Brainscape's Knowledge GenomeTM

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


See full index

NCLEX Review (by M.K.) > DIABETES > Flashcards

DIABETES Flashcards

1
Q

What are the 3 acute complications of diabetes

A
  1. Low blood glucose/ hypoglycemia
  2. DKA (Type 1 DM)
  3. HHK or HHS or HHNS (Type 2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the #1 diagnosis with HHK

A

Fluid deficit

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

Intervention with HHNK / HHS / HHNS

A

Give fluids!

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

Between DKA and HHNK is insulin essential in treating?

A

DKA

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

1 treatment with HHNK

A

Fluids!

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

Which of DKA or HHNK is higher priority?

A

DKA is a more acute condition and responds very quickly to insulin

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

What are long-term complications of diabetes

A

RELATED TO :
- Poor tissue perfusion
- Peripheral neuropathy
EXAMPLES: renal failure, gangrene. Heart failure, urinary incontinence pt cant feel a burn on the foot

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

What is the best indicator of long-tern blood glucose level

A

Hb A1C, a.k.a. glycosated Hb or glycosylated Hb

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

What is the nirmal Hb A1C

A

< 6

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

What hb A1c means you’re out of control?

A

> 8

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

What # of hb A1C is borderline

A

7

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

What do we see with alkalosis?

A

Tachycardia
Tachypnea
HTN
Seizures
Irritability
Spastic
Diarrhea
Borborygmi (increase bowel sounds)
Hyperreflexia
HYPOKALEMIA

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

What is the nursing intervention for alkalosis?

A

Pt needs SUCTIONING because of seizures

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

What is the opposite of DIABETES INSIPIDUS

A

SIADH

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

What does SIADH mean

A

Symptom of inappropriate ADH (antidiuretic hormone)

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

It presents w/ oliguria and no thirst
Decrease in urine output
And then, decrease serum specific gravity (due to retention of water)
Increase urine specific gravity (due to decrease urine volume)

A

SIADH

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

Whic =h is DM/DI, SIADH

  1. Losts of urine retaines, specific gravity is low
  2. Fluid volume deficit
  3. Fluid VOlume Excess
A
  1. SIADH
  2. DM/DI
  3. SIADH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Insulin dependent, Ketosis prone

A

TYPE I DM

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

Non-insulin dependent, Non-ketosis prone

A

TYPE II DM

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

What are signs and symptoms of DM

A

Polyuria
Polydipsia
Polyphagia (eat/swallow a lot)

21
Q

What is the treatment for DM I

A

(If u dont treat, they will die)

D Diet (calories from carbs, least important)
I Insulin (MOST important)
E Exercise

22
Q

What are treatent for DM II

A

They are DOA

D Diet (most important)
O oral hypoglycemic (only use insulin if BG if poorkly uncontrolled)
A Activity

23
Q

R- regular insulin

Onset:
Peak:
Duration:

A

Onset: 1 hour
Peak: 2 hours
Duration: 4 hours

1-2-4

24
Q

What kind of insulin do we NOT use for IV drip?

A

N-NPH, Intermediate insulin,

IT IS CLOUDY= Suspension = it precipitates(particles fall under when), CANNOT GIVE IV drip

*there is a general rule thatg do not put a cludy sol’n on a IV bag

25
Q

N-NPH, Intermediate Insulin

Onset:
Peak:
Duration:

A

Onset: 6 hours
Peak: 8-10 hours
Duration: 12 hours

6-8-10-12

26
Q

How would the board ask question about peak of insulin? For instance, you give 30 units of insulin NPH to a pt at 7 a.m. When do you check for hypoglycemia?

A

Answer = Add the insulin peak time to the time of insulin administration
• For instance, if the pt was given NPH at 7 a.m., add 8 to 10 hours to the time
• Answer = Check for hypoglycemia between 3 and 5 p.m.

27
Q

What is a fast acting insulin

A

LISPRO (Humalog)

28
Q

What is a long acting insulin

A

GLARGINE (LANTUS)

29
Q

Lispro (Humalog)

Onset:
Peak:
Duration:

A

Onset: 15 min
Peak: 30 min
Duration: 3 hours

15-30-3

30
Q

Rule in giving lispro (humalog)?

A

Don’t give it AC (before meal)… Give it with the meal

31
Q

What action invalidates the manufacturers date? (Insulin)

A

• Opening the package month
• Once the package is open, the new expiration date is 30 days after that *
• Open package without an opening or expiration date should be thrown out
• Label the package either with
o “OPEN” and date package is open or “EXP” and expiration date
• Once the package is open, refrigeration is optional
o However, unopened bottle must be kept refrigerated
o Although it is good practice to teach pt to refrigerate insulin at home

32
Q

What are 3 acute complications of Diabetes

A
  1. Low blood glucose
  2. DKA - High Glucose in a Type 1 (keto is the clue!)
  3. HHNK or HHS or HHNS
33
Q

What does hypoglycemia look like?

A

Think of Drunk pt in Shock

• Drunk
o Staggering gait
o Slurred speech
o Cerebral impairment (labile)
ra pidly A- emotions /fluctuating
o Slow reaction time
o Decrease social inhibition

• Shock—Vasomotor collapse
o Tachycardia, tachypnea, Low BP
o Cold/clammy, mottled skin

34
Q

What are signs and symptoms of hypoglycemia

A

• Drunk
o Staggering gait
o Slurred speech
o Cerebral impairment (labile)
ra pidly A- emotions /fluctuating
o Slow reaction time
o Decrease social inhibition

• Shock—Vasomotor collapse
o Tachycardia, tachypnea, Low BP
o Cold/clammy, mottled skin

35
Q

It is when there is high glucose in TYPE I DM (kete)

A

DKA

36
Q

What are causes of DKA

A

Too much food
Not enough insulin
Not enough exercise

However, THE #1 CAUSE IS acute viral Upper Respiratory Infection within last 2 weeks

37
Q

Treatment for hypoglucemia

A

1 sugar (sugar/crb) 1 starch (protein)

38
Q

What do u give an unconcious hypoglycemic pt

A

Glucagon IM
Dextrose IV (D10, D50) if in ER

39
Q

What are signs and symptoms of DKA

A

D Dehydration (dry, poor skin elasticity and turgor, warm)… Water is a coolant (you overheat, dehydration = increase in temperature)

K Ketones in serum, Kussmauls, High K+

AAcidoses, Acetone breath, Anorexia due to nausea

Nite: Ketone in urine does not necessarily mean DKA

40
Q

What is the treatment for DKA

A

Insulin IV (REGULAR!)
IV Fluid! 200 mL/hr (some of the fastest rate)

41
Q

• High blood sugar in a Type 2
• These pts don’t burn ketones, no acid
• Whenever you see this, think dehydration
• Severe Dehydration!
o Skin is dry, flushed, decreased turgor, increased HR
o #1 Nursing diagnosis: fluid volume deficit (same as dehydration)
o #1 Nursing intervention: Rehydration! * DO NOT give insulin
o Outcomes in successful treatment: Increase urine output, Moist mucous membrane, etc.
o Long-term complications: Poor perfusion, Peripheral neuropathy

A

HHNK or HHS or HHNS (Hyperglycemic, hyperosmotic, nonketotic)

42
Q

Between DKA and HHNK, which os more dependent on insulin?

A

DKA is more dependent on insulin
HHNK pt needs to be rehydrated

43
Q

Between DKA and HHNK, which one has a higher mortality rate?

A

HHNK

44
Q

Between DKA and HHNK, which is higher priority?

A

o DKA is a more acute condition and responds very quickly to insulin
o HHN pts show up late in the emergency room and do not readily respond to treatment

45
Q

What are long term complications of diabetes?

A

Related to poor tissue perfusion, or poor peripheral neuropathy
Examples of long term complication: Renal failure, Gangrene, heart failure, Urinary incontinence, Pt can’t feel a burn on the foot

*renal failure is a cause of poor perfusion
*unirnary incontinent in a cause of peripheral neuropathy

46
Q

Which lab test is the best indicator of long-term blood glucose level?

A

Hb A1C, a.k.a. glycosated Hb or glycosylated Hb
o Average blood sugar over last 90 days

47
Q

What A1C Hb is normal

A

< 6

48
Q

What Hb A1C is out of control

A

> 8

NCLEX Review (by M.K.) (21 decks)

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