Chapter 46 Flashcards by Christina Fairman

Elevated level of glucose in the blood is called?

Hyperglycemia

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What type of diabetes?
Usually young <30 yo
Thin at diagnosis
Ketosis prone when insulin is absent
Genetic
Needs exogenous insulin to preserve life

Type 1 diabetes

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What type of diabetes?
usually >30 yo
Obesity
Make control blood glucose through weight loss
Ketosis is uncommon
May need insulin on a short or long term basis

Type 2 diabetes

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What type of diabetes?
Onset during pregnancy in the second or third trimester
Caused by hormones
obesity
Age >30
Family history of diabetes

Gestational diabetes

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What type of diabetes has genetic tendencies that have been found and people with certain human leukocyte antigen types?

Type 1 diabetes

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When excess glucose is excreted in the urine, it is accompanied by loss of fluids and electrolytes, what is this called?

Osmotic diuresis

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A highly acidic substance formed when the liver breaks down free fatty acids in the absence of insulin is called?

Ketones

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A metabolic arrangement that occurs more commonly and people with type 1 diabetes
Deficiency of insulin
highly acidic ketone bodies are formed
Metabolic acidosis occurs

diabetic ketoacidosis (DKA)

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What are symptoms of DKA?

Polyuria
Polydipsia
n/v
Fatigue
Stupor and coma if not treated

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What are the two main problems related to insulin and type 2 diabetes?

Insulin resistance
Impaired insulin secretion

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Symptoms of type 2 diabetes include?

Irritability
fatigue
polyuria
polydipsia
poor wound healing
vaginal infections
blurred vision

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What are long-term diabetes complications

Eye disease
Peripheral neuropathy
peripheral vascular disease

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Women at high risk for gestational diabetes should be screened by a blood glucose test when?

At the first prenatal visit

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Women with a history of gestational diabetes should be screened when?

Every 3 years

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What are the 3 Ps with diabetes

Polyuria
Polydisia
Polyphagia

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Polydipsia

Increased thirst

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What is a normal hemoglobin A1C

<6.5%

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To promote a 1 to 2 pound weight loss per week how much calories are taken away from the daily total?

500 to 1000 calories

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What onset symptom is associated with type 1 diabetes

Weight loss

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What nutrient has the greatest effect on blood glucose levels because they are more quickly digested than other foods and are converted into glucose rapidly

Carbs

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What are examples of soluble fibers

Legumes, oats, and some fruits

What does soluble fiber do?

Slows stomach emptying

Type of insulin
Lispro, aspart, glulisine
Onset 15-30 min
Peak 30-90

Rapid acting

Type of insulin
Regular
Onset 30-60 min
Peak 2-3 hr
Can be given IV
Given 15 min before meal

Short acting

Type of insulin NPH onset 1-1.5 hr Peak 4-12 hr Food should be given around the peak time

Intermediate acting

Type of insulin Glargine Onset 3-6hr Continuous (no peak)

Long acting

Milky cloud insulin

Intermediate acting insulin

If insulin is injected into scarred areas what may happen?

Absorption may be delayed

Characterized by a relatively normal blood glucose level until approximately 3 AM when blood glucose level begins to rise

Dawn phenomenon

Nocturnal hypoglycemia followed by rebound hyperglycemia

Somogyi effect

What is a class of oral antidiabetic medication‘s that reduce insulin resistance and target tissues

Thiazolidinediones

When mixing rapid and short acting insulin‘s in a vial what should be drawn up first?

Short acting (regular)

The speed of absorption with insulin is greatest in what area of the body

Abdomen

Glucose that falls less than 70mg/dL

Hypoglycemia

What are symptoms of hypoglycemia

sweating Tremor tachycardia palpitations nervousness hunger

In a severe case of hypoglycemia what type of symptoms may the patient have?

Impaired function of the CNS Disoriented behavior, seizures, loss of consciousness

When blood glucose becomes too low what is recommended for the patient to do?

Consume 15 to 20 g of carbs A small juice or soda

And an adult who is glucose level is less than 54mg/dL and who is unconscious what should they take?

1mg of glucagon

Patients with severe DKA may lose up to how much water

6.5 L

When a patient has nausea and vomiting should they take their regular insulin dose

Take usual dose and consume frequent small portions of carbs

Absence or inadequate amount of insulin Seen in type 1 diabetes High sugars Ketones present Dehydration Kussmauls respirations Abdominal pain

DKA

What is the main goal with treating DKA?

Treat dehydration first w/ 0.9% NS Then start lowering blood glucose

High sugars of DKA range from what?

250-800 sometimes 1000

Metabolic disorder resulting from relative insulin deficiency initiated by an illness. Often associated with type 2 diabetes High sugar Dehydration Neuro symptoms (confusion)

Hyperglycemic hyperosmolar syndrome (HHS)

After HHS is resolved how long will it take for Neuro symptoms to clear up?

3-5 days

What are symptoms of diabetic neuropathy?

Prickling, tingling, burning Normally in feet

What is a symptom that is associated with autonomic neuropathy?

Urinary retention

Neuropathic condition Decrease or absence of anhidrosis (sweating) of body

Sudomotor neuropathy

Poor circulation of the lower extremities Development of gangrene

Peripheral vascular disease

In a hospital setting what can be given to provide calories to avoid hypoglycemia?

IV dextrose

What insulin should be taken alone?

(Glargine) a peak less basal insulin

With a diabetic foot ulcer what technique should you use when changing the dressing?

Sterile technique