environmental factors(viruses/obesity)

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5
Q

Insulin is a hormone produced by

A

the B-cells in the islets of Langerhans of the pancreas.

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6
Q

Insulin lowers blood glucose and facilitates a stable, normal glucose range of approximately

A

70-110 mg/dL

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7
Q

Which type of Diabetes Mellitus is more common in young people?

A

Type 1

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8
Q

90-95% of Diabetes is

A

Type 2

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9
Q

Often times in type 2 diabetes there are

A

no symptoms

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10
Q

Symptoms of type 2 diabetes include:

A

fatigue, ***recurrent infections, polyuria, polydipsia, and polyphagia

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11
Q

Symptoms of type 1 diabetes include:

A

fatigue, WEIGHT LOSS WITHOUT TRYING, polyuria, polydipsia, and polyphagia

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12
Q

Type 1 produces

A

none or minimal insulin

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13
Q

What type of DM has vascular and neurologic complications?

A

Type 1

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14
Q

Which type of diabetes requires nutrition therapy?

A

BOTH type 1 and type 2

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15
Q

Glucagon, epinephrin, growth hormone, and cortisol work to oppose the effects insulin and increase blood glucose levels, they do this by:

A

stimulating glucose production and release by the LIVER and by decreasing the movement of glucose into the cells.

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16
Q

Type 1 diabetes is

A

an autoimmune disorder in which the body develops antigens against insulin and/or the beta cells of the pancreas

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17
Q

Human leukocyte antigens(HLAs) make some people predisposed to

A

type 1 diabetes

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18
Q

classic symptoms of type 1 include:

A

it is Rapid, there is usually impending or actual ketoacidosis, excessive thirst, frequent urination, and excessive hunger

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19
Q

Risk factors for type 2 diabetes are:

A

being overweight or obese, being older

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20
Q

endogenous insulin is:

A

self made (in the body)

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21
Q

exogenous insulin is:

A

insulin from an outside source

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22
Q

Sometimes with type 1 diabetes patients experience a

A

honey moon period, or remission..usually occurs for 3-12 months after treatment is initiated.

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23
Q

Type 2 diabetes is more prevalent in:

A

African americans, Asians, Hispanics, Native Hawaiians, other pacific Islanders, and Native Americans

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24
Q

Type 2 diabetes is

A

insulant resistance, where secretions diminish overtime

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25
Q

Metabolic abnormalities have a role in type 2 diabetes:

A

a. there is insulin resistance, tissues do not respond to insulin because receptors are insufficient, or unresponsive or both
b. marked decrease of the ability of the pancreas to produce insulin(B cells become fatigued or when B-cell mass is lost
c. Inappropriate glucose production by the liver
d. altered production of hormones and cytokines by adipose tissue(adipokines)

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26
Q

five components of metabolic syndrome:

A
  1. elevated glucose levels
  2. abdominal obesity
  3. elevated BP
  4. high levels of triglycerides,
  5. decreased levels of high density lipoproteins(HDLs(Good cholesterol)
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27
Q

the average person has type 2 diabetes for

A

6 1/2 years before they are diagnosed because the signs of hyperglycemia don’t develop until 50-80% of beta cells are no longer secreting insulin!

28
Q

A1C is

A

glycosylated hemoglobin(used to diagnose Diabetes) at 6.5 it is diagnosed at 6.5%)

29
Q

Patients can be diagnosed with pre diabetes by doing a

A

2 hour oral glucose tolerance test

Normal level is 140-199

30
Q

pre diabetes is defined as:

A

impaired glucose tolerance or impaired fasting glucose

31
Q

people with pre diabetes should be monitored for:

A

symptoms such as fatigue, frequent infections, and slow healing wounds

32
Q

Women at high risk for gestational diabetes are:

A

obese, have a family history of diabetes, and are of advanced maternal age

33
Q

Women experiencing gestational diabetes have a

A

63% chance of developing type 2 diabetes within 16 years.

34
Q

Medical conditions that cause abnormal blood glucose levels:

A 
cushing syndrome
hyperthyroidism
recurrent pancreatitis
cystic fibrosis
hemochromatosis
parenteral nutrition
35
Q

3 commonly used medications that can induce diabetes in some people;

A

contraceptives, corticosteroids, thiazides, and atypical antipsychotics

36
Q

Diabetes caused by medical conditions or medications can

A

resolve when the underlying condition is treated or the medication is discontinued

37
Q

The osmotic effect of glucose produces the manifestations of

A

polydipsia and polyuria

38
Q

Polyphagia is a consequence of

A

cellular malnourishment when insulin deficiency prevents utilization of glucose for energy.

39
Q

In diabetes, weight loss may occur because the body cannot

A

get glucose and turns to other energy sources such as fat and protein

40
Q

In Diabetes, weakness and fatigue may occur because

A

the cells lack needed energy from glucose

41
Q

You should be concerned about the possibility of type 2 diabetes when:

A

your patient talks to you about recent visual changes and her recurrent vaginal yeast infections

42
Q

To diagnose diabetes:

A

often the doctor will order a COMPREHENSIVE METABOLIC PANEL (CMP) and look to see if there is an elevated blood glucose level that will trigger them to do an A1C (6.5% or higher is diagnostic of diabetes)

43
Q

Aa A1C of 6.5% means that:

A

6.5% of the total hemoglobin has glucose attached to it

44
Q

2 diseases that could influence the results of the A1C are

A

anemia and sickle cell anemia

these diseases affect red blood cells

45
Q

A1C goal for a patient with diabetes is

A

less than 7%

46
Q

Diabetes is

A

a chronic disease that is expensive and often requires major lifestyle changes. Maintaining blood glucose levels near normal is the goal.

47
Q

Rapid acting insulins:

A

Humolog

Novolog

48
Q

Short acting:

A

Humulin R, Novolin R

49
Q

Intermediate Acting

A

NPH (Humulin N, Novolin N)

50
Q

Long acting

A

Lantus

Lvemir

51
Q

Rapid acting insulin:

A

Onset:10-30 mins
Peak:30-3 hr.
Duration:3-5

52
Q

short acting insulin:

A

onset: 30-1 hr
peak: 2-5 hours
duration: 5-8 hours

53
Q

intermediate acting:

A

onset: 1.5-4 hours
Peak: 4-12
Duration:12-18

54
Q

Long acting:

A

onset: .8-4
peak: Less pronounced or none
duration: 16-24

55
Q

Which type of insulin most closely mimics natural insulin secretion?

A

basal bolus regimen

56
Q

Insulin preparations are clear solutions except:

A

NPH and protamine-containing insulin which are cloudy

57
Q

long acting insulins have less risk of hypoglycemia because they have

A

no pronounced peak

58
Q

Side effects of somogyi effect are

A

headache in morning, sweating and nightmares throughout the evening

59
Q

to prevent somogyi effect you would

A

decrease insulin

60
Q

dawn phenomenon is

A

an early-morning (usually between 2 a.m. and 8 a.m.) increase in blood sugar (glucose) relevant to people with diabetes. It is different from chronic Somogyi rebound in that dawn phenomenon is not associated with nocturnal hypoglycemia.

61
Q

treatment for somogyi effect is you give

A

less insulin in the evening

62
Q

treatment for dawn phenomenon is

A

an increase in insulin or an adjustment in administration time

63
Q

Afrezza is not recommended

A

in patients with asthma and can cause cough, throat pain and irritation

64
Q

Metformin works

A

to reduce glucose production by the liver(contraindicated in someone with a liver issue like drinking)

65
Q

MEtformin if administered before use of contrast die could

A

cause acute kidney injury which can induce lactic acidosis

66
Q

Glucotrol (a sulfonylurea):

A

increases insulin production by the pancreas

67
Q

Avandia is an insulin sensitizer that

A

won’t cause hypoglycemia, but may increase risk for heart attack

Patient Centered Care (1 decks)

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