Diabetes 2

Question 1

Diabetes nutritional therapy

Answer 1

Balanced energy intake
Provide optimal nutrition
Maintain reasonable weight
Preveent wide fluctuations in glucose

Question 2

For patients on insulin

Answer 2

Regular meal
Maintain consistent carbo
Easy snakes
Rapid acting insulin dosage adjustment before meal

Question 3

For patients with type 2 diabetes nutritional management

Answer 3

Regular healthy meals
For ovese- weight-loss
Achieve glucose and bp goals

Question 4

Glycaemic index (GI) of food

Answer 4

Rise of glucose level after carbohydrate-containing food is consumed
Ranks carbohydrates 0-100

Question 5

Glycaemic index

Answer 5

High gi (70 and above)
Medium gi( 56-69)
Low gi (55 and under)

Question 6

Benefits of exercise therapy

Answer 6

Lower bgbl by
-increasing uptake of glucose - - - improve use of insulin
Improve circulation and musclie tone
Aids losing weight

Question 7

Exercise recommendations

Answer 7

Type
-30 mins everyday
Start slow gradual goals after medical clearance
Monitor bg
After 1 hour of the meal
Snack to prevent hypoglycaemia 
Appropriate footwear 
Dont exercise if bg is >=13.5 or ketones present in urine

Question 8

Patient education

Answer 8

Pathophysiology
Treatment modalities
Recognising complications
Other information

Question 9

Pathophysiology patient edit

Answer 9

Definition of dm
Normal bgl range
Effect of insulin and exercise
Effect of food and stress

Question 10

Treatment modalities patient education

Answer 10

Info on relevant medication
Diet and exercise
Monitor bgl and ketones and interpreting results

Question 11

Recognising complication

Answer 11

Recognition normal and abnormal body que

Understanding hypocand hyper

Question 12

Other complications

Answer 12

Explanation of diagnotic test
Storing of insulin
Management of sharps
How to contact dr

Question 13

Pharmacological therapy

Glucose lowering agents

Answer 13

Insulin

Oral hypoglycaemic

Question 14

Insulin

Answer 14

Injection delivery
Subcut, insulin pen,insulin pump, jet injectors

Can be through iv

Differ fromceaxh orher
Clear or cloudy

Question 15

Oral hypoglycaemics

Answer 15

Work to improve mechanism by which the body produces and insulin and glucose

Question 16

Use of insulin

Answer 16

Type 1 - insulin theray for life
2 - insulin if oral hypoglycaemic and lifestyle is not enough
- illness, injury, stress, pregnancy

Question 17

Types of insulin

Answer 17

Rapid acting insulin
Short- acting : regular insulin 
Intermediate-acting insulin
Long-acting insulin
Combination therapy

Question 18

Rapid-acting insulin

Answer 18

15 mins onset
Peak 60-90 mins
Duratiin 3-4 hours
Ex: novorapid, humalog

Question 19

Shirt acting : regular insulin

Answer 19

30 mins on set
2-3 hr peak
4-6 hrs duration
Actrapid trade name

Question 20

Intermediate acting insulin

Answer 20

3-4 hrs onset
4-12 hrs peak
16-20 hrs duration
Prataphane trade name

Question 21

Long acting insulin

Answer 21

6-8 hours
12-16 hrs peak
20-30 hours duration
Lantus levemir

Question 22

Combination therapy

Answer 22

Varies

Question 23

Insulin delivery

Answer 23

Syringe
Pump
Pen
Iv infusion

Question 24

Insulin administration- nursing considerations

Answer 24

Usage of insulin syringe
Pharmacological action of insulin
Mising cloudy and clear insulin 
Injection sites
Scale chart
Iv therapy
Bgl monitoring patient self administration and management

Question 25

Oral hypoglycaemic agents | And nursing interventions

Answer 25

Oral medication that lower blood glucose For tyoe 2 diabetes Combination of oral drugs is fine Nursing interventions Understand action of medication Monitor bgl and hypoglycaemia Patient teaching

Question 26

Oral hypoglycaemic agents

Answer 26

``` Biguanides Sulfonylureas Meglinides A-glucosides inhibitors Thiazolidinediones Dipeptidyl peptidase -4 (ddp-4) inhibitor Dopamine receptor antagonist ```

Question 27

Biguanides Side effects Action Contraindications

Answer 27

Reduces glucose production by liver Wnhances insulin sensitivity of peripheral tissue Improve glucose transport Metformin Side effects Diarrhoea Lactic acidosis With old 1-2 days before IV contrast Contraindications Excessive alcohol intake, liver , cardiac disease

Question 28

Sulfonylureas Effects Action

Answer 28

Increase insulin production from pancreas- stimulate beta cells of pancreas to secrete more insulin Enhance cellular sensitivity to insulin Side effects Weight gain Hypoglycaemia Glipizide Glyburide Glimepiride

Question 29

Meglitinides Effect Action

Answer 29

Up insulin production from pancreas- stimulate beta cells from pancreas to secrete more insulin Hypoglycaemia Taken 30 mins before meal Should not be taken if meal is skipped Repaglinide Nateglinide

Question 30

a-glucosidase inhibitors

Answer 30

Acarbose Miglitol “Starch blockers” Slows down or delay absorption of glucose in small intestine Take with first bite with each meal Gas, abdominal pain, diarrhoea

Question 31

Thiazolidinediones

Answer 31

Pioglitazone Rosiglitazone Most effective in those with insulin resistance Increases glucose uptake in muscle Improves insulin sensitivity, transport and utilisation at target sites Bladder cancer heart failure stroke

Question 32

Dipeptidyl peptidase -4 (ddp-4) inhibitor

Answer 32

Gliptin Sitagliptin Saxagliptin Linagliptin Blocks inactivation of incretin hormones Increase insulin intake Decrease glucagon secretion Decrease hepatic glucose production Side effects Pancreatitis allergic reaction

Question 33

Dopamine receptor antagonists

Answer 33

Bromocriptine Though that patients eith type 2 diabetes nhave low levels of dopamine Increases dopamine receptor activity Hypotension

Question 34

Nursing process

Answer 34

``` Assessment Diagnosis Planning Implementation Evaluation ```

Question 35

Subjective data of a diabetic person

Answer 35

Past health history | Medications

Question 36

Objective data of a diabetic person

Answer 36

``` Bp resp pulse Bmi Foot and skin examination Oral exam Visual exam Bgl Neurologic Serum electrolyte levels ```

Question 37

Health promotion

Answer 37

Identify monitor abd teach patient Obesity prime factors Diabetes risk test Routine screening for all obeses and older 55