Test 3- diabetes Flashcards by Rachel P

The bodies ability to maintain steady states of blood glucose for optimal functioning despite nutritional intake

Glucose regulation

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Risk factors for diabetes mellitus ?

Poor wound healing , infection, ketoacidosis/causes

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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

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How does type one diabetes work in the body

Destruction of beta cells decrease insulin production

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How does type 2 diabetes work in body?

Decrease sensitivity of insulin receptor to insulin decrease uptake of glucose.

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How does gestational diabetes work in the body? (Pathophysiology)

Chronic low grade inflammation in the body due to the stresses of being pregnant ?

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This type of diabetes is more genetic, develops at adolescence, will be on insulin for he rest if your life

Ketoacidosis?

Type 1

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This type of diabetes can be prevented from healthy diet and nutrition. May need insulin, medications such as metformin

Diabetes 2

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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

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Diagnosis for diabetes include :

Glucose higher than what?

Fasting glucose higher than?

200

125

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If fasting glucose levels are normal, the diagnosis must be based on a ?

Glucose tolerance test

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How to manage diabetes ?

Biggest thing is what?

Biggest thing- educating pt

Medications

Exercise

Monitoring glucose

Diet

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Insulin preparations vary according to 3 main characteristics ?

Time of action

Species (source)

Manufacturer

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Use insulin syringes with what on them?

Units

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What part of body is for slow, medium, and fast acting insulin?

Slow - thigh/butt

Medium- under arms

Fast- stomach ? Lower back

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There are two general approaches to insulin therapy?

Conventional - keep consistent

Intensive- inpatient

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3 complications of insulin ?

Local allergic reactions

Systemic allergic reactions

Morning hyperglycemia

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Alternative methods of insulin delivery

Insulin pens

Jet injectors

Insulin pumps

Inhalant insulin

Transplantation of pancreatic cells

Implantable and inhalant insulin

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Types of oral anti diabetic meds to manage diabetes

When to administer?

Sulfonylureas

Biguanides

(Metformin, glayderide )

At meals or when doc orders

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What is the best way to avoid diabetes ?

Management of controlling blood sugars

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2 acute complications of diabetes related to short term imbalances in blood glucose ?

Hypoglycemia

Diabetic ketoacidosis

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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)

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Low bs usually occur is who?

Elderly or type 1

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High bs is what number?

Can do damage to what?

240 or higher

Eyes, kidneys , heart , nerves

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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