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Question 1

Statin drugs used

Answer 1

To treat hyperlipidemia (high cholesterol)

Question 2

What meds are used for HTN and renal insufficiency?

Answer 2

Ace inhibitors
Calcium channel blockers
Angiotensin ii receptor blockers

Question 3

What meds are not recommended for T2DM?

Answer 3

Beta blockers (-olol) but are used for HTN and decrease CVD

Question 4

Stop using ace inhibitors if

Answer 4

Dry hacking cough

Question 5

Diuretics are used for

Answer 5

Fluid overload and HTN control (Furosemide!)

Question 6

Metformin

Answer 6

Lowers BG and improves glucose tolerance
May cause weight loss
MUST be held 48 hrs prior to and after use of dye

Question 7

Sulfinylureas

Answer 7

Side effects: hypoglycemia and weight gain
Alcohol use can potentiate hypoglycemic effects
Increase insulin production from pancreas

Question 8

Diabetic retinopathy

Answer 8

Microvascular damage to retina

Question 9

Diabetic retinopathy increases risk for

Answer 9

Other eye diseases
-glaucoma
-blindness
-cataracts

Question 10

Nonproliferative diabetic retinopathy

Answer 10

Partial occlusion of small blood vessels in retina causes micro aneurysms

Question 11

Proliferative diabetic retinopathy

Answer 11

New blood vessels formed (neovascularization)
Can cause retinal detachment (blindness)

Question 12

Nephropathy

Answer 12

Leading cause of ESRD
Need to control HTN and tight BG control

Question 13

Labs for Nephropathy

Answer 13

UA — should be free of albumin, protein, glucose, nitrites, bacteria, etc.
BUN/Creatinine — BUN: 8-20; creatinine: 0.6-1.2
GFR — >60

Question 14

Cues for Nephropathy

Answer 14

Edema of face, hands, feet
UTI symptoms
Symptoms of renal failure: anorexia, nausea, fatigue, difficulty concentrating

Question 15

Sensory neuropathy

Answer 15

Loss of protective sensation in limbs

Question 16

Anti-seizure medications

Answer 16

Gabapentin is the gold standard
Used for sensory neuropathy

Question 17

Autonomic neuropathy

Answer 17

Gastroparesis — delayed gastric emptying
Cardiovascular abnormalities
Hypoglycemic unawareness

Question 18

Hypoglycemia unawareness is related to

Answer 18

Autonomic neuropathy and lack of counterregulatory hormones

Question 19

Autonomic neuropathy chronic complications

Answer 19

Sexual function
Neurogenic bladder (urinary retention) bethanochol!!!
Self catheterization is the last option

Question 20

Cholesterol should be

Answer 20

Less than 200

Question 21

LDL should be

Answer 21

Less than 100

Question 22

Triglycerides should be

Answer 22

Less than 150

Question 23

HDL should be

Answer 23

Women — more than 50
Men — more than 40

Question 24

Glycemic index

Answer 24

Refers to the response to 50 grams of glucose or white bread in a normal person without diabetes

Question 25

Foods with a high glycemic index do what?

Answer 25

Raise glucose levels faster and higher than foods with a low glycemic index

Question 26

Diabetes exercise

Answer 26

Exercise 1 hour after a meal, don’t want to exercise when meds peak Do not exercise if BG >300 and if ketones are present in urine

Question 27

Ketones

Answer 27

Break down fat rapidly

Question 28

Patients who use _______ are at an increased risk for ________

Answer 28

Insulin, meglitinides, and Sulfinylureas are at an increased risk for hypoglycemia

Question 29

Hydration

Answer 29

8 oz fluid per hr Every 3rd hour, consume 8oz of sodium rich choice like bullion

Question 30

SMBG

Answer 30

Every 2-4 hours while BG is elevated or until symptoms subside

Question 31

Ketones (Sick)

Answer 31

Every 4 hours or until negative (For type 2, determined for individual)

Question 32

Medication adjustments

Answer 32

Continue as able Adjust insulin doses to correct hyperglycemia (For type 2, hold metformin during serious illness)

Question 33

Food and beverage selections

Answer 33

Guide patients to consume 150-20g CHO daily in divided doses Switch to soft or liquids as tolerated

Question 34

Food and beverage selections

Answer 34

Guide patients to consume 150-20g CHO daily in divided doses Switch to soft or liquids as tolerated

Question 35

Informed consent

Answer 35

Adequate disclosure Patient must have clear understanding Consent must be given freely

Question 36

Adequate disclosure

Answer 36

Patient needs to know purpose of case Risk of non treatment Are there other treatments available Risk of procedure Probability of success

Question 37

NPO before surgery, why?

Answer 37

Risk for aspiration and pneumonia

Question 38

Universal protocol

Answer 38

Surgical timeout- all members of the surgical team stop what they are doing before the procedure starts to verify: Patient ID Procedure Surgical site (surgeon should mark procedure site)

Question 39

Ileostomy

Answer 39

Right side Small bowel —> loose, watery stool

Question 40

Colostomy

Answer 40

Left side Large intestine —> more formed stool

Question 41

If stoma is purple

Answer 41

Blood is not reaching Medical emergency Should be red or pink

Question 42

Always protect skin around stomach bag

Answer 42

Teach pt/fam Dont want bag to get so full that it starts to pull away from skin

Question 43

JP drain

Answer 43

If compressed, doing its job If not compressed, it is full. Empty, collect, measure If blood clot, milk the drain to create suction to remove blood clot Drainage should be serous/Sanguineous (pinkish clear)