Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult Health Test 3 > TEST 3 - Diabetes > Flashcards

TEST 3 - Diabetes Flashcards

1
Q

Osmotic diuresis

A

Excess glucose is excreted in urine, it is accompanied by excessive loss of fluids and electrolytes (usually occurs around BS: 180 -200)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Initial presentation of DMI

A

weight loss over few months
fatigue
increased rate of infection
rapid onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

S/S DMI (3)

A

polyuria
polydipsia
polyphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DMII characteristic fasting blood sugar

A

> 126

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

4 labs for diabetics

A

Hgb A1C
Serum CR
UA
Fasting lipid profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Important referrals

A

Podiatrist
Dietician
Ophthalmologist
Diabetic educator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

HGB A1C normal range

A

4-6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Goal of diabetic

A

<7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nursing managment (5)

A 
blood glucose monitoring
nutrition
meds
exercise
self-care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Rule of self monitoring DMI

A

2-4 times per day/ usually pre-prandial, post-prandial, and bedtime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rule of self monitoring DMII

A

2-4 times per week OR 2-3 times per day depending on blood sugar control and meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Blood glucose therapy goals
AC
PC

A

AC: 70-130
PC: <180

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

BMI goal (mainly DMII)

A

18.5 - 24.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

BP goal

A

<130/80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can hyperinsulinemia cause in DMI

A

weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dietary recommendations by macro

A

Carbs: 130g/day or 45-60g/meal

Fats: < 7% total daily calories

Protein: 15-20% of total calories consumed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why is alcohol a problem?

A

Inhibits gluconeogenesis by liver (glycogen - > glucose) ->can cause hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When to NOT exercise

A

w/n 1 hour insulin, at insulin peak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

General rule for complex carbs and exercise

A

15g carbs + protein snack

  • prior to exercise
  • for every 30-60 min exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Types of insulin by onset

A
  1. rapid-acting
  2. short acting
  3. intermediate-acting
  4. basal insulin= very long acting
  5. combination products
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Rapid acting insulin examples (4)

A

Insulin lispro
Insulin aspart
Insulin glulisine
Afrezza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Short acting examples (1)

A

regular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Intermediate acting examples

A

NPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Basal insulin examples

A

Insulin glargine/lantus

Insulin Detemir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Lispro O,P,D

A

O: 10-15 min
P: 1 hour
D: 2-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Aspart O,P,D

A

O: 5 -15 min
P: 40 – 50 min
D: 2 – 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Glulisine O,P,D

A

O: 5 – 15 min
P: 30 – 60 min
D: 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Regular O,P,D

A

O: 30 – 60 min
P: 2 – 3 hours
D: 4 – 6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

NPH O,P,D

A

O: 2 – 4 hours
P: 4 – 12 hours
D: 16 – 20 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Glargine/Lantus O,P,D

A

O: 1 hour
P: no peak
D: 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Afrezza O,P,D

A

O: <15 min
P: ~50 min
D: 2-3 hours

32
Q

“contraindications” for intensive regimen (4)

A

Recurring severe hypoglycemia
ESRD
Ineffective self-care skills
Nervous system disorder

33
Q

Drawing up insulin

A

cloudy clear clear cloudy

34
Q

Insulin admin considerations

A

NO shaking, rolling
check dose with other nurse
admin 5-15 minutes from prep

35
Q

Thighs O,D

A

O: fast
D: long

36
Q

Arm O,D

A

O: fast
D: short

37
Q

Abomen O,D

A

O:very fast
D: very short

38
Q

Butt O,D

A

O: very slow
D: very long

39
Q

Insulin options for pump

A

Lispro

Aspart

40
Q

Pump MOA

A

Continuous insulin infusion, basal rate
+
Bolus dose of insulin is administered based on total carbs consumed

41
Q

units per grams of carbs for pump

A

1 unit/15g

42
Q

Complications of insulin therapy (4)

A

systemic allergic rxn
insulin lipodystrophy
insulin resistance
morning hyperglycemia

43
Q

3 examples of morning hyperglycemia

A

dawn phenomenon
Somogyi effect
insulin waning

44
Q

Dawn phenomenon

A

normal until 3am, then rises as a result of nocturnal surges in growth hormone

45
Q

Somogy effect

A

Nocturnal hypoglycemia followed by rebound hyperglycemia

46
Q

Inulin waning

cause

A

progressive increase in BG from bedtime to morning

seen when NPH is given before dinner – give it after!

47
Q

5 medication classes

A
  1. insulin secretagogues
  2. insulin sensitizers
  3. Intestinal enzyme inhibitors
  4. incretins
  5. glucose offloading
48
Q

2 types of insulin secretagoues

A
  1. Sulfonylureas

2. Non-sulfonylurea insulin secretagogues

49
Q

Sulfonylureas (examples)

A

Glipizide
Glyburide
Glimepiride

50
Q

Non-Sulfonylurea insulin secretagogues (examples)

A

Nateglinide

Repaglinide

51
Q

Insulin Sensitizers (classes)

A
  1. Biguanides

2. Thiazolidinediones (TZDs)

52
Q

Biguanide example

A

Metformin

53
Q

Thaizolidinediones examples

A

Pioglitazone

Rosiglitazone

54
Q

Intestinal enzyme inhbitors

A

Alpha-glucosidase inhibitors

55
Q

Alphaglucosidase inhibitor examples

A

Miglitol

Acarbose

56
Q

Incretins (2 classes)

A
  1. DPP-4 inhibitors

2. GLP-1 agonists

57
Q

DPP-4 inhibitor examples

A

sitaglipitin
linagliptin
saxagliptin
alogliptin

58
Q

GLP-1 agonist examples

A

exenatide

pramlintide

59
Q

Glucose offloading class

A

SGLT-2 inhibitors

60
Q

SGLT-2 inhibitor example

A

Canagliflozin

61
Q

Meds that INCREASE BG as a SE

A 
estrogens
corticosteroids
lithium salts
niacin
potassium depleting diuretics
caffeine
nicotine/weed
CCBs
62
Q

Meds that DECREASE BG as a se

A 
Salicylates
Beta-blockers
Acetaminophen
NSAIDs
Potassium
ETOH
63
Q

Hyperglycemic Hyperosmolar syndrome

A 
Type II complication
hyperglycemia
osmotic diuresis
hypernatremia
profound dehydration
64
Q

hyperglycemia s/s

A

3 Ps
blurred vision
weakness
headache

65
Q

DKA labs

A 
BG (high)
bicarbonate (low)
pH (low)
PCO2 (low)
serum keton bodies (high)
UA (ketones present)
Electrolytes
Creat, HCT, BUN
66
Q

Late stage HHS

A

altered sensorium
seizures
hemiparesis

67
Q

hypoglycemia nursing intervention (conscious)

A
  1. Immediately give a 15-20g carb replacement per physician order or standing protocol
  2. Check blood glucose with monitor/call lab for confirmatory serum level
  3. Retest in 15 minutes and repeat dose of glucose if BG<70
68
Q

Nursing Interventions (unconscious)

A
  1. Administer glucagon 1 mg IM or SQ or IV 50% dextrose in water 25-50mL slowly as needed
  2. Maintain patent airway
  3. Maintain IV access
  4. Protect from injury
  5. Review events leading up to event to ascertain probable cause
  6. Pt and family edu re s/s/risk factors/prevention/tx
  7. Instruct pt to wear medic-alert bracelet
69
Q

Microvascular complications

A
  1. Diabetic Retinopathy
  2. Diabetic Nephropathy
  3. Diabetic Neuropathy
70
Q

Microvascular complication categories (2)

A
  1. Non-proliferative

2. Proliferative

71
Q

Neuropathy meds (3 classe)

A

SNRIs (duloxetine)
TCAs (amitriptyline)
Anti-seizure meds (gabapentin, pregabalin)

72
Q

Nephropathy s/s

A 
Weakness
Fatigue
Dry flaky gray-bronze skin
HTN
Pitting edema
Crackles, tenacious sputum
Ammonia odor to breath
Anemia, thrombocytopenia
73
Q

Treatment of microalbuminuria

A

ACE Inhibitor (lower BP to prevent leaking of albumin – also protects kidneys)

74
Q

NPO considerations

A
  • half dose of usual intermediate acting insulin OR holding of usual intermediate acting insulin (consult provider!)
  • more frequent blood glucose monitoring
75
Q

Enteral tube feedings

A

-contain less protein and fat than the ADA diet and more simple CHOs

76
Q

TPN considerations

A
  • regular insulin via IV/TPN solution
  • short/intermediate acting insulin to fill in between
  • If TPN is intermittent – SQ insulin should be given so peak action coincides with TPN infusion

Adult Health Test 3 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions