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Flashcards in Diabetes Deck (115):
1

How much insulin does the pancreas secrete daily?

40-50 units

2

What is the first major organ that insulin reaches?

The liver

3

What secretes insulin?

The beta cells of the Islets of Langerhan of the Pancreas gland

4

What does insulin promote in muscles?

Protein and glycogen synthesis

5

Converting fats to acids

Ketogenesis

6

What is insulin made of?

Alpha and Beta chains

7

What is the secretion of low levels of insulin during fasting called?

Basal insulin secretion

8

Promotes the production and storage of glycogen

Glycogenisis

9

What are the characteristics of diabetes mellitus?

Hyperglycemia, Glycosuria, and Ketonuria

10

How does insulin inhibit tissue breakdown?

Inhibits liver glycogenolysis, ketogenesis, and gluconeogenisis

11

Conversion of proteins to glucose

Gluconeogenisis

12

Precursors of insulin

Preproinsulin and Proinsulin

13

Which insulin precursor must be made smaller before becoming active?

Preproinsulin

14

Which electrolyte does insulin allow to pass from the ECF to the ICF?

Potassium

15

Inhibits glycogen breakdown into glucose

Glycogenolysis

16

What is increased when a patient is stressed?

Glycogenisis

17

What is the increased level of insulin after eating called?

Prandial Secretion

18

An endocrine disorder in which there is insufficient amount or lack of insulin secretion to metabolize carbohydrates

Diabetes Mellitus

19

What does insulin promote in fat cells?

Triglyceride storage

20

What molecules does insulin increase the synthesis of?

Proteins and lipids

21

What is proinsulin made of?

Alpha, beta, and c-peptide chains

22

What is the main fuel for the CNS?

Glucose

23

What is insulin's purpose?

Takes sugar into the cells

24

How long after eating is insulin released?

10 minutes

25

Which of the precursors of insulin is inactive?

Preproinsulin

26

What historical questions should a patient be asked during an assessment for diabetes?

How long they have been feeling off and if they've lost any weight

27

What types of carbohydrates should diabetics eat?

Complex carbs

28

What is the most accurate blood test for diabetes?

A1c

29

Finger-stick test used to monitor blood sugar

FSBS

30

What happens in the absence of insulin?

Hyperglycemia, polyuria, polydipsia, polyphagia, hemoconcentration, hypervolemia, hyperviscosity, hypoperfusion, hypoxia, acidosis, Kussmaul respirations, hypokalemia, or hyperkalemia

31

What are the clinical manifestations of hypoglycemia?

Sudden onset of weakness, diaphoretic, sweat, pallor, tremors, nervousness, hunger, diplopia, confusion, aphasia, vertigo, and convulsions

32

What level does a patient's fasting blood glucose have to be at in order to be diagnosed with diabetes?

Greater than 110 mg/dL

33

How much glucose does the body need to support the brain?

70-100 mg/dL

34

Why do diabetics develop extensive skin wounds?

The excess glucose in the blood stream damages their nerves and skin integrity

35

What are the clinical manifestations of hyperglycemia?

Gradual onset of polyuria, polyphagia, polydispsia, dehydration, hypotension, mental changes, glycosuria, fever, hypokalemia, hyponatremia, seizures, and coma

36

Follows the life of a hemoglobin cell and its average glucose level

A1c

37

What chemical stops the production of insulin when glucose levels are decreased?

Glucagon

38

What are the respirations that diabetics demonstrate in the absence of insulin?

Kusmaul

39

What types of infection generally increases in patients with diabetes?

Vaginal infections

40

Why does the brain need a continuous supply of glucose?

Because it does not make or store it

41

At what level does an A1c indicate diabetes?

>6.9%

42

What does the urine test of a diabetic test for?

Keytones, renal function, and glucose

43

How is glucose made?

Glycogenolysis

44

What is the best thing to eat to quickly raise blood sugar?

Milk, ice cream, cheese, and crackers

45

What is the treatment for hypoglycemia?

Sugar followed by a protein or IV glucose

46

When glucose is not available, what does the brain use for fuel?

Fatty acids (trigylcerides)

47

What is the priority nursing diagnosis for diabetics?

Risk for injury

48

What are the nursing interventions to prevent injuries of diabetic patients?

Dietary interventions, blood glucose monitoring, and giving proper medications

49

What is broken down if liver glucose is not available?

Fat or amino acids

50

What does glucagon do?

Causes the release of glucose from the liver

51

How long can insulins be kept?

Four weeks

52

Surge of glucose released at dawn

Dawn's phenomenon

53

Why are intensified insulin therapy regimens the best?

Because they act more like regular body function

54

What should the diet of a diabetic patient look like?

High protein, high fat, and no simple carbs

55

How should two insulins be drawn into one syringe?

Clear before cloudy

56

What are the complications of insulin therapy?

Hypoglycemia, lipoatrophy, Dawn phenomenon, and Somagyi's phenomenon

57

What is more dangerous, hypo or hyperglycemia?

Short term hypo, long term hyper

58

What preventative actions should be taught to diabetics?

Proper skin and foot care, proper eye exams, proper diet and fluids, diabetic neuropathy, diabetic retinopathy, diabetic nephropathy, and diabetic gastroparesis

59

When should diabetics not exercise?

If their blood sugar is over 250 or they have glycosuria

60

What is the hallmark of diabetic ketoacidosis?

Presence of ketone bodies in the urine and blood

61

What common complications can occur in patients with diabetes?

Hyperglycemia, hypoglycemia, diabetic ketoacidosis, and hyperosmolar hyperglycemic nonkeytonic syndrome

62

Blood sugar drops rapidly over night

Somagyi's phenomenon

63

What are the nursing interventions for diabetic ketoacidosis?

Monitoring for manifestations, assessment of airway, LOC, hydration status, and blood glucose levels, and management of fluid and electrolytes

64

What teaching should take place for patients on oral hypoglycemics?

Monitor serum glucose levels daily, teach the patients the signs and symptoms of hyper/hypoglycemia, altered liver or renal function will affect the medication's action, avoid OTC drugs without MD's approval, know appropriate times to administer the medications

65

How often should diabetics exercise?

Three times a week

66

What do patients with ketoacidosis need?

Hydration, insulin, and electrolyte replacement

67

How long does ketoacidosis take to develop?

4-10 hours

68

What are the blood sugar levels in patients with diabetic ketoacidosis?

Around 600

69

Why does HHNC not occur in patients with type 1 diabetes?

Because they have absolutely no insulin

70

What should the diet of a diabetic patient look like?

60% Carbs, 30% fats, and 12-20% protein

71

What is the goal of drug therapy for patients with diabetic ketoacidosis?

Lower serum glucose by 75 to 150 mg/dL/hr

72

What happens in patients with HHNC?

Fluid moves from indie to outside the cell causing diuresis and loss of sodium and potassium

73

What does diabetic ketoacidosis occasionally occur with?

Infection

74

What is the purpose of exercise for diabetics?

To control and lower blood glucose and reduce the amount of insulin needed

75

What are the nursing interventions for patients with diabetic ketoacidosis?

Keep airway patent, suction, cardiac monitoring, vital signs monitoring, monitor central venous pressure, ABG, BS, chemistry panel, administration of sodium bicarb, foley to monitor fluid output, strict I/Os, and frequent repositioning

76

What are the nursing interventions for diabetic patients with ineffective tissue perfusion?

Control of blood glucose levels, yearly evaluation of kidney function, control of blood pressure levels, prompt treatment of UTIs, avoidance of nephrotoxic drugs, diet therapy, fluid and electrolyte management

77

Which types of patients are candidates for whole-pancreas transplantation?

Type 1 diabetics only

78

What are the key nursing diagnoses for patients with diabetes?

Anxiety and fear, altered nutrition, pain, and fluid volume deficit

79

What causes HHNC?

Lack of a thirst center, causing profound dehydration without thirst and severe hyper glycemia

80

What interventions should be done for diabetics with chronic pain?

Maintenance of normal blood glucose levels, anticonvulsants, antidepressants, and capsaicin cream

81

What is the drug therapy for diabetic patients with hypoglycemia?

Glucagon, 50% dextrose, diazoxide, and octreotide

82

What are the nursing interventions for patients with diabetes?

Prevent complication, monitor blood sugars, administer meds and diet, teach diet and meds, and constantly assess

83

What are the chronic complications of diabetes?

Cardiovascular disease, cerebrovascular disease, retinopathy problems, diabetic neuropathy, diabetic nephropathy, and male erectile dysfunction

84

What should diabetics do to take care of their feet?

Cleanse and inspect feet daily, wear properly fitting shoes, avoid walking barefoot, trim toenails properly, report non healing breaks in the skin, and wear flat shoes

85

What would a patient who in HHNC have blood sugars of?

1000s

86

How soon should a patient in HHNC have their blood sugars restored to normal?

36-72 hours

87

What interventions should be done for diabetic patients with disturbed sensory perception?

Blood glucose control, and environmental management

88

What wound care should be performed for diabetic patients?

Wound environment, debridement, elimination of pressure on infected area, and growth factors applied to wounds

89

What are the Sulfonylureas?

Glipizade and glucotrol XL

90

What are the signs and symptoms of HHNC?

Hypotension, mental changes, dehydration, hypokalemia, and hyponatremia

91

What are the meglitinide analogs?

Prandin and starlix

92

How fast should a diabetic patient in HHNC be given insulin?

10 units/hour

93

What are the biguanides?

Metformin and glucophage XL

94

What is the onset of the meglitinide analogs?

Short acting

95

What is the treatment for HHNC?

Give insulin and correct the fluid and electrolyte imbalances

96

What should be monitored when taking thiazolidinediones?

Monitor liver function

97

What needs to be monitored when taking alpha-glucosidase inhibitors?

Kidney function

98

What are the thiazolidinediones?

Actos and avandia

99

What are the alpha-glucosidase inhibitors?

Precose and Glyset

100

Which type of oral hypoglycemics should be held 48 hours before tests with contrast dyes

Biguanides

101

What is the onset and peak of Apidra?

Onset 20 minutes and peak 30-90 minutes

102

What are the classifications of insulins?

Rapid-acting, short-acting, intermediate-acting and long-acting

103

What are the types of short-acting insulin?

Novolin R and Humulin R

104

What are the types of rapid acting insulins?

Novalog, Apidra, and Humalog

105

What are the onset and peak of Humulin R?

Onset 30 minutes and peak 2-4 hours

106

What are the classifications of oral hypoglycemics?

Sulfonylura, meglitinide analogs, biguanides, thiazolidinediones, and alpha-glycosidease inhibitors

107

What are the onset and peak of Humulin R Concentrated?

Onset 90 minutes and peak 4-12 hours

108

What is the onset and peak of Humalog?

Onset 15 minutes and peak 1-3 hours

109

What is the onset and peak of Novolin R?

Onset 30 minutes and peak 2.5-5 hours

110

What is the onset and peak of novolog?

Onset 15 min and peak 1-3 hours

111

Which insulin should never be mixed with anything else?

Lantus

112

What is the long-acting insulin?

Lantus

113

What is the intermediate-acting insulin?

NPH, Humulin N, Novolin N, and ReliOn N

114

What is the onset and peak of Lantus?

Onset 2-4 hours and no peak

115

What is the onset and peak of NPH?

Onset 90 minutes and peak 4-12 hours