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52 Cards in this Set
- Front
- Back
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What % of people with DM have type I?
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5%
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What is the exocrine function of the pancreas?
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Releases digestive enzymes
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What is the endocrine function of the pancreas?
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It produces insulin in the beta cells of the Islet of langerhans
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What are the 5 functions of insulin?
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1. Transport & metabolizes glucose for E
2. Stimulates the storage of glucose in the liver to glycogen 3. Enhances the storage of fat in adipose tissue 4. Transports amino acids & glucose into cells 5. Inhibits the breakdown of stored glycogen, protein and fat |
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What is the function of the pancreas during fasting
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1. Pancreas releases insulin
2. Pancreas releases glucagon give a constant level of BS |
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What is the main dysfunction in Type I DM?
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The destruction of the beta cell and therefore no insulin is produced
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In Type I DM, what occurs unrestrained? What do they lead to?
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Glycogenolysis and glyconeogensis
Fat breakdown: all lead to hyperglycemia and fat breakdown to ketoacidosis |
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What are the etiologies of Type 2 DM?
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1. Insulin resistance
2. Decreased insulin production |
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Which type of DM can go into diabetic ketoacidosis?
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Type 1 only
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Which is the most accurate diagnostic test for DM that cannot be manipulated?
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A1C
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What are the diagnostic tests used for DM?
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1. Fasting glucose > 126
2. Random level of 200 or > on one or more occasion 3. A1C > 6.5 or 7 |
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What are the SxS of Hyperglycemia?
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1. Extreme thirst
2. Hunger 3. Frequent urination 4. Dry skin 5. decreased healing 6. Blurred vision 7. drowsiness 8. Blurred vision 9. FVD |
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What are some late signs of hyperglycemia?
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1. Hypotension
2. hypovolemia 3. decreased urine output 4. mental changes 5. coma |
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How often do Type 1's usually check their BS?
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2-4/day
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When hospitalized, what are all DMs monitored using?
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Fractionals: sliding scale
Checked AC and bedtime |
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What class of drugs are used to treat Insulin resistant Type 2s?
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Antihyperglycemic agents
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Hypoglycemic agents are used to treat Type 2s with what problem?
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A decreased insulin production
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What is the function of antihyperglycemics?
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help the body utilize the insulin that the person has more efficiently. Does not cause hypoglycemia
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Which drugs cause the pancreas to increase production of insulin? What is a complication of these drugs?
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hypoglycemic agents
They can cause hypoglycemia |
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Which insulin cannot be mixed with other types of insulin?
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Glargine
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When are short/regular insulins administered?
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20-30 mins before a meal
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What insulin is often given to cover a current meal as well as subsequent meals?
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70/30 insulin
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Which insulin groups often provide a constant level of insulin and act as a basal insulin?
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Long acting insulin
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Which insulin has no peak?
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Long acting glargine (lantus)
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What important education information must be given to type I DMs?
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Rotate injection sites for insulin to prevent lipoatrophy
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How many injections a day are common for a DM pt following a conventional routine?
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2 injections of 70/30
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What devices have made compliance to insulin use more common?
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the Insulin pens
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What are the SxS of Hypoglycemia?
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1. Tachycardia
2. sweating 3. dizziness 4. shaking 5. anxious 6. hunger 7. impaired vision 8. weakness 9. headache 10. irritable |
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what glucose level is often seen in pts who fall into a coma?
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< 40
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What are the nursing interventions for hypoglycemia?
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1. Give sugar
2. glucagon IV 3. check VS 4. Monitor BS 5. maintain airway if comatose |
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What is the old saying to determine hyper or hypoglycemia?
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Cold and clammy give them candy
Hot and dry your sugar is high |
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What occurs to a pts respiratory rate in ketoacidosis?
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It becomes rapid and deep. Kusmals respirations
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When administering insulin to a pt, what must the nursing staff also have available and why?
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Potassium! to replace it to prevent arrhythmias
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What are the sick day rules for Type I DMs?
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Take insulin as usual
-Test BS q 3-4 hours -test detones if BS > 200 -Report BS > 300 -eat small freq meals -If having V/D drink a coke q 30 mins |
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What is a serious complication that can occur with even Type 2 diabetics in a hyperglycemic state?
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Hyperglycemic hyperosmolar Nonketoic syndrome (HHNS)
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What is the clinical picture of HHNS?
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1. hyperglycemia
2. FVD 3. Tachy 4. alterations in sensorium |
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what BS is commonly seen with HHNS?
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> 1000
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How is HHNS prevented?
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following sick day rules
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What is the mortality rate for HHNS?
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50%
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What will the nurse see in the assessment of HHNS?
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1. Type 2
2. BS > 1000 3. RR: WNL 4. pH: WNL 5. NO ketones |
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What microvascular complication of DM causes tingling in the feet?
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neuropathy
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What is the most common cause of blindness in people ages 20-90?
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Diabetic retinopathy
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What % of DM pt have HTN?
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> 60%
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Pts with DM are ___ to ____ times more likely to have an MI or Stroke.
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3 to 4
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What % of dialysis pts have DM?
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60%
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lWhat are 3 complications of DM that can take place in the macrovasculature?
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1. CAD
2. CVD 3. PVD |
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What are DM patients at risk for in their urinary and GI systems?
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Urinary retention
constipation |
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What is Diabetes Insipidus?
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A pituitary disorder that leads to polyuria and polydipsia.
Deficiency in ADH production: the body cannot hold onto fluid |
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What are the Tx for Diabetes Insipidus?
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1. Replace fluids
2. I&O 3. Diet: high Na and high K 4. aqueous vasopressin (sub Q) or desmorpressin (nasal route) |
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What are the risk factors for Metabolic Syndrome (syndrome X)?
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1. high triglycerides > 150
2. low HDL < 40 3. HIgh BP > 130/85 4. insulin resistance 5. Waist line |
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What are the waist line values for men and women that make them at risk for syndrome x?
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men: > 40
women: > 35 |
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How many liters of urine can be lost by a pt with diabetes insipidus in 24 hours on average?
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4-12 L
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