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3910 Health Promotion & Caring: Client's with Health Challenges I > Week 4 Diabetes > Flashcards

Week 4 Diabetes Flashcards

1
Q

Normal Eating

A
  • Secrete insulin
  • Glucose moves from blood into cells
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2
Q

Normal Fasting

A
  • Basal insulin release
  • Glucagon release when BG low
  • Liver secretes glucose
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3
Q

Diabetes Eating

A
  • Insulin excretion/use disrupted
  • Glucose isn’t broken down to be usable
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4
Q

Type 1 (T1D)

A
  • Complete lack of insulin in body
  • Autoimmune
  • Genetic component
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5
Q

Type 2 (T2D)

A
  • Insulin resistance
  • Metabolic syndrome (hypertension, obesity etc)
  • Acquired illness
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6
Q

Symptom Assessment

A
  • Signs of high or low blood sugar
  • Glucose excreted by kidneys
  • Fluid/protein follow by osmosis
  • Fluid volume deficit
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7
Q

Symptoms of Diabetes

A
  • Neurocognitive - dizziness/confusion
  • Polydipsia
  • Weight - loss
  • Hungry
  • Polyuria
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8
Q

Hyperglycaemia Complications

A
  • Glucose damages vessels
  • Atherosclerosis & poor perfusion
  • Damages many body systems including nervous
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9
Q

Ocular Complications

A
  • Damage to micro-vessels in eye
  • Blindness, blurred vision
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10
Q

Cardiac Complications

A
  • Atherosclerosis
  • Increased risk of MI, CAD, stroke, HTN
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11
Q

Renal Complications

A
  • Damage to nephrons
  • Increased risk of chronic kidney disease
  • Neuropathy in bladder
  • Neurogenic bladder, UTI
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12
Q

Vascular Complications

A
  • Peripheral vascular disease
  • Peripheral neuropathy
  • Poor wound healing
  • Numbness feet/hands
  • Falls risk
  • Mobility
  • Foot ulcers
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13
Q

Immune System Complications

A
  • Impaired perfusion - limits movement of immune cells to infection sites
  • High blood glucose is breeding ground for infection
  • Decreased neutrophil synthesis
  • Risk of septic shock
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14
Q

Integumentary Complications

A
  • Impaired wound healing
  • Impaired immunity
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15
Q

Critical BG Levels

A

<2.8mmol/L
>20mmol/L

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16
Q

Normal BG Levels

A
  • Random <7.7mmol/L
  • Fasting 4.0-7.0mmol/L
  • HbA1C <6.5%
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17
Q

Diabetic BG Levels

A
  • Random >11.1mmol/L
  • Fasting >7.0mmol/L
  • HbA1C > 6.5%
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18
Q

Hemoglobin A1C (HbA1C)

A
  • Amount of glucose attached to Hb
  • Reflects average serum glucose level over previous 2-3 months
  • High = poor control of diabetes
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19
Q

Acute Hypoglycemia

A
  1. Development of autonomic & neuroglycopenic symptoms
  2. Low plasma glucose < 4.0mmol/L
  3. Symptoms that respond to carbs
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20
Q

Acute Hypoglycemia Causes

A
  • Too much insulin/oral antihyperglycemic agents
  • Inadequate food intake
  • Excessive physical activity
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21
Q

Autonomic (Neurogenic) S&S

A
  • Trembling
  • Palpitations
  • Sweating anxiety
  • Hunger
  • Nausea
  • Tingling
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22
Q

Neuroglycopenic S&S - elderly/very severe hypoglycemia

A
  • Poor concentration
  • Confusion
  • Weakness
  • Drowsiness
  • Vision changes
  • Speech issues
  • Headache
  • Dizziness
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23
Q

Mild Hypoglycemia

A
  • Autonomic symptoms
  • Able to self-treat
  • 2.8-4.0mmol/L
24
Q

Moderate Hypoglycemia

A
  • Autonomic & neuroglycopenic symptoms
  • Ability to self-treat
  • 2.8-4.0mmol/L
25
Q

Severe Hypoglycemia

A
  • Autonomic & neuroglycopenic symptoms
  • <2.8mmol/L
  • Unconsciousness may occur
26
Q

Mild-Moderate Hypoglycemia Treatment

A
  • Oral ingestion of 15g of carbs
  • Retest BG in 15 mins
  • Re-treat with another 15g of carbs if BG levels remain <4.0mmol/L
27
Q

Severe Hypoglycemia Treatment Conscious

A
  • Oral ingestion of 20g carbs
  • Retest BG in 15 mins
  • Re-treat if BG level remains <4.0mmol/L
28
Q

Severe Hypoglycemia Treatment Unconscious

A
  • IV access (Pre-established) IV push D5W (20-50mL) over 1-3 mins
  • No IV access - SC/IM glucagon 1mg
29
Q

Hypoglycemia Recovery

A
  • BG > 4.0
  • Monitor closely
  • Eat usual meal/provide additional snack
  • Causes??
30
Q

Hypoglycemia Electrolyte Caution

A
  • Body releases adrenaline when in hypoglycemia
  • Causes rapid uptake of K into cells
31
Q

Hyperglycemia

A
  • High plasma glucose
  • T1D less tolerant than T2D
  • Not enough insulin/lack of effective stimulation
32
Q

Diabetic Keto Acidosis

A
  • T1D hyperglycemia emergency
    >13.9mmol/L
33
Q

Hyperglycemic Hyperosmolar Syndrome

A
  • T2D hyperglycemia emergency >33mmol/L
34
Q

Early Hyperglycemia Signs

A
  • Tiredness
  • Polyurea, dehydration
  • Polydipsia
35
Q

T2D Diet Teaching

A
  • Healthy fats
  • High fiber carbs
  • Eat a bedtime snack
36
Q

Insulin Considerations

A
  • Check BG prior to admin
  • Admin amount based on sliding scale
  • Give food during insulin peak
  • No mixing long acting with other types
  • Draw clear (regular) then cloudy (NPH)
37
Q

Rapid Insulin

A
  • Onset 15mins
  • Peak 30-90mins
  • Duration 3-4hrs
38
Q

Short Acting Insulin

A
  • Peak 2-3 hrs
  • Duration 4-6 hrs
  • 20-30mins before meal
39
Q

Intermediate Insulin

A
  • Peak 4-12 hrs
  • Duration 16-20hrs
  • Post meal
40
Q

Long Acting Insulin

A
  • No peak
  • Duration >24 hrs
  • Basal dose
41
Q

Oral Antihyperglycemic Agents

A
  • T2D only
  • Diet & exercise first
  • Avoid Iron, calcium - poor absorption
42
Q

Metformin

A

Treat hyperglycemia, lower BG

43
Q

Metformin Side Effects

A
  • Stomach pain
  • GI upset
  • Gas
  • Bloating
  • N/V/D
  • Constipation
44
Q

Metformin Nursing Considerations

A
  • Monitor BG - hypoglycemia risk
  • Potentially hepatotoxic - monitor ALT & AST
  • Contraindicated in eGFR <30
  • Hold before contrast dye
45
Q

Glyburide

A

Treat hyperglycemia, lower BG

46
Q

Glyburide Side Effects

A
  • GI upset
  • Skin reactions - sunscreen
  • Weight gain
47
Q

Glyburide Nursing Considerations

A
  • Monitor BG - hypoglycemia risk
  • Avoid EtOH - risk of hypo
  • Lower alcohol intake
  • Hypo symptom teachings & actions
  • Caution with heart failure/MI
48
Q

Rosiglitazone, Pioglitazone

A

Treat hyperglycemia, lower BG

49
Q

Rosiglitazone Side Effects

A
  • Weight gain
  • Edema
  • Macular edema
  • Heart failure
50
Q

Rosiglitazone Nursing Considerations

A
  • Monitor BG - high risk of hypo
  • Potentially hepatotoxic
  • Increased risk of bladder CA of genetic origin
51
Q

Acarbose

A

Treat hyperglycemia, lower BG

52
Q

Acarbose Side Effects

A
  • Gas
  • Diarrhea
  • Bloating
  • Stomach pain
  • GI upset
  • NV
53
Q

Acarbose Nursing Considerations

A
  • Monitor BG - hypo risk
  • Avoid in clients with GI issues (IBS, Crohn’s)
54
Q

Levothyroxine (Synthroid)

A

Treats hypothyroidism

55
Q

Levothyroxine Side Effects

A
  • Fever/hot flashes
  • Sweating
  • Nervousness
  • Irritability
  • NVD
  • Headache
  • Insomnia
56
Q

Levothyroxine Nursing Considerations

A
  • Monitor toxicity
  • Risk of hyperthyroidism
  • Tachycardia, chest pain, palpations
  • Take in morning without food
  • Avoid calcium & iron
  • Avoid fluctuations in thyroid levels
57
Q

Hyperthyroidism Treatment

A
  1. Oral iodine
    - Destroys thyroid hormone
    - Attaches to hormone & helps excrete

3910 Health Promotion & Caring: Client's with Health Challenges I (5 decks)

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