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Elaina: Hospital Medicine > DM Management > Flashcards

Flashcards in DM Management Deck (14)
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1
Q

what percentage of diabetics are type 2?

A

90 percent

10 percent type 1
in case you can’t math good

2
Q

glucose less than ___ is often associated with which four events?

A

less than 70

1) arrhythmia
2) delirium
3) aspiration
4) falls

3
Q

what are three commonly prescribed drugs/drug regimens that often precipitate hypoglycemia?

A

1) sulfonylureas
2) sliding scales
3) intensive insulin therapy

4
Q

what are the acceptable glucose ranges for a NON-critically ill hospitalized patient in terms of:

1) pre-meal
2) fasting
3) average random

A

pre-meal less than 140

fasting no lower than 90

average random less than 180

5
Q

how can we avoid the two most common mistakes that often precipitate hypoglycemia?

A

in terms of sulfonylureas (and some other agents) – hold for ANY chance of poor PO intake and write specific nursing orders

sliding scale: just don’t set it and forget it! continue close monitoring – even though we use short acting insulin and we don’t fear hypoglycemia that much

6
Q

treatment of hypoglycemia?

A

prevent it!

asymptomatic or mildly symptomatic who can take PO safely – 20 g oral glucose (tabs, juice, milk, snack, full meal)

one amp of D50 does the trick too (prevents recurrent hypoglycemia)

7
Q

where do we want to keep glucose blood levels below to prevent severe hyperglycemia?

A

keep below 180

8
Q

what are 3 major complications of severe hyperglycemia?

A

1) increased risk of infection (neutrophil fxn decreased)
2) volume depletion (dehydration) bc of osmotic diuresis – electrolyte disturbane and renal failure
3) calorie and protein loss, edema

9
Q

under circumstance do we worry about precipitating hyperglycemia?

A

when we have to hold meds

10
Q

why would we have to hold meds, which would put a patient at risk for developing hyperglycemia?

A

1) hypoglycemia prevention (sulfonylurea)
2) renal failure (stop almost all agents)
3) lactic acidosis in association with contrast studies (metformin)
4) ventricular dysfunction (TZD)

11
Q

why does the sliding scale put a diabetic in danger of developing hypoglycemia?

A

nurse is adding what is recommended on the sliding scale to patient’s existing insulin regimen

12
Q

how do we calculate our daily insulin requirement?

A

1) 50 percent dose giving as basal (lantus–1 dose)
2) 50 percent short acting (aspart or lispro)
3) divide short acting over the day (3x)

13
Q

you will adjust the ____ up to meet the less than 180 goal to avoid having to use the ____

A

adjust scheduled insulin

avoid need for sliding scale

14
Q

if you learn your patient has type 1 diabetes, what do you need to make sure to do?

A

drop everything and throw up the red flags

make sure steady source of insulin even if NPO – keep pump going