Exam 4 Flashcards
(48 cards)
How do we diagnose patients with diabetes?
An A1C level of 6.5% or higher
What are some symptoms of hypoglycemia?
- blood glucose <70
- cold clammy skin
- nervousness, tremors
- changes in vision
- hunger
- unsteady gait, slurred speech
- tachycardia
- faintness, dizziness
- seizures, coma
- emotional changes, headache
What is done for a conscious patient with hypoglycemia?
- give 15g of simple carbs
- wait 15min then check glucose again
- still <70? Repeat 15g of simple carbs
- repeat up to 3x
*if no improvement still? Go to hospital
What do you do with an unconscious patient with hypoglycemia or their hypoglycemia is getting worse?
- use glucagon paste
- in hospital, give IM glucagon OR glucose/dextrose in IV
- Turn patient on side to prevent aspiration
What are some examples of simple carbs?
4-6oz of soda, 5-8 lifesavers, 1tbsp of syrup or honey, 4 tsp of jelly, 4-6oz of orange juice, 2 tbsp of raisins, commercial dextrose products, 4-5 crackers
Symptoms of hyperglycemia include…
- Elevated blood glucose
- blurred vision
- increased urination
- N/V, abdominal cramps
- mood swings
- weakness, fatigue
- increased appetite to lack of appetite
- headache
Target organ damage can be a result of persistent hyperglycemia. What do you see?
- stroke
- hypertension
- kidney damage
- peripheral neuropathy
- peripheral vascular atherosclerosis
- vision changes
Screenings for eyes, kidneys, BP, etc need to be done for patients with hyperglycemia.
True
False
TRUE
- eye exams, creatinine, etc
How many grams of carbs is a diabetic patient supposed to be getting per day?
25g to 30g per day
*better if including dietary fiber
Where can fat intake for diabetic patients come from?
Olives, nuts, avocados, plants
*healthy fats. Minimize trans fat
Cholesterol - <200g per day
Protein intake is individualized per patient. What type of protein is preferred?
Lean protein
How much exercise should a client with diabetes get?
150 minutes/week
*moderate-intensity aerobic activity AND resistance training 3x/week
Type 1 diabetes patients need to delay activity if ….
Need to delay activity if glucose is <250 and ketones present in urine
How should a diabetic patient eat meals and activity?
- exercise 1 hour after meal OR
- have a 10-15g carb snack
- check glucose before exercise
*if long exercise time, carb snack every 30min while exercising
What is the first line treatment med for type 2 diabetes?
Metformin
Can a diabetic patient getting a test done with IV contrast still take their metformin?
NO!!!
*client needs to stop metformin 2 days before and after test
What is a major side effect of sulfonylureas (like glipizide, glyburide, -ide)???
Hypoglycemia
Once insulin is opened, how does it need to be stored?
In refrigerator but NOT a must
Foot care is important patient teaching for diabetic clients. What are some good care methods?
- wear diabetic socks and footwear that fit correctly
- skin and nail care
- daily inspection of feet
- diligent wound care for foot ulcers
*prompt treatment of small problems
Somgoyi effect is a problem with insulin therapy meaning…
High dose of insulin causing a decreased glucose during the night then elevated elevated in the morning
The problem with insulin therapy called the dawn phenomenon means…
Morning hyperglycemia present on awakening
The main risk factor of metabolic syndrome in diabetes is what?
Central/abdominal obesity
What two types of headache are usually caused by stress?
Tension and Cluster headaches
Sumatriptan is a medication for headaches. Clients with what conditions should not take this medication?
Hypertension, PVD, CAD, Stroke
