Brainscape's Knowledge GenomeTM

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


See full index

med/surg 2 > class 8 diabetes > Flashcards

class 8 diabetes Flashcards

1
Q

what is diabetes mellitus

A

a metabolic disorder characterized by the presence of hyperglycemia due to:
1. the impairment of insulin secretion, defective insulin production, action, or both
2. inefficient utilization of insulin in the body (insulin resistance
0

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

what happens if there is beta cell destruction in DM

A

absolute insulin deficiency

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

classic symptoms of DM

A

polyuria, polydipsia, polyphagia (3 p’s), unexplained weight loss

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

controllable risk factors for DM

A

sedentary lifestyle
obesity

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

uncontrollable risk factors for DM

A

-family hx
-race
-autoimmune
-metabolic conditons
-HTN

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

tx for type 1

A

insulin

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

tx for type 2

A

lifestyle
po hypoglycemic
insulin as a last line

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

tx for prediabetes

A

education & lifestyle

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

3 things to minimize complications

A

-early screening
-intervention
-optimization of glycemic control

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

what is prediabetes

A

a condition where blood sugar levels are higher than normal, but are not yet high enough to be diagnosed as type 2 diabetes
-they may not go on to develop diabetes

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

how does DKA develop

A

when there is no insulin to use blood glucose for energy the body breaks down fat stores to get energy when creates ketones

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

age of onset for DM1

A

any age
peak incidence is age 10-15

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

age of onset DM2

A

over 30/any age
increasing rates in children

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

symptoms of DM1

A

abrupt
-3 p’s: polyuria, polydipsia, polyphagia
-fatigue
-weight loss

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

symptoms of DM2

A

frequently none, gradual & vague
-s/s of glucose intolerance
-fatigue
-recurrent infections (^B/G=immune dysfunction)

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

ketosis in DM1

A

can occur often
DKA

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

ketosis in DM2

A

very rare
can experience HHNS

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

management of DM1

A

insulin

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

management of DM2

A

lifestyle mod
may need oral hypoglycemics
insulin if necessary (last resort)

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

normal fasting b/g in adults

A

4-7

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

normal fasting b/g in kids

A

4-8

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

hypoglycemia=

A

<4

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

critical hypoglycemia

A

<2.8

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

lab results for diagnosis of DM

A

-fasting plasma glucose (pg) >=7
-2h pg in a 75g OGTT >=11.1
-random pg >11.1
-HbgA1C: over 7 adults, 7.5 kids

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

HbgA1C: prediabetes

A

6.0-6.4

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

what is HbgA1C

A

measures the % of RBC’s that are coated in glucose over a 120 day period

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

HbgA1c; # predict the development of retinopathy

A

6.5 or greater

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

how often should HbgA1C be taken if blood glucose targets are not being met/making changes to management

A

every 3 months

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

factors that can alter HbgA1c:

A

anything that affects RBC’s
-age
-chronic conditions that affect RBC production
-dec EPO
-iron def anemia

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

nonpharm management of type 1 and 2

A

diet
exercise
maintaining a healthy weight
regular screening for complications

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

potential causes of diabetes in ages 5-7

A

stress of school
inc exposure to infectious disease

32
Q

potential causes of diabetes in ages 11-13

A

puberty
rapid growth
inc emotional stress
insulin antagonism of sex hormones

33
Q

why is diabetes difficult to manage in children

A

-growing (spurts and plateaus)
-energy expenditure (irregular)
-varying nutritional needs (irregular)
-psychosocial impacts (diagnosis, puberty, resentment)

34
Q

signs and symptoms of hypoglycemia

A

-reduced cognition
-tremors
-diaphoresis
-weakness
-hunger
-headache
-irritability
-seizure

35
Q

signs of hyperglycemia

A

-3 p’s
-dehydration
-fatigue
-fruity breath
-kussmaul breathing
-weight loss
-hunger
-poor wound healing

36
Q

hypoglycemia treatment

A

-early detection is key
-if conscious give carbs/glucose tabs
-pt should have usual meal or snack once b/d is safe
-if normal meal is >1h away, 15g of carbs and a protein should be given
-pt should not be encouraged to change normal eating schedules when low/high, just correct then continue with normal meals/snacks

37
Q

tx of hypo in <5yr

A

5g carbs
(40ml juice/soda/sweet drink, 2 dextrose tabs)

38
Q

tx of hypo 5-10 yr

A

10g carbs
(85ml juice/soda/sweet drink, 3 dex tabs)

39
Q

tx hypo >10 yr

A

15g carbs
(125ml juice/soda/sweet drink, 5 dex tabs)

40
Q

tx of critical hypo in hospital

A

0.5-1g/kg of 50% dextrose IV over 1-3 minutes followed by continuous infusion

41
Q

home management of unconscious critical hypo in <=5 yrs

A

0.5mg glucagon subcut or IM

42
Q

home management of unconscious critical hypo in >5 yrs

A

1 mg glucagon subcut or IM

43
Q

what causes DKA

A

absolute deficiency of insulin (very hyperglycemic)

44
Q

onset of DKA (dm1)

A

sudden

45
Q

symptoms of DKA (dm1)

A

ketosis
kussmaul breathing
“fruity” breath
dehydration
electrolyte loss

46
Q

serum glucose in DKA (dm1)

A

> 13.9mmol/L

47
Q

serum ketones in DKA (dm1)

A

positive

48
Q

arterial pH in DKA (dm1)

A

<7.3 (metabolic acidosis)

49
Q

urine ketones in DKA (dm1)

A

positive

50
Q

onset of HHNS (DM2)

A

gradual (inc mortality d/t going undetected)

51
Q

symptoms of HHNS (DM2)

A

neurological symptoms
dehydration
electrolyte loss

52
Q

serum glucose in HHNS (DM2)

A

> 33.3mmol/L

53
Q

serum ketones in HHNS (DM2)

A

negative

54
Q

arterial pH in HHNS (DM2)

A

7.35-7.45

55
Q

urine ketones in HHNS (DM2)

A

negative

56
Q

priority with DKA pt’s

A

1: ABC’s
2: IV fluids (isotonic w insulin drip at very slow rate d/t potassium)
neuro assessment
BG Q1H
ABG’s, lytes
EKG
I&O (foley)
tx source (ABX)
transition to subcut insulin when well

57
Q

what is Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

A

-hyperglycemia that occurs without ketosis and acidosis
-typical in type 2 diabetes
-treatment includes insulin admin, fluid replacement & correction of electrolyte imbalances

58
Q

long term complications: macrovascular

A

-coronary artery disease
-cerebrovascular disease
-peripheral vascular disease

59
Q

long term complications: micro vascular

A

-retinopathy
-nephropathy
-neuropathy

60
Q

complication: retinopathy

A

rupture of microvascular (viterous hemorrhage) and aneurysms in the retina
-causes sudden blurred vision
-can lead to retinal detachment and cataracts

61
Q

clinical manifestations of nephropathy

A

-albuminuria (d/t kidney damage)
-fatigue
-thirst
-anemia (dec EPO d/t dec kidney func)
-weight loss
-frequent UTI’s

62
Q

s&s of nephropathy

A

-swollen periphery
-nausea & loss
-fatigue/insomnia
-dry/itchy skin
-difficulty concentrating

63
Q

clinical manifestations peripheral neuropathy

A

tingling, prickling, burning
-leads to total numbness

64
Q

clinical manifestations of autonomic neuropathies

A

-cardiac (silent, painless, ischemia), GI, & renal systems (subjective to UTI’s)

65
Q

clinical manifestations of sudomotor neuropathy

A

-dry feet; cracks->ulcers
-profuse sweating up top

66
Q

foot & leg symptoms neuropathy

A

-dry cracked, scaly feet, diabetic ulcers
-peripheral vascular disease
-immunocompromise
-takes 10-15 years to develop these complications

67
Q

diabetes and mental health

A

-stressful
-financial burden
-fear of complications/life implications
-stigma
-lifestyle management

68
Q

hospital & community nursing care

A

-skin assessment
-neurovascular assessment
-monitor B/G
-prevent infection
-education
-medication adherence
-administer insulin (if necessary)
-mental health/psychosocial assesment regularly

69
Q

patient education

A

-about disease
-insulin therapy and technique
-self monitoring B/G
-nutriton
-urine testing
-lifestyle

70
Q

nutrition and activity

A

-match insulin to carb intake
-individualized
-encourage activity
-have carb snack on had all the time

71
Q

influences on blood glucose

A

-illness & infection (inc)
-excercise (dec)
-diet
-alcohol (dec)
-stress (inc)

72
Q

insulin syringe guidelines

A

-4-8mm needle
-re-suspension of cloudy insulin
-subcut: 45-90 degree angle
-site rotation

73
Q

insulin pen guidelines

A

-dial
-prime with 2 units
-hold for at least 10 secs in
-site rotation

74
Q

insulin pump therapy

A

-continous subcut line
-can bolus for meals
-small amt of insulin administered 24/7 to mimic pancreas

75
Q

common insulin pump problems

A

-site not working
-tubing blocked, torn or leaking
-air in tubing
-reservoir empty
-not changing sites every 3 days

76
Q

implications for nursing

A

-regular assessment for LT complications
-assess impact on mental health
-education
-promote self-management
-engage in public awareness campaigns
-early detection is critical
-advocacy efforts to improve access to resource

med/surg 2 (17 decks)

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