Test 3- diabetes Flashcards
The bodies ability to maintain steady states of blood glucose for optimal functioning despite nutritional intake
Glucose regulation
Risk factors for diabetes mellitus ?
Poor wound healing , infection, ketoacidosis/causes
What are the different types of diabetes ?
Type 1- insulin dependent
Type 2-non insulin dependent
Gestational diabetes
Diabetes mellitus associated with other conditions or syndrome
How does type one diabetes work in the body
Destruction of beta cells decrease insulin production
How does type 2 diabetes work in body?
Decrease sensitivity of insulin receptor to insulin decrease uptake of glucose.
How does gestational diabetes work in the body? (Pathophysiology)
Chronic low grade inflammation in the body due to the stresses of being pregnant ?
This type of diabetes is more genetic, develops at adolescence, will be on insulin for he rest if your life
Ketoacidosis?
Type 1
This type of diabetes can be prevented from healthy diet and nutrition. May need insulin, medications such as metformin
Diabetes 2
Signs and symptoms that occur in all types of diabetes?
Three Ps - polyuria, polydipsia, polyphagia
Fatigue and weakness
Sudden vision changes
Tingling or numbness in hands or feet
Dry skin
Skin lesions or wounds that are slow to heal
Recurrent infections
Diagnosis for diabetes include :
Glucose higher than what?
Fasting glucose higher than?
200
125
If fasting glucose levels are normal, the diagnosis must be based on a ?
Glucose tolerance test
How to manage diabetes ?
Biggest thing is what?
Biggest thing- educating pt
Medications
Exercise
Monitoring glucose
Diet
Insulin preparations vary according to 3 main characteristics ?
Time of action
Species (source)
Manufacturer
Use insulin syringes with what on them?
Units
What part of body is for slow, medium, and fast acting insulin?
Slow - thigh/butt
Medium- under arms
Fast- stomach ? Lower back
There are two general approaches to insulin therapy?
Conventional - keep consistent
Intensive- inpatient
3 complications of insulin ?
Local allergic reactions
Systemic allergic reactions
Morning hyperglycemia
Alternative methods of insulin delivery
Insulin pens
Jet injectors
Insulin pumps
Inhalant insulin
Transplantation of pancreatic cells
Implantable and inhalant insulin
Types of oral anti diabetic meds to manage diabetes
When to administer?
Sulfonylureas
Biguanides
(Metformin, glayderide )
??
At meals or when doc orders
What is the best way to avoid diabetes ?
Management of controlling blood sugars
2 acute complications of diabetes related to short term imbalances in blood glucose ?
Hypoglycemia
Diabetic ketoacidosis
In elderly patients with diabetes low blood sugar is a concern for what reasons ?
Elderly people often live alone and do not recognize symptoms
It takes longer for meds to be excreted by the kidneys due to decreasing kidney function
Skipping meals may occur because of decreased appetite or money issues
Insulin error administration due to bad eye sight (overdose)
Low bs usually occur is who?
Elderly or type 1
High bs is what number?
Can do damage to what?
240 or higher
Eyes, kidneys , heart , nerves
Why to teach diabetics foot care?
Diabetics can’t always feel feet (neuropathy)
Very important to know patients history of what ?
Bs levels
Symptoms of low bs ?
Shaky, fast heart beat, sweating, dizzy, anxious, hungry, blurry vision, weakness or fatigue , headache, irritable
Hyperglycemia symptoms ?
Thirsty
Need to urinate
Dry skin
Hungry
Blurry vision
Drowsy
Slow healing wounds
What to asses with someone who has diabetes ?
History Diet Exercise BS hx Infections
What are the nursing process steps for someone newly diagnosed with diabetes mellitus ?
Assessment Nursing diagnosis Potential complications Planning and goals - monitor sugars Nursing interventions Evaluation
What is the first thing to teach patients ?
To manage and monitor bs
How to teach patients to take care of their feet?
Inspect feet
Wash feet daily
Keep skin soft and dry
Smooth corns and calluses gently trim your toenails each week or when needed
Wear shoes and socks at all times
Protect your feet from hot and cool
Keep the blood flowing to your feet
Check with your health care provider
What is the key to preventing diabetes?
Management
What are the long-term complications of diabetes?
Macrocascular- brain , heart, pvd
Microvascular- eyes, renal, neuropathy
Neuropathy- * mostly
Three diabetic complications contribute to the increased risk of foot problems and infections ?
Neuropathy
Peripheral vascular disease
Immunocompromise
Management (teaching proper foot care)
Special issues in diabetic care?
Or common diabetic complications ?
Diabetics undergoing surgery- poor wound healing
Management of hospitalized pts with diabetes
High or low bs during hospitalization
Common alteration in diet
Hygiene
Stress
Bs too high and mouth smells sweet - don’t confuse with hyperglycemia
Diabetes Ketoacidosis
Hot and dry sugar high
(Need sugar) what type ?
Type 2
Cold and clammy need some candy what type ?
Type 1
When should someone eat after give a very short acting insulin?
Types?
5-10 min after injection
Lasts 5 or less hours
Humalog, novalog , aprida
When can someone eat after giving a short acting insulin?
Types?
15-30 min
Lasts 5-8 hours
Humulin , novolin
This insulin lasts up to 24 hours - too insulin vial between palms of hands to equally distribute
Types?
Intermediate acting
Humulin , Novolin
Lasts up to 24 hrs - usually given once a day l. Can’t be mixed with any other insulin preparations. Lantus is usually given with evening real at bedtime
Types?
Long acting
- lantus , levimir
His type of insulin should be given 5-10 min before eating meal - roll vial between palms to equally distribute
How long lasts ?
Types?
Premixed
10-24 hours depending of type
Humulin, humalog, Novolog
When may some one have sliding scale insulin ?
Times of surgery,illness, stress , regular regimen
What does a sliding scale determine ?
Insulin dosages based on blood sugar level
For sliding scale a dose may be administered how often ? Depending on what?
4-6 hours based on blood glucose level
What are the benefits of sliding scale ?
To be flexible with insulin as needed and to monitor bs frequently
How to administer insulin?
What degree and area?
90 degree angle or 45 degree angle
Stomach, arms, thighs, hips, sub-scapular regions
With insulin , where does absorption occur the most quickly ?
Abdomen
Then the thighs, hips, and subscapular areas
Why should we rotate sites with insulin?
Prevent lipodystrophy (damage to the fat which decreases absorption)
This type of diabetics should monitor feet and bs levels
Most common
Non insulin dependent
Can be prevented by diet and exercise adult onset
More common in obese children
Increase blood glucose to insulin resistance or deficiency
Diabetic 2
Management of type 2?
Diet therapy
Exercise
Educate
Monitor
Meds - metformin
Signs and symptoms of diabetes type 2
Polyuria- increased pee Polydipsia - more thirst Polyphagia- more appetite Fatigue Weakness Vision changes Neuropathy Dry skin Slow healing Sweet breath
This type of diabetesstarts at youth
More genetic
Need insulin daily
3 ps
Less common
Increase glucose
Pan tease cells are destroyed
Immune compromised
Diabetes 1
Management of diabetes 1 ?
Always require insulin in addition to dietary control and exercise.
Can have insulin pump
Educate pt
Cold and clammy need candy
Signs and symptoms of diabetes 1 ?
Blurred vision
Angling of hands and feet, weight loss, hunger, increased urination, increased thirst, hunger, poor wound healing, fatigue, vaginal infections, hypoglycemia, ketoacidosis, DKA, can lead to neuropathy, PVT
Medication used to treat type two diabetes
What to avoid
Metformin and glyburide
Alcohol
What a pt can wear so that one is aware of their treatment ?
Medic Alert braclet
Diabetes is a systemic disease caused by an imbalance of what?
Insulin supply and demand
Most disorders of the endocrine system are a result of ?
Hypofunction or hyperfunction
Role of the nurse with diabetes ?
Educate client about disease
Medication therapy
Management of complications
Ways to monitor glucose levels and ketones ?
Self monitoring blood glucose
Continuous glucose monitoring system
Glycated hemoglobin
Testing for ketones- bad diet
The pituitary gland produces insufficient ADH, hence the canoes make a lot of urine
Diabetes insipidus
Continuous Elevated bs will begin to impact body how?
It will have an impact on blood vessels, causes damage to the vessel walls and and organs overtime
What populations have increased risk of abnormal glucose regulation?
People with strong family history, ethnic groups, infants, elderly
What should a nurse observe in a newly created ostomy ?
Skin care , attachment Of the ostomy, observing the psycho social adjustment of the patient, function, elimination habits
Reasons one may need an ostomy ?
Control of function, retention, discomfort with illumination, diseases, cancer, inflammatory bowel disease, anomalies, infections or trauma
