Diabetes

Question 1

Diabetes Mellitus is an error of glucose metabolism

Describe type 1 & 2

Answer 1

1. Born with. Body doesn’t produce insulin
2. Insulin resistance. Body doesn’t respond to insulin

Question 2

Diabetes Insipidus is Polyuria & Polydipsia leading to _____ due to low _____

Answer 2

Dehydration/ AHD

Question 3

Diabetes Insipidus is a type of Diabetes Mellitus

True or False

Answer 3

False

It’s just the fluid part

Polyuria & Polydipsia leading to dehydration - due to low ADH

Question 4

How are DI & SIADH related to one another

Describe: Urine output, Urine Concentration, Fluid levels, Serum & Urine specific gravity levels

Answer 4

DI
Urine Output: High Dilute
Fluid levels: Deficte Overload
Serum Specific Gravity: Increased
Urine Specific Gravity: Decreased

SIADH: Body retains water
Urine Output: Low Concentrated
Fluid levels: Fluid Overload
Serum Specific Gravity: Decreased
Urine Specific Gravity: Increased

Question 5

Type 1

Treat with

Diet, insulin, exercise

Which is most important

Answer 5

Insulin

Question 6

Type II

Treat

Diet, oral hypoglycemia, active

Which is most important

Answer 6

Diet

Question 7

S&S of Diabetes Mellitus 1 & 2

(3)

Answer 7

Polyuria, polydipsia,polyphagia

Question 8

Primary dietary restriction in Type 2

Answer 8

Calorie restriction

Question 9

How many meals should a type 2 eat daily

Answer 9

6

Question 10

Which is best to restrict calories to 1600 or divide daily food into 6 meals for type 2 diabetic

Answer 10

Calorie restrictions

Question 11

Regular Insulin (R) Clear, IV drip, rapid/intermediate

Onset
Peak
Duration
Pattern

Answer 11

Onset: 1h
Peak: 2h
Duration: 4h
Pattern: 1-2-4

Question 12

Regular Insulin (R)
(Clear/ Cloudy)
(IV drip / Suspension)
(Rapid/intermediate)

Answer 12

Clear
IV drip
Rapid / Intermediate

Question 13

NPH (N) -cloudy, suspension (precipitate), NO IV, intermediate

Onset:
Peak:
Duration:
Pattern:

Answer 13

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

Question 14

NPH (N)
(Clear /cloudy)
(IV Drip / suspension (precipitate))
( intermediate / rapid)

Answer 14

Cloudy
Suspension (precipitate)
Intermediate

Question 15

Lispro- Short Acting - don’t give AC, give with food

Onset:
Peak:
Duration:
Pattern:

Answer 15

Onset: 15 mins
Peak: 30 mins
Duration: 3 hrs
Pattern: 15 - 30 - 3

Question 16

When do you give lispro

Answer 16

With food

Question 17

Glargin (Lantis): long acting - little

Duration

Safety precaution

Answer 17

Duration: 12 - 24

Safety precautions: Never mix

Question 18

If pt was given NPH at 0700, when do you check for hypoglycemia

Answer 18

1500 - 1700

Question 19

Once insulin package is opened, when is the new expiration date?

Answer 19

30 days after opening

Question 20

Does opened insulin need to be put in the refrigerator in the hospital?

How about at home?

Answer 20

Refrigeration not need in hospital

Needed at Home

Question 21

If a patient has to exercise (increase / decrease) insulin dose.

Should the patient consume fast acting carbs snacks?

Answer 21

Decrease insulin with exercise

Eat fast acting carb snacks

Question 22

Sick day

When sick serum glucose (down / up)

If a patient doesn’t eat when sick do you still administer insulin?

Answer 22

Glucose levels go up

Give insulin to Sick patients even if they didn’t eat

Question 23

3 acute symptoms of Diabetes

Answer 23

Low blood Glucose: Causes Too much Insulin / Exercise. Not enough Food
Danger BRAIN DAMAGE

DKA: #1 Acute Viral Upper Respitory Infections W/in last 2 Weeks

Other Causes Too much Food, not enough insulin, not enough exercise

S & S
Dehydration
K Ketones (in blood), Kussmaul, K hgh
A acidosis metabolic, acetone breath, Anorexia

HHNK (TYPE 2)
S&S Dehydration
Skin: Hot Flushed dry
Nursing Intervention: Give fluids
Outcomes: increases output

Question 24

(Must Know) S&S Hypoglycemic

Answer 24

Drunk and in Shock

Labile (All over the place)
Judgements, reaction time, emotions
Staggering, Slurred Speech

(SHOCK)
SWEATY
TACHYCARDIA/ LOW BP
Skin Cold Clammy, Mottled

Question 25

What do you do if a patient is hypoglycemic

Answer 25

What to do: Give Sugar & Startch / Sugar & Protein Admin Juice, honey, jam + Crackers Possible 15 grams wait 15 mins

Question 26

If patient is unconscious from hypoglycemia What do you do?

Answer 26

Give Glucagon IM Dextrose 10 / 50 IV

Question 27

A patient is hypoglycemic and just passed out. The 2 options to help are: Give Glucagon IM Dextrose 10 / 50 IV What would determine when to give each medication

Answer 27

Glucagon IM for home patients not hooked up to IV Dextrose if they already have an IV running

Question 28

In which will you need to use Insulin DKA / HHNK

Answer 28

DKA

Question 29

Long term complications of DM Related to 2 problems Every symptom can be attributed to one of these

Answer 29

Poor tissue perfusion Peripheral neuropathy

Question 30

Long terms complications of DM

Answer 30

Renal failure Gangrene Statis Ulcers Blindness impotence Heart disease

Question 31

Long term complications DM 1. Renal failure 2. Lost control of bladder, incontinence 3. Can't feel it when they injur themselves 4. Poor healing when they injury themselves

Answer 31

1. Poor tissue perfusion 2. Peripheral neuropathy 3. Peripheral neuropathy 4. Poor tissue perfusion

Question 32

Which lab test is best to evaluate long-term blood glucose levels

Answer 32

Hemoglobin HA1C

Question 33

HA1C desirable level HA1C Out of Control Level

Answer 33

<6 7 mean Dr's have to look at you >8