Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NUR 333 > E2 Care of the diabetic patient > Flashcards

E2 Care of the diabetic patient Flashcards

(66 cards)

Start Studying
1
Q

When does Type 1 & 2 develop?

A

T1: Younger People
T2: Adults >45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Is T1 or T2 more common?

A

Type 2 more common
Type 1 is only 5-10% of all diabetic cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the main difference between the beta cells of T1 and T2?

A

T1: No endogenous insulin production due to destruction of beta cells in the pancreas

T2: Beta cells wear out, cells become insulin resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The 3 P’s of Type 1

A

Polyphagia- Increased hunger
Polydipsia- Excessive thirst
Polyuria- Excessive urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Significance of S/S for T1 and T2

A

T1: S/S normally more abrupt

T2: S/S can go undiagnosed for years, screen on risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Symptoms of diabetes

A

-Fatigue
-Recurrent infections (sick)
-Slow wound healing

(T1: Polyphagia, Polydipsia, Polyuria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Non-modifiable risk factors for T2

A

-Family history
-Age over 45
-History of gestational diabetes
-Race/ethnicity (African Americans, hispanics, Pacific Islanders, American Indians)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Modifiable risk factors for T2

A

-Decreased Physical Activity
-High body fat or body weight
-High BP
-High cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Labs for diabetes

A
  1. Fasting Glucose: Normal <126mg/dL
  2. Casual blood glucose: Normal <200mg/dL
  3. Urine ketones: High amount indicates hyperglycemia
  4. Lipid profile: Elevated HDL, LDL, triglycerides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What casual blood glucose is considered a medical emergency?

A

> 300mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oral glucose tolerance test

A

-Used commonly to diagnose gestational diabetes
-Not usually for diagnosing type 1 or 2
-Fasting glucose drawn, client consumes oral glucose, glucose levels obtained every 30 mins for 2 hours
-Fasting should be <110
-At 1 hour <180
-At 2 hours <140

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Glycosylated Hemoglobin (HbA1C)

A

-Average glucose level past 3 months
-Used commonly to diagnosis and evaluate effectiveness of interventions
-Normal 4-6%
-Diabetic >6.5%
-Acceptable range for diabetic 6-8% with target 7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diabetes diagnostic criteria

A

Atleast 1 of the following:
1. A1C of 6.5% or higher
2. Fasting level >126mg/dL
3. OGTT at 2hr 200mg/dL
4. Classic symptoms of hyperglycemia (3 P’s or unexplained weight loss)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

For diagnosis of Type 1 diabetes, would need ________-

A

islet cell autoantibody testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a prediabetic patient?

A

Impaired glucose tolerance, impaired fasting glucose, or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Patients with pre-diabetes are at HIGH risk for developing

A

type 2 diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the S/S of prediabetes?

A

Typically None
But, longterm damage can already be occuring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diagnostic criteria for pre-diabetes

A

-An A1C of 5.7-6.4
-Fasting blood sugar of 100-125mg/dL
-An OGTT 2 hour blood sugar of 140mg/dL-199mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can we do for pre-diabetic patients?

A

-TEACH
-Lifestyle modification
-Encourage close monitoring of blood glucose and HbA1C
-Monitor for S/S: Fatigue, slow wound healing, frequently getting sick
-Diet modification: Monitor carbs and sugar intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Oral medications are used most frequently in

A

Type 2 diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Often in hospitalized patients oral medications are

A

stopped and put on insulin while acutely ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do diabetic oral medications do?

A
  1. Reverse insulin resistance
  2. Increase insulin production
  3. Decrease hepatic glucose production
  4. Help body get rid of excess glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When should metformin be held?

A

Before Procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Steroids make your blood sugar _____
What should you do?

A

rise

May need to alter insulin regimen at home, adjust basal dosage, increased scheduled doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Why is being sick a big problem for diabetics?
1. Causes stress which causes body to release more glucose 2. More prone to DKA, HHNS when sick 3. Stomach virus may lead to decreased eating and drinking (need to still take oral meds)
26
What to do when a patient with DM is sick?
1. Notify HCP 2. Monitor BS more frequently 3. Continue to take meds 4. Prevent dehydration 5. Meet carbohydrate needs: through oral food intake or liquid (gatorade/ pedialyte) 6. Rest
27
Call the provider when
1. Urine Ketones 2. BS >250mg/dL 3. Fever >101.5, not responding to Tylenol 4. Feeling confused/ disoriented/ rapid breathing 5. Persistant N/V/D 6. Inability to tolerate liquids 7. Illness lasting longer than 2 days
28
Continuous glucose monitors are most common for
Type 1
29
Nursing management of insulin
1. Mimic bodies normal insulin production 2. Combines "Basal" insulin with "meal time" insulin 3. Use rapid and short acting (bolus) insulin before meals 4. Use a background insulin once a day 5. Typically get 4 injections a day
30
Rapid acting insulin
Insulin lispro (Humalog) Onset: 15 mins Peak: 1 hr Duration: 2-4 hrs Insulin aspart (Novolog) Insulin glulisine (Apidra)
31
Short acting
Human regular (Novalin R/ Humalin R) Onset: 30-60 mins Peak: 2-6 hrs Duration: 3-8 hrs
32
Intermediate acting
NPH (Humalin N) Onset: 2-4 hrs Peak: 4-10 hrs Duration: 10-20 hrs
33
Long acting
Insulin glargine (lantus) Onset: 70 mins Peak: None Duration: 24hrs Insulin detemir (Levemir) Insulin degludec (Tresiba)
34
Insulin is a HIGH ALERT medication, therefore you need to
1. Always check glucose level before given med 2. Check diet order and patients oral intake tolerance 3. Know onset/peak/duration
35
Teaching points for diabetics
1. Teaching is the most important point 2. Observe pt self-administer 3. Timing is crucial 4. Monitor for side effects of hypoglycemia
36
S/S of hypoglycemia
Sweating Blurry Vision Dizziness Anxiety Hunger Irritability Shakiness Fast heartbeat Headache Weakness/ Fatigue
37
Hypoglycemia is when the blood sugar is
<70 Symptoms can occur at higher # if uncontrolled diabetes
38
What is the Rule of 15
If conscious and able to swallow give 15g simple carbohydrates (4 oz juice, regular soda, 3 glucose tablets, tablespoon honey) Avoid sugars w/fats (candy bars)
39
15g of CHO increases BS
50mg/dL
40
How often should you recheck FSBS if hypoglycemic?
Every 15 minutes until <70, then give food
41
If patient is unconsious/ unable to swallow:
IM glucagon or IV D50 (25-50mL)
42
Hyperglycemia BS:
250-300
43
Causes of hyperglycemia
-Illness -Infection -Self-management issues -Stress
44
S/S of hyperglycemia
Weakness Fatigue Blurry Vision Headache N/V/D
45
Treatment for hyperglycemia
1. Check for ketones in urine 2. Insulin 3. Drink fluid, prevent dehydration 4. Education on prevention
46
Crisis situation of hyperglycemia?
500+ Diabetic ketoacidosis (DKA) or Hyperglycemic Syndrome (HHS)
47
Insulin pump:
1. Continuous release of SQ insulin infusion: Uses rapid acting insulin 2. Pts receive continuous basal infusion 3. Still required to check 4 times a day 4. Usually deactivated in hospital and switched to sliding scale regimen
48
Problems to be aware of with insulin pumps
1. Infection at insertion site 2. Increased risk for DKA if pump malfunctions 3. Cost
49
What is the goal for diabetes management?
Prevent long term damage in organ disease, angiopathy (damage to blood vessels
50
Macrovascular disease
Damage to large vessels: Coronary arteries (CVS) Peripheral vascular (extremities) Cerebral vascular (brain)
51
Microvascular
Damage to capillaries: Retinopathies (eye capillaries) Nephropathies (Kidneys) Neuropathies (Sensation to extremities)
52
Women with diabetes have a _____ of CVD than those without
4-6x risk
53
Men have ______ of CVD
2-3x
54
What is body part is at highest risk for Neuropathy
Lower extremities & feet Foot ulcerations and lower extremity amputations common complications
55
What is neuropathy
loss of protective sensation (LOPS)- prevents patient from being aware that injury has occured
56
Nutritional considerations for diabetics
Balanced, high fiber, low fat, low cholesterol diet is best
57
Example of Carbohydrates
grains, fruits, legumes, milk Limit simple carbs like pasta & bread Should be 45-65% of total daily caloric intake
58
Example of Fats
Polyunsaturated fats such as Fish
59
Example of Fiber
beans, veggies, oats, whole grains
60
Example of Protein
meats, eggs, fish, nuts, and beans Should be 15-20% of total caloric intake
61
Alcohol with diabetics
limit alcohol intake 1 for women 2 for males
62
Precautions when it comes to exercise with diabetics
-Appropriate foot wear -Do not exercise if BS <80 or >250 -Best to exercise after meals -If more than 1 hour has passed since eating and plan on high intensity exercise eat a carbohydrate snack prior -Wear a medical alert bracelet
63
Nursing considerations for the hospitalized diabetic patietns
1. Stress/ surgery can increased blood glucose levels 2. Wound healing is impaired 3. High risk of infection
64
Diabetic Dermopathy
reddish-brownish spots, usually on shins Not life threatening but can clue us to uncontrolled diabetes
65
Acanthosis nigricans
Brown/Black thickening of skin, often seen in skin folds Not life threatening but can clue us to uncontrolled diabetes
66
Necrobiosis lipoidica diabeticorum
Red patches around blood vessels Not life threatening but can clue us to uncontrolled diabetes

NUR 333 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions