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NCLEX - HURST REVIEW (Endocrine) > Endocrine: Diabetes (General Treatment - Type 1 & Type 2) > Flashcards

Endocrine: Diabetes (General Treatment - Type 1 & Type 2) Flashcards

1
Q

Clients should be taught what to help with glycemic control ?

A

How to count Carbs

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2
Q

For Diabetics, Carbs should include what ?

A
  • Fruits
  • Vegetables
  • Whole grains
  • Low fat dairy
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3
Q

With Diabetes, why are we worried about carbohydrates ?

A

Because Sugar destroys vessels just like fat

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4
Q

TESTING STARTEGY

Extremes in blood sugar = ?

A

Vascular damage

This is why poor circulation occurs

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5
Q

Diabetics need to add what types of foods to there diet ?

A

High fiber foods

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6
Q

What effect do High fiber foods have on Diabetes ?

A

Slows down glucose absorption in the intestines

therefore, eliminating the sharp rise and fall in blood sugar

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7
Q

True or False:

Individualized nutrition counseling based on a thorough nutritional assessment is best ?

A

True

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8
Q

Which method is the best for visual meal planning ?

A

The Plate method

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9
Q

What size plate should be used for meals ?
How should it be filled ?
What can be added as a low calorie drink ?

A
  • 9 inch plate
  • 1/2 of plate with non-starchy vegetables
    1/4 of the plate with carbs
    1/4 of the plate with proteins
  • A glass of water
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10
Q

What is the goal of exercise for a Diabetic ?

A

For it to be Regular and Consistent

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11
Q

When should Diabetics begin to exercise ?

A

when blood sugars normalize

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12
Q

What should Diabetics do pre-exercise to prevent hypoglycemia ?

A

Eat

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13
Q

Exercise should take place when blood sugars are at there what ?

A

Highest

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14
Q

True or False:

You should exercise at the same time and amount daily ?

A

True

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15
Q

Oral Anti-diabetics and Non-insulin injectables are medications prescribed for what Type of Diabetes ?

A

Type 2

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16
Q

Oral Anti-diabetics and Non-insulin injectables are administered how ?

A

Orally or Subcutaneously

* Dont think Sub q is insulin just because it’s Sub q

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17
Q

How do Oral Anti-diabetics and Non-insulin injectables work ? (By improving 2 things)

A
  • How to the body produces insulin

- How the body uses insulin and glucose

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18
Q

What is the most widely used oral anti-diabetic ?

A

Metformin (Glucophage)

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19
Q

For MOST clients, what is the first choice medication ?

A

Metformin

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20
Q

You may see Metformin used for what else ?

A
  • Weight control in Type 2 diabetics

- Some clients with Pre-diabetes

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21
Q

Why is Metformin a favorite ?

A

Because it reduces glucose production & enhances how glucose enters the cell

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22
Q

If Metformin is not controlling the blood glucose levels, what will be done ?

A

Another anti-diabetic will be ordered

possibly, Glargine (Lantus)

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23
Q

Clients undergoing surgery or any radiologic procedure that involves contrast dye should do what ?

A

Temporarily discontinue Metformin

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24
Q

When can Metformin be resumed following surgery or radiologic procedures that involved contrast dye ?

A

48 hours after the procedure if kidney function has returned and the creatinine level is normal

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25
Q

What are Examples of Non-insulin Injectable medications ?

A
  • Dulaglutide* (Trulicity)
  • Semaglutide* (Ozempic)
  • Pramlintide* (Symlin)
  • = Generic Names (NCLEX = ONLY generic names)
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26
Q

What are the 2 benefits of Non-insulin Injectables ?

A
  1. Timing (taken once a day, once every 2 days, or once a week)
  2. Weight loss (moderate loss is seen in some clients)
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27
Q

Who is Insulin required for ?

A
  • ALL type 1 diabetics

- SOME type 2 diabetics

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28
Q

Initially, Insulin is based on what ?

A

Body weight

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29
Q

What is the average Adult dose of Insulin ?

A

0.4 - 1.0 unit/kg/day

30
Q

Insulin is adjusted until what ?

A
  • Blood sugar is normal
    &
  • There is no more glucose or ketones in the urine
31
Q

When should Rapid-acting insulin be given ?

A

Give with food at the bedside ONLY !

32
Q

What is the standard/only insulin that can be given IV ?

A

Regular insulin

Think: Regular goes Right into the vein

33
Q

What makes NPH insulin cloudy ?

A

d/t time release particles

34
Q

What appearance does Regular insulin have ?

A

Clear

35
Q

Which type of insulin is cloudy ?

A

NPH

36
Q

When drawing up Regular and NPH insulin, which one should you draw up first ?

A

Regular

Memory Trick for drawing up Regular & NPH insulin

im Not Retired, im an RN

  • Inject NPH with air 1st
  • Inject Regular with air 2nd
  • Withdraw Regular 1st
  • Withdraw NPH 2nd
37
Q

What other insulins are also Clear but CANNOT be mixed with others or be given IV ?

A

Long Acting insulins

38
Q

What other insulin aside from Regular can also be given IV ?

A

Rapid-acting

39
Q

The goal is to keep the __________ meal glucose near normal at 80 to 130mg/dL ?

A

Before

40
Q

What is the most common method of daily dosing insulin ?

A

Basal Bolus Dosing

41
Q

The total daily dose of insulin with Basla/Bolus method is a combination of what ?

A

A Long-acting (basal) insulin and a Rapid-acting (bolus) insulin

(NPH is sometimes used to replace rapid-acting because its cheaper)

42
Q

In the Basal/Bolus insulin method, how often is the Long-acting insulin given ?

A

Once a day

43
Q

In the Basal/Bolus insulin method, how often is the Rapid-acting insulin given ?

A

Given throughout the day before meals in divided doses

and it covers the food eaten at meals

44
Q

Are snacks required with basal/bolus insulin dosing ?

A

No

but clients still must eat when dosing with a raid-acting insulin, so you should have food available

45
Q

Clients should eat when insulin is at its what ?

A

Peak

46
Q

When insulin is at its peak, the blood sugar is what ?

A

At it’s lowest

47
Q

You should always monitor a client on insulin for what ?

A

Hypoglycemia

b/c, at all times insulin is in the system

48
Q

TESTING STRATEGY

Illness = ?

A

DKA

49
Q

Glycosylated Hemoglobin (HbA1C) blood tests gives an average of what your blood sugar has been over the past _____________ ?

A

3 to 4 months

50
Q

HbA1C’s are drawn every ?

A

3-6 months

51
Q

What happens to your blood sugar when you are sick or stressed ?

A

It Increases

52
Q

A HbA1C of what Is diagnostic for diabetes ?

A

Greater than or equal to 6.5%

53
Q

For people with Diabetes, the ideal goal for their HbA1C is what ?

A

Less than or equal to 7%

54
Q

What is a normal HbA1C in a Non-diabetic ?

A

Less than or equal to 5.7%

55
Q

True or False:

An increase in the blood sugar when sick or stressed, is a normal reaction to help us fight the illness or stressor ?

A

True

56
Q

What should we teach diabetics about giving insulin ?

A

Rotate sites (rotate within an area first)

B/c otherwise tissue gets hard & will not properly absorb

57
Q

What are insulin infusion pumps ?

A

Portable pumps people wear

58
Q

What is an alternative to daily insulin injections ?

A

Insulin Infusion pumps

59
Q

What is the only type of insulin used in Insulin Infusion pumps ?

A

rapid-acting

60
Q

Insulin Infusion Pumps obtain better what ?

Why ?

A

Control

B/c you receive a basal dose of insulin from the pump and boluses of additional insulin as needed with meals or if they have an elevated blood sugar

61
Q

______________ insulin is the standard insulin that can be given in IV fluids as an intravenous infusion ?

A

Regular

62
Q

____________________ insulin is the only insulin that can be given via a Subcutaneous insulin infusion pump ?

A

Rapid-acting insulin

63
Q

What are small computerized devices worn by the client that provide both a continuous (basal) dosing of rapid-acting insulin and on-demand (bolus) dosing ?

A

Insulin infusion pumps

64
Q

What are the s/s of Hypoglycemia ?

A
  • Cold & clammy (cold & clammy need some candy)
  • Nervous
  • Confusion
  • Shaky
  • Headache
  • Nausea
  • Increased pulse
  • Hunger
  • Jittery
65
Q

If Hypoglycemic, what should a patient do ?

A

Eat a simple carb

66
Q

Snacks for Hypoglycemia should be what ?

A

15 grams of carbohydrates

Ex: 4-6oz of coke, 8-10 lifesavers, etc

67
Q

Glucose absorption is delayed in what types of foods ?

A

Foods with lots of fat

68
Q

Once the blood sugar is up, what should the client do ?

A

Eat a complex carb & protein

69
Q
  • You enter a diabetic client’s room and they are unconscious… do you treat this client like they are hypoglycemic or hyperglycemic ?
  • How would you Tx this client ?
A
  • Hypoglycemic (b/c hypoglycemia is more immediately life-threatening)
  • D50W (hard to push, need a large bore IV if you have a choice)
  • Injectable glucagon (used when there is no IV access; can be given subq, IM, or IV)
70
Q

What things would you teach, for Hypoglycemia prevention ?

A
  • Eat
  • Take insulin regularly
  • Know the s/s of hypoglycemia
  • Check blood glucose regularly
71
Q

What is Hypoglycemia defined as ? (lab value wise)

A

Glucose level of 70mg/dL or less

72
Q

If a client is Hypoglycemic and also unconscious what types of things should you give to raise the blood sugar ?

A

Put syrup, honey, jelly, or sugar in the mouth/on the gums

NCLEX - HURST REVIEW (Endocrine) (10 decks)

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