Lecture 5

Question 1

Diabetes Mellitus

Answer 1

is an error in glucose metabolism

Question 2

Diabetes Insipidus

Answer 2

is diabetes without the glucose part
- Causes polydipsia and polyuria due to low ADH and dehydration

Question 3

SIADH

Answer 3

The syndrome of inappropriate Antidiuretic Hormome.
- the opposite of DI
- oliguria and no thirst

Question 4

Urine specific Gravity

Answer 4

less urine -> High urine specific gravity (SIADH)

More urine -> less urine specific gravity (DI)

Question 5

Fluid Volume Deficit/ Dehydration

Answer 5

DI, DM

Question 6

FLuid volume overload/ urine retention

Answer 6

SIADH

Question 7

DM type 1 Characteristics and tx

Answer 7

insulin dependent, juvenile onset, ketosis prone
- DIE Insulin (1), Exercise (2), Diet (3)

Question 8

DM type 2 Characteristics and tx

Answer 8

Insulin Resistant, adult onset, non ketosis prone

• Diet (1), oral hypoglycemic, activity

Question 9

Type 2 DM Diet

Answer 9

Calorie restriction is the most important thing!
- Also they need to east 6 small meals a day

Question 10

Regular Insulin

Answer 10

Clear, IV, Drip, Rapid/intermediate
onset: 1h
Peak: 2H
Duration: 4H
Pattern: 1-2-4
R means rapid and run IV

Question 11

NPH insulin

Answer 11

Cloudy, Non- IV, Suspension, true intermediate
onset:6h
Peak:8-10H
Duration: 12
Pattern: 6-8-10-12
N means Not so fast and not in the bag

Question 12

Lispro

Answer 12

Short acting only give with meals
onset: 15 mins
Peak: 30 mins
Duration: 3 hours

15-30-3

Question 13

Glargine

Answer 13

Very long acting only one that can be given at bedtime

Duration: 12-24
No peak

Question 14

What invalidates a manufacturers exp date for insulin

Answer 14

• open the package
  -once its open new exp date is 30 days after that
  -A package without an exp date should be thrown out
• label the package with an exp date
  -Refrigeration is optional in hospital once package is open however pts must know to refrigerate their insulin at home

Question 15

Exercise does what to insulin

Answer 15

its basically like another shot of insulin
so with more exercise they need less insulin
- pts must also have a carbohydrate rich snack with them

Question 16

Sick days with Insulin

Answer 16

• GLucose goes up regardlessif patient eats or not
• They need to take there insulin still
• Take sips of water tp prevent dehydration
• stay active to lower glucose

Question 17

Hypoglycemia

Answer 17

CAuses: Too much insulin(1), exercise, not enough food
Dangers: Brain Damage

Question 18

Hypoglycemia S/s

Answer 18

Drunk in Shock
Drunk: Staggering gait, slurred speech, cerebral impairment, slow reaction time

Shock: Tachycardia, cold, clammy, hypotensive, tachypnea

Question 19

Tx For hypoglycemia

Answer 19

If conscious: give sugar/rapidly metabolized carbs
BEst answer: one sugar + protein
Bad answer is candy and soda= 2 sugars or more are bad

Question 20

If patient is unconscious with hypoglycemia

Answer 20

At home give IM glucagon
In Hospital: D10 or D50 IV

Question 21

DKA

Answer 21

Hyperglycemia in TD1M with ketones

Question 22

DKA causes

Answer 22

1 cause is acute viral upper respitratory infection for 2 weeks

• not enough

Question 23

DKA s/s

Answer 23

D- Dehydration ( flushing overheating)
K- Ketones, Kussmauls, High K
A- Acidosis, acetone breath, anorexia

Question 24

Tx for DKA

Answer 24

IV fluids at 200mL or faster
IV regular insulin
d5 will not create a hypoglycemic

Question 25

HHS

Answer 25

Hyperglycemia in Type2 DM
- no acidosis
- no ketones

Question 26

Symptoms of HHNS

Answer 26

-Severe Dehydration
-dry flushed, dry, increased HR
-ND: FLuid Volume DEficit

Question 27

Intervetnion for HHNK

Answer 27

Giving fluids
- Success: seeing incrased u/o, moist mucous,
-long term complications: poor perfusion and peripheral neuropathy

Question 28

DKA or HHNK Higher mortality rate?

Answer 28

HHNK

Question 29

Most Priority

Answer 29

DKA

Question 30

Long term complications of DM

Answer 30

Poor tissue perfusion or peripheral neuropathy

Question 31

Lab test for long term blood sugar level

Answer 31

Hb A1C= avg blood sugar over 3 months
Hb <6 is normal
Hb >8 is abnormal
Hb =7 borderline needs further assessment