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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

(72 cards)

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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
What are Examples of Non-insulin Injectable medications ?
- Dulaglutide* (Trulicity) - Semaglutide* (Ozempic) - Pramlintide* (Symlin) * = Generic Names (NCLEX = ONLY generic names)
26
What are the 2 benefits of Non-insulin Injectables ?
1. Timing (taken once a day, once every 2 days, or once a week) 2. Weight loss (moderate loss is seen in some clients)
27
Who is Insulin required for ?
- ALL type 1 diabetics | - SOME type 2 diabetics
28
Initially, Insulin is based on what ?
Body weight
29
What is the average Adult dose of Insulin ?
0.4 - 1.0 unit/kg/day
30
Insulin is adjusted until what ?
- Blood sugar is normal & - There is no more glucose or ketones in the urine
31
When should Rapid-acting insulin be given ?
Give with food at the bedside ONLY !
32
What is the standard/only insulin that can be given IV ?
Regular insulin Think: Regular goes Right into the vein
33
What makes NPH insulin cloudy ?
d/t time release particles
34
What appearance does Regular insulin have ?
Clear
35
Which type of insulin is cloudy ?
NPH
36
When drawing up Regular and NPH insulin, which one should you draw up first ?
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
What other insulins are also Clear but CANNOT be mixed with others or be given IV ?
Long Acting insulins
38
What other insulin aside from Regular can also be given IV ?
Rapid-acting
39
The goal is to keep the __________ meal glucose near normal at 80 to 130mg/dL ?
Before
40
What is the most common method of daily dosing insulin ?
Basal Bolus Dosing
41
The total daily dose of insulin with Basla/Bolus method is a combination of what ?
A Long-acting (basal) insulin and a Rapid-acting (bolus) insulin (NPH is sometimes used to replace rapid-acting because its cheaper)
42
In the Basal/Bolus insulin method, how often is the Long-acting insulin given ?
Once a day
43
In the Basal/Bolus insulin method, how often is the Rapid-acting insulin given ?
Given throughout the day before meals in divided doses | and it covers the food eaten at meals
44
Are snacks required with basal/bolus insulin dosing ?
No | but clients still must eat when dosing with a raid-acting insulin, so you should have food available
45
Clients should eat when insulin is at its what ?
Peak
46
When insulin is at its peak, the blood sugar is what ?
At it's lowest
47
You should always monitor a client on insulin for what ?
Hypoglycemia | b/c, at all times insulin is in the system
48
TESTING STRATEGY Illness = ?
DKA
49
Glycosylated Hemoglobin (HbA1C) blood tests gives an average of what your blood sugar has been over the past _____________ ?
3 to 4 months
50
HbA1C's are drawn every ?
3-6 months
51
What happens to your blood sugar when you are sick or stressed ?
It Increases
52
A HbA1C of what Is diagnostic for diabetes ?
Greater than or equal to 6.5%
53
For people with Diabetes, the ideal goal for their HbA1C is what ?
Less than or equal to 7%
54
What is a normal HbA1C in a Non-diabetic ?
Less than or equal to 5.7%
55
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 ?
True
56
What should we teach diabetics about giving insulin ?
Rotate sites (rotate within an area first) B/c otherwise tissue gets hard & will not properly absorb
57
What are insulin infusion pumps ?
Portable pumps people wear
58
What is an alternative to daily insulin injections ?
Insulin Infusion pumps
59
What is the only type of insulin used in Insulin Infusion pumps ?
rapid-acting
60
Insulin Infusion Pumps obtain better what ? Why ?
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
______________ insulin is the standard insulin that can be given in IV fluids as an intravenous infusion ?
Regular
62
____________________ insulin is the only insulin that can be given via a Subcutaneous insulin infusion pump ?
Rapid-acting insulin
63
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 ?
Insulin infusion pumps
64
What are the s/s of Hypoglycemia ?
- Cold & clammy (cold & clammy need some candy) - Nervous - Confusion - Shaky - Headache - Nausea - Increased pulse - Hunger - Jittery
65
If Hypoglycemic, what should a patient do ?
Eat a simple carb
66
Snacks for Hypoglycemia should be what ?
15 grams of carbohydrates | Ex: 4-6oz of coke, 8-10 lifesavers, etc
67
Glucose absorption is delayed in what types of foods ?
Foods with lots of fat
68
Once the blood sugar is up, what should the client do ?
Eat a complex carb & protein
69
- 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 ?
- 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
What things would you teach, for Hypoglycemia prevention ?
- Eat - Take insulin regularly - Know the s/s of hypoglycemia - Check blood glucose regularly
71
What is Hypoglycemia defined as ? (lab value wise)
Glucose level of 70mg/dL or less
72
If a client is Hypoglycemic and also unconscious what types of things should you give to raise the blood sugar ?
Put syrup, honey, jelly, or sugar in the mouth/on the gums

NCLEX - HURST REVIEW (Endocrine) (10 decks)

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