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Quiz 3 Fundamentals > diabetes > Flashcards

diabetes Flashcards

(64 cards)

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1
Q

hot and dry

A

sugar high

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2
Q

cold and clammy

A

need some candy

sugar low

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3
Q

hyperglycemia

A

high sugar

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4
Q

hyperglycemia symptoms

A 
headache
sweaty
blurry vision
ringing in the ears
increase heart rate
hunger
trembling
feeling anxious
weakness tired
imitability
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5
Q

DKA

A

diabetic ketoacidosis

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6
Q

what is DKA

A

without insulin - glucose cannot get into cells (remain in blood steam)

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7
Q

DKA: as _____ rises, the liver produces ____

why?

A

blood glucose rise the liver produces more glucose becuase it senses that the cells are starving

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8
Q

DKA: what happens when blood glucose rises

A

lead to dehydration

lowering of the bloods pH (acidodic)

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9
Q

DKA: kidneys kick in when? what do they try to do?

A

kidneys kick in as blood glucose rises

  • kidneys attempt to get rid of the excess glucose
  • glucose is spilled into the urine, water follows it - resulting in polyuria and the ensuing thirst polydipsia
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10
Q

acidodic: DKA

A

blood pH lowers

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11
Q

number one treatment for DKA

A

fluid treatment for dehydration - although putting out lots of urine very dehydrated

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12
Q

DKA: where do cells get energy from?

A

can’t get it from glucose. get energy from fat but in doing so produce ketones

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13
Q

DKA: what happens when you use ketones?

A

ketones are acidic and as they build up they lower the pH of blood. oH needs to stay normal - breaths become faster to raise pH level in blood

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14
Q

precipitating factors of DKA

A 
illness
infection
inadequate insulin dosage
undiagnosed type 1 diabetes
poor self management
neglect
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15
Q

DKA - clinical manifestations

A
  • abdominal pain, anorexia, nausea
  • dehydration
  • sweet fruity breath from ketones
  • polyuria
  • polydipsia
  • Kuusmaul respirations
  • blood glucose level higher than 250
  • blood pH lower than 7.3
  • serum bicarbonte level lower than 16
  • moderate to high ketones in urine or serum
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16
Q

polyuria

polydipsia

A

excess urine output

excess hunger

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17
Q

Kuusmaul respirations (DKA)

A

trying to blow off CO2

to increase blood PH

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18
Q

DKA - blood glucose level

A

250 mg/dL or more

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19
Q

DKA - blood pH

A

lower than 7.30

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20
Q

DKA - serum bicarbonate level

A

lower than 16 mEQ/L

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21
Q

Signs of DKA

A
  • onset over 4-10 hours
  • breath smeels fruity
  • Kussmaul Respirations
  • thirsty/dehydrated
  • acidosis (overproduction of acid in blood)
  • tachycardia
  • hypotension
  • high blood sugar
  • hyperkalemia (high potassium levels)
  • polyuria
  • low potasium and electrolytes
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22
Q

Early signs of DKA

A
  • dry craked lips
  • lethargy weakness
  • dry skin
  • ski tenting
  • polyuria
  • fever
  • sunken eyes and loose skin
  • decreased BP
  • ketones in urine
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23
Q

First thing you do to a DKA patient

A

rehydrate

-normal saline - 2 to 8 liters over 24 hours

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24
Q

how much saline do you give first to a DKA patient

A

1 liter in first hour

2-8 liters over 24 hours

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25
Treatment of DKA - Insulin
-"bolus" of regular insulin -continuous IV insulin NEVER GIVE SQ INSULIN TO A DKA PATIENT
26
Electrolyte Replacement - DKA
Restore potassium balance - hypokalemia - potassoim needed with insulin to move glucose in cells - correct pH
27
Treatment of DKA in hospital
- Rehydrate - Insulin - Electrolytes
28
HHNS
hyperosmolar hyperglycemic nonketoic syndrome
29
HHNS - what is it
- most common type 2 DM - High BS without ketones - extreme dehydration - decreased consiousness - usually seen in people with poor control of Type II - gradual onset
30
DKA & HHNS - onset
DKA - sudden | HHNS - gradual
31
Sugar Levels - HHNS
extremely high | 600-2000
32
Osmolality of HHNS
extreme lack of water - 6 to 8 L lost | -serum now has high osmolality to it greater than 350 because so much water was taken out of bloo
33
normal level of osmolality
275 - 295 Osm/kg
34
HHS may be brought on by what?
- infection - other illness (heart attack, stroke) - medicines that decrease effect of insulin in body - medicines that increase fluid loss - diaharrea, nausea, vommiting - decreased potassium level
35
What is HHS
Hyperosmolar Hyerglycemic Syndrome
36
HHS - what does dehydration cause?
increased blood concentration or hyperosmolarity - a condition which the blood has a high concentration of sodium, glucose and other substances that normally cause water to move into the blood stream -this draws the water out of ht ebody's other organs, including the brain
37
HHS treatment
- rehydrate (improves BP, urine output, circulation) - fluids and K+ - insulin drip
38
Hypoglycemia
too much insulin in proportion to glucose in the blood
39
Hypoglycemia blood glucose level
50mg/dL
40
normal glucose level
70-110
41
symptoms of hypoglycemia
- depend on the patient - shaking - sweating - anxious - dizziness - hunger - tachycardia (increased hear rate) - blurry vision - weakness fatigue - headache - irritable
42
hypoglycemia risk factors
- too much insulin (insulin reaction or insulin shock) - too little food - excessive exercise - sleeping in late - nutritional/fluid imbalances (nausea vomitting) - alcohol intake/drugs
43
Hypoglycemia Treatment - pt awake | Rule of 15
consume 15g of a simple carb (juice) - recheck glucose level 15 minutes - repeat if less than 70
44
Hyoglycemia - what to avoid
- foods with fat (decrease absorption of sugar) | - avoid overtreatment (stay within 15g)
45
Hypoglycemia - patient not alert enough to swallow
D50 (dextrose 50%) | IV push
46
Hypoglycemia - what to do when no IV
glucagon 1 mg, IM or SQ | -helps release glucose from the liver
47
hyperglycemia causes non-enzymatic glycosylation - what is it?
reversible attachment of glucose to proteins, lipids, nucleic acids without the activation of enzymes
48
Chronic hyperglycemia - what happens to glucose | -what does this form
becomes irreversibly bound to collagen and other proteins in the blood vessel wals and interstitial tissue -advanced glycosylation end-products (AGE)
49
AGE - what does it damage
blood vessels and tissue
50
3 macrovascular chronic diabetes complications
medium to large BV - cardiovascular - cerebrovascular (stroke) - peripheral vascular (ulcerations on ankle)
51
3 microvascular chronic diabetes complications
- nephropathy - neuropathy - retinopathy
52
proliferative retinopathy - what is it
- growth of abnormal blood vessels - retinal neovascularization (create more BV lead to vitreous hemmorrhage) stimulated by retinal isschemia (lack of oxygen)
53
proliferative retinopathy - untreated what does it cause
- vitreous hemmorrhage | - retinal detachment
54
proliferative retinopathy - treatment
laser therapy
55
nephropathy - what is it
*single most common cause of end stage renal disease (ESRD) - sclerosis (hardening) or thickening of the capilarry basement membrane - due to chronic filtering of high serum glucose levels
56
what causes nephropathy
chronic filtering of high serum glucose
57
early sign of nephropathy
micro-proteinuria | -protein in urine
58
what causes nephropathy
- smoking - hypertension - genetic predisposition
59
Treatment of nephropathy
- dialysis | - kidney transplant
60
what causes neuropathy
- common complication in diabetes - vascular insufficiency - chronic glucose elevation - hypertension - cigarete smoking
61
mono-neuropathy
sharp stabbing pains - damage to single nerve - ciadica or carpal tunnel
62
polyneuropathy
tingling,numbness, burning - total sensory loss - damage to multiple nerves - worse at night - hyperestisia (hypersensitive)
63
treatment of mono neuropathy
surgical decompression for compression lesions
64
treatment of polyneuropathy
foot care | -education to prevent trauma/ulcers

Quiz 3 Fundamentals (5 decks)

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