Brainscape's Knowledge GenomeTM

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


See full index

Fundamentals II > Wk 3: Care of the Diabetic Patient > Flashcards

Wk 3: Care of the Diabetic Patient Flashcards

1
Q

Autoimmune destruction of beta cells in our pancreas

A

Type 1 diabetes

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

Step 1 in diabetes type 1 development

A

Autoantigens form on insulin-producing beta cells and circulate in the blood and lymphatics

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

Step 2 in diabetes type 1 development

A

Activation of cellular immunity and humoral immunity towards beta cells

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

Step 3 in diabetes type 1 development

A

Destruction of beta cells with decreased insulin secretion

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

Macrophages and T cytotoxic cells are part of __ immunity.

A

Cellular immunity

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

Autoantibodies are part of __ immunity

A

humoral

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

Beta cells overworked and cells become immune or resistant to insulin

A

type 2 diabetes

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

Type 1 more common in…

A

younger adults

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

Signs and symptoms are more abrupt in __ diabetes

A

type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Type 1 diabetes represents __ - __ % of all diabetes

A

5-10%

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

Type 1 diabetes have no __ insulin production

A

endogenous

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

Type 1 diabetes must have insulin __.

A

replacement

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

3 P’s for diabetes

A

Polyuria, polydipsia, polyphagia

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

Type 2 diabetes more common in adults and can go…

A

undiagnosed for years

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

Type 2 diabetes: Doctors most often screen based on

A

risk factors, not signs and symptoms

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

Diabetic type 2 patients are insulin __

A

RESISTANT

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

Some type 2 diabetes can need insulin __

A

replacement

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

Type 2 diabetes often treated with __ or __

A

oral or subcut medications

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

Excessive thirst

A

polydipsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Excessive urination

A

polyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Excessive hunger

A

polyphagia

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

Normal fasting blood glucose

A

less than 126 mg/dL

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

To test for a fasting blood glucose the patient will have not had any food or drink in…

A

8 hours

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

Casual blood glucose normal level

A

less than 200 mg/dL

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

High urine ketones is associated with

A

Hyperglycemia

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

What level of urine ketones is associated with a medical emergency

A

Over 300 mg/dL

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

__ and __ may be elevated in patients with diabetes (lipids)

A

LDL and triglycerides

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

Diabetics may have low lipid __ levels

A

HDL

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

OGTT

A

Oral glucose tolerance test

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

Oral glucose tolerance test is commonly used to diagnose

A

gestational diabetes

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

To test for a oral glucose tolerance test, you must draw a

A

fasting glucose prior to testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

After the patient consumes oral glucose in a GTT, the patient’s glucose levels are obtained every…

A

30 minutes until 2 hours post consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Fasting glucose in an OB patient prior to GTT should be

A

less than 110 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

At one hour after oral glucose consumption for the GTT, an OB patient’s blood glucose should be

A

less than 180 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

At two hours after oral glucose consumption for the GTT, an OB patient’s blood glucose should be

A

less than 140 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

HbA1C

A

Glycosylated Hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

HbA1C is the indicator for AVERAGE glucose level over the…

A

past 120 days (3 months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

HgA1C is most commonly used for

A

diagnosis of diabetes and intervention evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Normal A1C

A

4-6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

A1C diabetic level

A

6.5% or greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

For those diagnosed with diabetes, what is the acceptable reference A1C level?

A

6-8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the target A1C level for those diagnosed with diabetes?

A

7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

A1C normal level

A

About 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

A1C pre diabetic level

A

5.7-6.4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

A1C diabetic range

A

6.5 or greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Fasting plasma glucose normal range

A

Less than 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Fasting plasma glucose pre diabetic range

A

100-125

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Fasting plasma glucose diabetic range

A

126 or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Oral GTT normal range

A

139 or below

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Oral GTT pre diabetic range

A

140-199

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Oral GTT diabetic range

A

200 or above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

If in the pre diabetic range for A1C, GTT, or fasting glucose this is indicative of

A

the possible development of diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

To be diagnosed with diabetes you must have at least ONE of the following:

A

1) A1C 6.5 or higher, 2) Fasting blood glucose of 126 mg/dL or higher, 3) GTT 12 hr level of 200 mg/dL, 4) Classic symptoms of hyperglycemia, random GTT greater than 200, or hyperglycemic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Classic signs of hyperglycemia

A

3 P’s or unexplained weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

If someone has labs indicative of diabetes you would

A

repeat labs before diagnosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Lab diagnostic criteria are more common to diagnose

A

Type 2 diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

To diagnose type 1 diabetes…

A

Islet cell autoantibody testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How to evaluate the effectiveness of treatment for type 1 diabetics

A

A1C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Impaired GTT, impaired fasting-glucose, or both

A

Pre-diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

There are typically no symptoms associated with pre-diabetes however,

A

long-term damage can already by occurring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What can we do for a patient who is pre-diabetic?

A

TEACH! Lifestyle modifications, blood glucose and A1C monitoring, symptom monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Symptoms of diabetes

A

Fatigue, slow wound healing, getting sick frequently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Diet modifications for the pre-diabetic

A

Avoiding sugary foods and monitoring carbohydrate intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Oral medications are started at a low dose and increased gradually based on

A

A1C levels and fasting glucose levels (usually AM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Oral medications are most frequently used in

A

type 2 diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Oral diabetes medications work in 3 main ways

A

Reverse insulin resistance, increase insulin production, or increase hepatic glucose production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

In hospitalized patients taking oral diabetes medications…

A

Oral medications are stopped and they are put on insulin while acutely ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Putting patients on insulin while in the hospital can cause

A

Increased anxiety, so you must explain to the patient why you are using the insulin and that they will resume their medication when going back home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

You may need to hold metformin before

A

certain procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

When a diabetic patient is actually ill they will often be started on

A

Oral or IV steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What do steroids do to blood sugar?

A

Increase it, dramatically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

If a patient is prescribed steroids they may need to… (3)

A

1) Alter insulin regimen at home, 2) Adjust basal dosage, 3) increase scheduled doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Illness naturally causes body

A

Stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Stress on the body to release more hormones which causes the body to release more

A

Glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

If a diabetic patient is ill, they may need to

A

Check blood glucose more often and adjust insulin regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Diabetic patients are more prone to go into __ or __ when sick

A

DKA or HHNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

If a diabetic patient has a stomach illness, they may not be eating or drinking. As a nurse you should…

A

Tell them to check their blood sugar more often and treat as necessary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Diabetics still need to do what when they are sick to their stomach

A

Take their oral medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Nursing teaching point: Tell diabetic patients to do what when they are sick

A

Notify their HCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Nursing teaching point: Tell diabetic patients to monitor their blood glucose more frequently when sick, maybe every

A

2-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Nursing teaching point: Diabetics when sick need to continue to __ & __

A

Take medications and stay hydrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Nursing teaching point: When diabetics become ill, they need to maintain their

A

Carbohydrate needs, either through oral food or liquid such as gatorade or pedialyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Nursing teaching point: When diabetics are sick they need to…

A

REST!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Tell diabetics to call HCP if urine positive for…

A

Ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Tell diabetics to call HCP is their blood sugar is greater than…

A

250 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Tell diabetics to call HCP is fever greater than __ and not responding to __

A

Fever greater than 101.5 and not responding to Tylenol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Tell diabetics to call HCP if they are feeling…

A

confused, disoriented, or have rapid breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Tell diabetics to call HCP is they are consistently having these GI symptoms

A

nausea, vomiting, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Tell diabetes to call HCP is they are unable to tolerate

A

liquids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Tell diabetics to call HCP is their illness lasts longer than

A

2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Critical part of diabetes management

A

the patient’s self-monitoring of blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Frequently of blood sugar checks depends on these factors (5)

A

1) glycemic goals, 2) type of diabetes, 3) medication regimen, 4) access to supplies and equipment, 5) patient’s willingness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

If a patient is newly diagnosed and/or only on oral medications for diabetes, they should check their blood sugar

A

Once in the morning and once before they go to bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Patients who are on insulin should check their blood sugar

A

Multiple times per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Continuous glucose monitoring is more commonly used in…

A

Type 1 diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

However, continuous glucose monitoring can be very

A

expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

With continuous glucose monitoring, the patient can use

A

An insulin pump, or respond to readings with medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

In healthcare, we do our best to mimic the body’s

A

normal insulin production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

How do we best mimic normal body insulin production?

A

Combine basal insulin with mealtime insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Combining basal insulin with mealtime insulin is called a

A

“basal-bolus” regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What type of insulin is used for bolus

A

Rapid or short acting insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What type of insulin is given once a day, typically in the morning

A

Basal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Typical basal-bolus insulin regimen

A

4x, basal at bedtime, and bolus before each meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Basal insulin

A

Glargine

105
Q

Bolus insulin

A

NovoLog or Regular

106
Q

Rapid acting insulin

A

lispro, aspart, glulisine

107
Q

lispro

A

Humalog

108
Q

aspart

A

NovoLog

109
Q

glulisine

A

Apidra

110
Q

Short acting insulin

A

Regular

111
Q

Regular insulin types

A

Humulin R or Novolin R

112
Q

Intermediate acting insulin

A

NPH, or Humulin N or Novocain N

113
Q

Long acting insulin

A

glargine, detemir, degludec

114
Q

glargine

A

Lantus

115
Q

detemir

A

Levemir

116
Q

degludec

A

Tresiba

117
Q

Inhaled insulin

A

Afrezza

118
Q

Onset of rapid acting insulin

A

10-30 minutes

119
Q

Peak of rapid acting insulin

A

30 min - 3 hrs

120
Q

Duration of rapid acting insulin

A

3-5 hrs

121
Q

Onset of short acting insulin

A

30 mins - 1 hr

122
Q

Peak of short acting insulin

A

2-5 hrs

123
Q

Duration of short acting insulin

A

5-8 hrs

124
Q

Onset of intermediate acting insulin

A

1.5-4 hrs

125
Q

Peak of intermediate acting insulin

A

4-12 hrs

126
Q

Duration of intermediate acting insulin

A

12-18 hrs

127
Q

Onset of long acting insulin

A

0.8-4 hrs

128
Q

Peak of long acting insulin

A

less defined or no pronounced peak

129
Q

Duration of long acting insulin

A

16-24 hrs

130
Q

Onset of inhaled insulin

A

12-15 mins

131
Q

Peak of inhaled insulin

A

60 mins

132
Q

Duration of inhaled insulin

A

2.5-3 hrs

133
Q

Most commonly used rapid acting insulin type

A

lispro (Novolog)

134
Q

Most commonly used regular or short acting insulin type

A

human regular (Novalin R/Humalin R)

135
Q

Most commonly used intermediate acting insulin type used

A

NPH (Humalin N)

136
Q

Most commonly used long acting insulin type

A

glargine (Lantus)

137
Q

Typically providers use a combination of

A

rapid, regular and long acting insulin regimens

138
Q

Insulin is a…

A

high alert medication

139
Q

First, before you ever give an insulin injection you need to know

A

the patient’s current glucose

140
Q

Second, you must check the.. (2)

A

1) diet order, 2) patient’s oral intake tolerance

141
Q

If a patient is on a scheduled insulin regimen but the patient isn’t eating…

A

You may need to hold the insulin and contact the provider

142
Q

What do you do if your patient is NPO but is scheduled for insulin?

A

Hospital policy whether you give 50% or hold

143
Q

When giving insulin it’s very important to know these three things

A

Hospital policy, patient’s blood sugar, and if patient has been eating

144
Q

If you give insulin and your patient throws up, what may happen?

A

They may become hypoglycemic

145
Q

What is the MOST important point for patients on insulin?

A

Teaching!

146
Q

Many times, diabetics understand their bodies…

A

better than we do, listen to them!

147
Q

For newly diagnosed patients you should…

A

Observe their self-administration of insulin

148
Q

What is crucial for insulin injections?

A

TIMING! Understand when it is administered, when it will take effect, and when you might see adverse reactions such as hypoglycemia

149
Q

Hypoglycemia can…

A

Kill people

150
Q

Hypoglycemia can cause __ if it is not treated

A

seizures

151
Q

Blood sugar less than 70

A

Hypoglycemia

152
Q

If blood sugar is greater than 70, especially in an uncontrolled diabetic

A

they can still have symptoms of hypoglycemia

153
Q

Symptoms of hypoglycemia (10)

A

Sweating, blurry vision, dizziness, anxiety, irritability, hunger, shakiness, tachycardia, headache, fatigue

154
Q

After checking airway and circulation, if a patient is unresponsive you should check

A

blood sugar!

155
Q

Hypoglycemic patients can feel like they are going to…

A

die

156
Q

To treat hypoglycemia, first thing you do is

A

confirm they are hypoglycemic based off blood glucose

157
Q

Follow rule of 15 for hypoglycemia

A

If sugar is low, give them 15 grams of carbohydrates

158
Q

Carbohydrates sources to give a diabetic experiencing hypoglycemia

A

15g of simple sugars such as 4 oz juice or regular soda, or 3 glucose tabs

159
Q

You should avoid simple sugars that are paired with

A

Fat because it delays absorption (such as a candy bar)

160
Q

If the patient is unresponsive they will not be able to swallow so…

A

the rule of 15 is not appropriate

161
Q

15 grams of simple carbohydrates will increase the blood sugar by

A

50 mg/dL in about 15 minutes

162
Q

Also equivalent to 15 grams of simple sugars

A

1 tbs of honey or 5-8 lifesavers

163
Q

Once their blood sugar has risen after following the rule of 15, then you encourage

A

the patient to eat a regular meal

164
Q

If after 15 minutes the patient’s blood sugar is still less than 70…

A

Repeat the rule of 15 process

165
Q

If patient is unresponsive and cannot swallow you can give…

A

IM glucagon or D50 (25-50ml) IV

166
Q

At home a diabetic can use __ if unable to swallow

A

a jelly SL that will absorb even if unable to swallow

167
Q

Other complication that can occur with insulin administration

A

hyperglycemia

168
Q

Hyperglycemia is typically due to…

A

illness, infection, self-management issues, stress

169
Q

What does a patient look like who is extremely hyperglycemic?

A

Weakness, fatigue, blurry vision, headache, nausea, vomiting, diarrhea

170
Q

A patient with hyperglycemia will have a blood sugar of

A

250, even greater than 300

171
Q

For hyperglycemia, check urine for

A

ketones!

172
Q

To treat hyperglycemia administer

A

Insulin, have patient drink fluids, and educate on prevention

173
Q

Greater than 300 blood sugar

A

Is considered an emergency and patient should go to ER

174
Q

Greater than __ ketones, let the provider know

A

300

175
Q

Crisis situations for hyperglycemia

A

DKA, and HHS (Hyperglycemic hyperosmolar syndrome)

176
Q

DKA and HHS are conditions that are

A

life-threatening due to uncontrolled hyperglycemia

177
Q

Release continuous infusion of subcut insulin

A

Insulin pumps

178
Q

Insulin pumps use __ or __ types of insulin

A

rapid acting or regular

179
Q

With insulin pumps patients are receiving a continuous

A

basal infusion

180
Q

Patients have the ability to alter the basal rate of their inulin pump and also

A

can give themselves a bolus based on finger stick reading

181
Q

With an insulin pump you still need to check your insulin at least

A

4x per day, breakfast, lunch, dinner, and before bedtime

182
Q

Most users of insulin pumps use monitors that are connected to their

A

phones so they can constantly see what their blood sugar is

183
Q

If a patient with a pump is admitted…

A

Their pump is deactivated and they are switched to a sliding scale insulin regimen so we can gain greater control of their levels

184
Q

Problems to be aware of for insulin pumps:

A

Infection at insertion site, increased risk for DKA if pump malfunctions, and high cost

185
Q

You cannot __ or __ with insulin pumps

A

Swim or take a bath, but you can take the pump off and do those activities

186
Q

Chronic complicated of diabetes (long term hyperglycemia) are related to…

A

end-organ disease from chronic damage to blood vessels

187
Q

chronic damage to blood vessels is called

A

angiopathy

188
Q

Angiopathy is typically what causes __ in patients with diabetes

A

death

189
Q

Cardiovascular related death due to angiopathy

A

68%

190
Q

Stroke related death due to angiopathy

A

16%

191
Q

Damage to large vessels such as coronary arteries, peripheral vascular, or cerebral vascular

A

Macrovascular angiopathy

192
Q

Damage to capillaries such as retinopathy, nephropathy, or neuropathy

A

Microvascular angiopathy

193
Q

Women with diabetes have __x the risk of CVD than those without

A

4-6x

194
Q

Men with diabetes have __x the risk of CVD than those without

A

2-3x

195
Q

Nursing teaching points for macrovascular disease (CVD)

A

Stop smoking, control blood pressure, modify high fat diet

196
Q

If a patient has metabolic syndrome, their risk of death is

A

very much increased

197
Q

Damage to the retina related to chronic hyperglycemia

A

Retinopathy

198
Q

Damage to small blood vessels in the kidneys

A

Nephropathy

199
Q

Nerve damage due to metabolic imbalances associated with hyperglycemia

A

Neuropathy

200
Q

Retinopathy, nephropathy, and neuropathy are examples of

A

microvascular complications

201
Q

Diabetes is the leading cause of end-stage

A

renal disease

202
Q

Much more likely to get kidney disease if you have…

A

Hypertension AND diabetes

203
Q

__% of diabetics have some type of neuropathy

A

60-70%

204
Q

Major contributor to amputation

A

diabetic neuropathy

205
Q

Only prevention for diabetic neuropathy

A

Early screening and keeping blood sugar under control

206
Q

Neuropathy is typically in that patient’s

A

feet and lower extremities

207
Q

Common complications of neuropathy

A

Foot ulcerations and lower extremity amputations

208
Q

What causes the complications of neuropathy?

A

Loss of protective sensation, prevents patients from being aware that an injury has occurred

209
Q

Patients with neuropathy can become

A

Neuroischemic and loose bloodflow

210
Q

Because of the loss of blood flow, the patient’s wound will become

A

Ischemic and amputation will be needed

211
Q

Diabetic foot care is the

A

nurse’s job!!

212
Q

Wash feet daily with…

A

mild soap and warm water after testing water with hands

213
Q

Pat feet dry especially…

A

between toes

214
Q

Inspect feet daily for…

A

cuts, swelling, blisters, red areas

215
Q

Use __ to prevent dry skin and cracking

A

lanolin

216
Q

Do not put lanolin

A

between toes

217
Q

You can use __ of sweaty feet

A

mild foot powder

218
Q

Do not use __ __ to removed calluses or corns

A

commercial remedies

219
Q

Clean any cuts with

A

mild soap and water

220
Q

Do not clean cuts with

A

iodine, alcohol, or adhesives

221
Q

Tell patients to report any

A

skin infections or non-healing sores

222
Q

You should trim nails

A

after shower or bath

223
Q

Cut nails evenly with

A

rounded contours

224
Q

Separate overlapping toes with

A

cotton

225
Q

Educate patient to wear shoes with

A

soles and to shake out before wearing

226
Q

Educate patient to never go

A

barefoot, wear open toed or open heeled or plastic shoes

227
Q

Educate patient to wear socks that are

A

clean and absorbent

228
Q

Educate patient not to use

A

hot water bottles

229
Q

What type of diet is best for diabetics

A

Balanced, high fiber, low fat, low cholesterol

230
Q

Encourage patients to each complex carbohydrates such as

A

grains, fruits, vegetables, legumes and milk

231
Q

Carbohydrates still need to be about __ of total caloric intake

A

45-65%

232
Q

Teach patients to limit simple carbohydrates such as

A

pasta and bread

233
Q

Teach diabetic patients to eat a diet low in __ and __ fats

A

saturated and trans

234
Q

Best type of fats to eat

A

polyunsaturated, can be found in fish and nuts

235
Q

Crucial for diabetic patients. Can improve carb metabolism and lower cholesterol

A

Fiber!

236
Q

Good sources of fiber

A

Beans, vegetables, oats, whole grains

237
Q

15-20% of diet

A

Protein, preferably from lean meats

238
Q

Limit alcohol to

A

1 drink daily for women, 2 drinks daily for men

239
Q

Alcohol turns into…

A

Sugar and can increase blood sugar

240
Q

Alcohol can also have intense

A

rebound effects and dramatically lower blood sugar as well

241
Q

Alternative sweeteners are

A

acceptable alternatives to sugar for patients with diabetes

242
Q

Consistent carb diets or

A

CC

243
Q

CC1

A

60g of carbs/meal, 1500 calories

244
Q

CC2

A

75g of carb/meal, 1800 cals

245
Q

CC3

A

90g of carb/meal, 2200 cals

246
Q

Carb counting is common, especially for

A

Type 1 diabetics

247
Q

Exercise will __ blood sugar

A

lower

248
Q

It’s best to exercise after

A

meals

249
Q

Tell patients not to exercise if blood sugar is

A

less than 80 or higher than 250

250
Q

Teach patient to eat a carbohydrate snack

A

prior to a high intensity workout

251
Q

Teach patient while exercising to wear a

A

medical alert bracelet, so if they pass out people around them will know what’s going on

252
Q

Teach patient to always think about their

A

feet! Teach them to wear good fitting shoes

253
Q

Stress such as surgery can

A

increase blood glucose levels

254
Q

Common for a controlled diabetic to become

A

uncontrolled while admitted to the hospital and this can upset them

255
Q

Wound healing is __ in patients with diabetes

A

impaired, can take longer and at higher risk for infection

256
Q

Integumentary concerns associated with uncontrolled hyperglycemia

A

diabetic dermopathy, acenthosis nigricans, necrobiosis lipidica diabeticorum

257
Q

Diabetic dermopathy

A

Reddish-brownish spots, usually not the shins

258
Q

Acanthosis nigricans

A

Brown/black thickening of skin, often seen in skin folds

259
Q

Necrobiosis lipoidica diabeticorum

A

Red patches around the blood vessels

Fundamentals II (2 decks)

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