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Med Surg 1 > Assessment and Management of Diabetes Overview (Part 1 and 2) > Flashcards

Assessment and Management of Diabetes Overview (Part 1 and 2) Flashcards

1
Q

pre diabetes

A

at risk for developing diabetes if they do not make life style changes
- exercise
- eating healthier
- losing weight

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2
Q

complications

A

blindness
kidney failure
heart disease
stroke
loss of toes, feet, or legs

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3
Q

type 1

A

body doesn’t make enough insulin
can develop at any age (normally younger)
no known way to prevent
require insulin
autoimmune

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4
Q

type 2

A

body can’t use insulin properly
cells can become resistant/pancreas cannot produce enough insulin
can develop at any age
most cases can be prevented
could use insulin but not require

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5
Q

risk factors for type 2 diabetes

A

being overweight
having a family history
being physically inactive
being 45 or older

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6
Q

risk factors

A

family history of diabetes
obesity
race/ethnicity
age
hypertension
previously identified fasting glucose or impaired glucose tolerance
HDL
history of gestational diabetes or delivery of a baby over 9lbs
smoking
A1C

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7
Q

insulin does what

A

insulin helps glucose enter cells

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8
Q

symptoms of hyperglycemia

A

increased thirst
increased urination
blurry vision
feeling tired
slow healing of cuts or wounds
more frequent infections
weight loss
nausea and vomiting

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9
Q

3 P’s

A

polyuria: glucose is dumped into urine which draws in water which leads to dehydration

polydipsia: dehydrated due to increase urination

polyphagia: occurs because the body thinks there is no energy because nothing is entering the cells

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10
Q

type 2 diabetics onset

A

more vague symptoms
slower onset

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11
Q

do type 1 require insulin

A

always needed

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12
Q

type 1 diabetic onset

A

suddenly

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13
Q

diabetic ketoacidosis

A

3 P’s
hyperglycemia
ketosis
metabolic acidosis

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14
Q

symptoms of type 2

A

increased thirst
increased urination
feeling tired
blurred vision
more frequent infections

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15
Q

treatment for type 2
- always includes

A

education
healthy eating
blood glucose monitoring
physical activity

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16
Q

treatment for type 2
- may include

A

medication
insulin

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17
Q

patient centered care

A

individualize
learns differently
respect beliefs
meet pt where they are at

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18
Q

assessment and diagnostic findings
- glucose

A

fasting blood glucose 126mg/dL or more
random glucose exceeding 200mg/dL
HgbA1C >6.5%

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19
Q

gerontological considerations for glucose monitoring

A

glucose tolerance test

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20
Q

A1C measures what

A

long term glucose range
90-120 days/3 months

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21
Q

other lab diagnostics

A

lipid panel: HDL risk, CV stroke
BUN/CR: kidney damage
UA, micro albuminuria: kidney damage
ECG: CV risk

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22
Q

A1C is it the same for everyone

A

indvidual goals

23
Q

five components of diabetic care

A

nutritional therapy
exercise
monitoring
pharmacological
education

24
Q

therapeutic goal

A

to achieve normal blood glucose levels without hypoglycemia while maintaining high quality of life

25
Q

nutritional therapy

A

maintain the pleasure of eating, include personal and cultural preferences
promote exercise and activity

26
Q

meal planning

A

must be considerate of patient preferences
- lifestyle, eating times, ethnic and cultural background

27
Q

if a patient requires insulin they need to have consistency in

A

amount of carbs and calories and time between meals with addition of snacks
essential in prevention of hypoglycemic episodes

28
Q

diet should consist of

A

50-60% carbs (whole grains
20-30% fat
10-20% protein
25g/day fiber

29
Q

what is a glycemic index

A

how fast they make blood sugar rise

30
Q

how do we identify high glycemic index

A

monitor BS after ingestion of certain foods to help identify personal glycemic index to improve glucose control

31
Q

alcohol

A

can cause hypo/hyper
mixer can cause hyper
can still drink in moderation
eat before and throughout drinking to prevent hypo
decrease awareness when drunk so unaware of hypo/hyper
hypo and hyper look similar to drunk

32
Q

sweeteners

A

nutritive: calories
non nutritive: no calories
still contribute tosuagr

33
Q

labels

A

refer to dietition

34
Q

exercise does what to blood sugar

A

lowers blood sugar

35
Q

exercise precautions

A

snack pre/post exercise 15 gram carb with protein
frequent BS monitoring

36
Q

when do we not want patients to exercise

A

BS greater than 250
ketones

do not being until negative ketones and BS normal

37
Q

gerotinlogic consideration exercise

A

realistic goals
- don’t want them to run a marathon

38
Q

risk of self monitoring

A

errors
lack of compliance

39
Q

errors with self monitoring

A

not enough blood
alcohol swabs
expired strips
calibrating
lack of compliance

40
Q

why have lack of compliance with self monitoring

A

hurts

41
Q

target range for A1C

A

less than 7%

42
Q

A1C measures how long

A

120 days

43
Q

methods of delivery

A

pens, syringe, pump

44
Q

mixing insulin

A

clear before cloudy

45
Q

injection rules

A

systemic rotation of sites within an autonomic area recommended
do not use same exact site more than once in 2-3 weeks
if exercising do not inject in limb that will be exercised

46
Q

oral anti diabetic used by their selves

A

addition to life style modifications

47
Q

oral medications

A

metofmin
sulfonylureas

48
Q

metformin contraindicated

A

kidney or liver impairment

49
Q

metformin and in the hospital

A

normally is discontinued in hospital

50
Q

metformin and contrast

A

metformin must be discontinued 48 hours prior to contrast otherwise could lead to kidney failure

51
Q

sulfonylureas

A

increased risk for hypoglycemia with elderly
beta blockers use may decrease or mask s/s of hypoglycemia

52
Q

basic survival skills

A

definition
normal BS ranges
effects of therapy
treatment modalities
complications

53
Q

sick day rules

A

take insulin or oral anti diabetic agent as usual
test blood glucose and urine ketones
report elevated BS levels or ketones
- increased insulin coverage may be required
take liquids more frequently to prevent dehydration
consume soft foods six to eight times a day if unable to follow a normal diet
report nausea, vomiting, diarrhea to provider

54
Q

why do we want diabetics to take insulin

A

because BS goes up when you are sick

Med Surg 1 (47 decks)

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