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Med-Surg Exam 3 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

______ is made from the alpha cells (counterregulatory hormone)

A

glucagon

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2
Q

____ is made by the beta cells

A

insulin

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3
Q

insulin is not needed for the ______ or ______

A

brain or liver

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4
Q

Destruction of beta cells by the immune system (80-90% of cells destroyed)

A

type 1 DM

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5
Q

what are the 3 P’s?

A

o Polyuria
o Polydipsia
o Polyphagia

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6
Q

Insulin is present but there is cellular resistance to it

A

type 2 DM

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7
Q

what are risk factors for type 2 DM?

A

Obesity is a major risk factor
o Also, family history, HTN, sedentary lifestyle
o Metabolic syndrome

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8
Q

what is metabolic syndrome?

A

 Elevated LDL’s
 Blood pressure

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9
Q

The placenta blocks the action of the mother’s insulin

A

gestational diabetes

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10
Q

in gestational diabetes, mother may need up to ____ the amount of insulin by the third trimester

A

3 times

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11
Q

babies from mother with gestational DM are usually delievered by? why?

A

-by C-section due to the babies’ weight
-Baby puts on extra weight due to the extra sugar from the mom being given to the baby

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12
Q

diabetes insipidus is caused by?

A

o Brain tumors
o Infections
o CBA’s
o Pituitary surgery
o Renal or organ failure
*ADH insufficiency (produced by the hypothalamus)
o Hypernatremia!

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13
Q

Why do we change injection sites of insulin?

A

to prevent lipodystrophy
* Tissues become hardened
* Medication absorption is affected/hindered

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14
Q

what are some rapid acting insulins?

A
  • lispro (Humalog)
  • aspart (Novolog)
  • glulisine (Apridra)
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15
Q
A
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16
Q

what is a short-acting insulin example?

A
  • Regular (Humulin R, Novolin R)
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17
Q

what is an intermediate acting insulin example?

A
  • NPH (Humulin-N, Novolin N
18
Q

what are some long-acting insulin example?

A
  • glargine (Lantus/Toujeo)
  • detemir (Levemir)
19
Q

what is the Somogyi Effect

A

 hypoglycemia during late evening
 insulin causes counter-regulatory response
 hyperglycemia in early morning

20
Q

what is the Dawn Phenomenon

A

Abnormal early morning increase in blood glucose
Surge of hormones early morning as bedtime insulin is wearing off
Results in increased fasting glucose

21
Q

what are some other treatments for DM other than insulin and meds?

A

Stem cell treatments
Islet cell transplants
Gene therapy (beta cells with interleukin 10)
Pancreas transplants

22
Q

what is considered hypoglycemia?

A

<70

23
Q

what are s/sx of hypoglycemia?

A

 Confusion
 Irritability
 Diaphoresis
 Tremors
 Hunger
 Rapid pulse
 Hypotension
 Sweating
 Anxiety
 Weakness
 Visual disturbances

24
Q

some long term complications of hypoglycemia:

A

 Hypertension
 Hyperlipidemia
 Blindness
 End-stage kidney disease
 Amputations
 Neuropathy
 Macrovascular

25
Q

macrovascular complications from hypoglycemia?

A
  • ATH
  • CAD
  • HTN
  • Stroke
  • PVD
26
Q

microvascular complications from hypoglycemia?

A
  • Diabetic retinopathy
  • Diabetic nephropathy
  • Diabetic neuropathy
    o Foot ulcers/amputations
  • Mood alterations
  • Infection
27
Q

how many times a day should a patient check their blood sugar?

A

3-4 times

28
Q

what electrolyte imbalance would you exspect from a patient with HHNKS or DKA?

A

potassium

29
Q

what are ketones?

A

a by-product of fat metabolism
-commonly seen in starvation

30
Q

what does insulin do?

A

promotes glucose transport from the bloodstream to the cell

31
Q

what are some conterregulatory hormones to insulin?

A

glucagon
epinephrine
growth hormone
cortisol

32
Q

what insulins should not be mixed with othrs?

A

insulin glargine (lantus)
insulin detemir (levemir)

33
Q

what BS level do the kidneys start to pour glucose out in the urine?

A

180

34
Q

what to do when a diabetic pt is going into surgery?

A
  1. stop oral diabetic pills
  2. stop sq insulin
  3. dextrose may be needed (NPO)
35
Q

not DC of metformin can cause what?

A

lactic acidosis

36
Q

when a pt is unconscious how should you treat?

A

im injection of glucagon
admin D50

37
Q

what causes HHNKS?

A

dehydration secondary to an illness in a type 2 diabetic

38
Q

what causes DKA?

A

lack of insulin and ketosis

39
Q

how do we treat HHNKS?

A

hydration
insulin
correct electrolyte imbalances

40
Q

how do we treat DKA?

A

airway managment
fluid replacment
insulin replacment
elcetrolyte replacment
sodium bicarb?

41
Q

what are the sick day guidelines?

A

-increase frequency of BS checks
-check urine for ketones
-drink plenty of fluids
-watch for s/sx of dehydration

Med-Surg Exam 3 (3 decks)

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