Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
70 Cards in this Set
- Front
- Back
|
Diabetes is the term that describes the altered metabolism of the following. Select all that apply:
a. proteins b. fats c. glucose d. sodium e. potassium |
a. proteins
b. fats c. carbohydrates (in the form of glucose) |
|
|
Which cultural groups are most at risk for Diabetes?
|
Hispanic
Asian African Americans |
|
|
What types of drugs raise blood glucose?
|
corticosteroids (prednisone)
birth control TZD Estrogen |
|
|
What types of cells produce insulin and where are they located?
|
Beta Cells in the Islet of Langerhans in the Pancreas produce insulin.
|
|
|
Does the Type 1 Diabetic have abnormalities in the beta cell, plasma cell, or target cell?
|
Type 1 Diabetics have abnormalities in the Beta Cell. They have either no Beta Cells or their Beta Cells produce no insulin. The patient is prone to viral infections.
|
|
|
What does it mean for the Type 2 Diabetic that they have abnormalities in their Plasma Cells?
|
Type 2 Diabetics plasma cells don't carry insulin to the target cell.
|
|
|
What does it mean for the Type 2 Diabetic that they have abnormalities in their Target Cells?
|
Type 2 Diabetics target cells don't accept insulin, or there aren't enough receptors or the target cell is defective.
|
|
|
What are the classic symptoms of Diabetes?
|
Polyphagia
Polydipsia Polyuria |
|
|
Define Diabetic Ketoacidosis.
|
Hydrogen goes into the cells
Potassium comes out. Renal Failure/More glucose Patient tries to blow off glucose with Kussmaul's Respirations and Fruity Breath. Ketones in the urine. |
|
|
How is DKA treated?
|
IV regular insulin
IV potassium |
|
|
Describe the Type 1 Diabetic.
|
* Insulin Dependent
* absolute insulin deficiency * child's growth/development is stunted * has complications *girls=overweight *boys=underweight |
|
|
Describe the Type 2 Diabetic.
|
* not insulin dependent
* adult onset * will need insulin at some point * patient is usually obese * tired, irritable * long wound healing * treated with diet, exercise * oral insulin or injected insulin |
|
|
This term describes a group of disorders that all have insulin resistance.
|
Metabolic Syndrome.
|
|
|
Conditions that increase the risk of insulin resistance include:
|
a. sedentary lifestyle
b. abdominal obesity |
|
|
Risk factors include the following. Select all that apply:
a. obesity b. over 45 years of age c. smoking d. gave birth to a baby over 9 lbs. e. family history |
a. obesity
b. over 45 years of age d. gave birth to a baby over 9 pounds e. family history |
|
|
This test is a 4 to 8 hour fast and confirmation of Diabetes Type 2 is made on two separate occasions when blood sugar is over 126.
|
Fasting Blood Sugar.
|
|
|
This is a fasting test with a glucose bolus given after the fast. Glucose is then measured at intervals. A diagnosis of Diabetes Type 2 is made when the blood glucose is over 200 after 2 hours.
|
Serial Blood Test/ Glucose Tolerance Test.
|
|
|
This is known as the honesty test and measures the amount of glucose that joins with protein in the capillary basement membrane.
|
Glycosylated Hemoglobin A1C.
|
|
|
The patient is diagnosed with Type 2 Diabetes when A1C is _____ or higher. The goal is to have the A1C at _____.
|
Diagnosed at 6.5% or higher
Goal: 6%. |
|
|
True or False: A Glucometer is covered by insurance by test strips never are.
|
True.
|
|
|
What should the diabetic patient be asked during a diagnostic assessment?
|
*age
*occupation *weight/height *history *exercise program *complications *"What do you know about diabetes"? |
|
|
At what age can the child with diabetes help manage their illness?
|
4 years old. Before 4 years of age, the parent should manage it.
|
|
|
What should be included for the teen/adolescent with diabetes?
a. free test strips b. snacks c. group education d. membership in the American Diabetes Association. |
c. Group Education.
*body image is very important * often rebel |
|
|
What should be considered in a plan for the elderly diabetic?
|
a. money
b. arthritis (dexterity) c. manipulation of syringes |
|
|
What should the diabetic who exercises be taught?
|
*they need to eat a snack before and during exercising.
*otherwise they could become very hypoglycemic. *they need to wear an Medic Alert when exercising. |
|
|
What should the diabetic who doesn't exercise be taught?
|
*they need to walk 1-2 miles every day after eating because glucose is elevated.
|
|
|
True or False: If the person who is diabetic isn't exercising, they need to increase their insulin dose.
|
True.
|
|
|
True or False. Exercise increases pressure in the eyes and can contribute to Diabetic Retinopathy.
|
True.
|
|
|
Describe the Exchange Diet
|
*helps patient to maintain ideal weight.
*exchange certain foods for others of comparable value. |
|
|
How many calories per day are recommended by the American Diabetic Association for the person with Diabetes?
|
1800.
|
|
|
How does fiber affect the diabetic patient?
|
*slows digestion & absorption time
*blood glucose rises slowly *high fiber diet needs 75% less insulin. |
|
|
Which diabetic definitely needs a snack?
|
Type 2.
|
|
|
What type of snack is recommended for the diabetic patient?
|
A snack with protein so it takes longer for the blood sugar to spike.
|
|
|
Describe the Glycemic Index.
|
*Atkins Diet.
* determines how much certain foods raise your blood sugar. |
|
|
Which oral insulins need a supplemental snack?
|
Intermediate (NPH)
Long Acting (Lantus, Levemir) |
|
|
What are symptoms of hypoglycemia?
|
*diaphoretic
*cold, clammy skin *headache *shaky *irritable *headache *confused *staggered gait |
|
|
What is the function of insulin pumps?
|
Insulin Pumps give a continuous delievery of insulin but do not measure blood glucose.
|
|
|
How many units are in an orange syringe?
How many units are in a green syringe? |
Orange Syringe=100 units
Green Syringe=80 units |
|
|
True or False: Insulin syringes can be reused.
|
True. Insulin syringes can be reused for up to 7 days.
|
|
|
What are common anatomical sites for insulin injection?
|
*thigh
*upper back arm *2" outside of the belly button |
|
|
What prevents delayed absorption of insulin?
|
rotating sites prevents delayed absorption.
|
|
|
Which anatomical site gives the quickest absorption of insulin?
|
the abdomen
|
|
|
What anatomical site give the lowest absorption of insulin?
|
the thigh
|
|
|
The diabetic patient you are preparing to administer insulin mentions that she is a distance runner. Where should you administer her insulin?
a. thigh b. back of the arm c. don't give her any insulin d. abdomen |
d. abdomen
|
|
|
What group needs 15-20% more insulin due to decreased insulin transport?
|
Smokers.
|
|
|
Define Dawn Phenomenon.
|
*body releases growth hormone between 4 and 5 am
*growth hormone increases blood glucose. the patient needs more insulin |
|
|
How is Dawn Phenomenon treated?
|
intermediate insulin (NPH) at 9-10 pm or increase the amount of the intermediate dose.
|
|
|
Define Somogyi Phenomenon.
|
*too much insulin causes hypoglycemia.
* body secretes stress hormone and blood sugar goes up. |
|
|
Define Hypertrophy.
|
subcutaneous tissue at injection site thickens and scar tissue forms.
*common in men & children |
|
|
Define Atrophy.
|
dimpling at the injection site
*common in children & women |
|
|
How is Lipodystrophy treated?
|
*rotate site
*inject at 90 degrees *give at room temperature |
|
|
What should you instruct the diabetic patient who is ill?
|
*continue to take insulin
*eat 15 grams of carbs *check urine for ketones *regular insulin if more is needed *someone in the home needs to know how to deliver insulin. |
|
|
How is hyperglycemia prevented during surgery?
|
*hang IV insulin
*goal is to keep blood glucose at 200. |
|
|
True or False: Placenta Enzymes destroys insulin in the second trimester.
|
True.
|
|
|
What can occur if the patient continues to take oral medications during pregnancy?
|
high chance of birth defects.
|
|
|
What problems does hyperglycemia cause in the first trimester?
|
baby can have brain problems.
|
|
|
What problems does hyperglycemia cause in the second trimester?
|
mom has kidney problems
|
|
|
What problems does hyperglycemia cause in the third trimester?
|
*glucose crosses the placenta.
*prevents insulin from going back to mom. * baby gets all the glucose and gets big. * baby is macrosomic. |
|
|
What should you teach the mom with diabetes about breastfeeding?
|
more calories
more insulin |
|
|
What should be given to the patient with Hypoglycemia who is concious?
|
*15 grams of quick sugar
*1/2 cup soda *1/2 cup apple or orange juice *honey *5-6 lifesavers *don't give chocolate due to longer absorption |
|
|
What should be given to the hypoglycemic patient who is unconcious?
|
*glucagon paste under the tongue
*cake icing *always give up a second sugar *50% glucose IV push when unconcious. |
|
|
Describe Hyperosmolar Hyperglycemic Nonketotic Coma.
|
*Type 2 Diabetics
* from illness, MI, stroke * elderly *no ketones formed *treated with tons of fluids since patient is dehydrated. |
|
|
Describe Macrovascular Complications.
|
*Peripheral Vascular Disease
*Coronary Artery Disease (everyone gets these). |
|
|
Describe Microvascular Complications.
|
*damage to basement capillary membrane.
* glycoproteins on basement capillary membrane. |
|
|
Describe Peripheral Neuropathy.
|
*pain
*paresthesia *sensitive skin *calluses and corns on the feet |
|
|
What should the patient with peripheral neuropathy be taught?
|
*podiatrist
*inspect feet daily * no hot pads * no plastic shoes * cut nails straight across * cotton socks |
|
|
Describe Visceral Neuropathy.
|
*headache
*impotence *decreased female libido *dyplopia *eye pain |
|
|
Describe Nephropathy.
|
*vascular changes to kidneys
*dialysis |
|
|
Describe Diabetic Retinopathy.
|
leading cause of blindness
blurred vision |
|
|
Describe travel for the diabetic.
|
*take syringes, insulin
* take snack *take prescription for security * leave watch set to home when leaving time zone and make adjustment when you get to your destination. |
