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43 Cards in this Set
- Front
- Back
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What did Type 1 diabetes used to be called?
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Juvenile Onset
or Insulin Dependent Diabetes |
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What is Type 1 Diabetes caused from?
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autoimmune destruction of the beta or islet cells of the pancrease which produce the hormone insulin
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What does insulin do in the body?
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Insulin is required for glucose metabolism (using blood sugar for fuel in the cells)
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What did Type 2 diabetes used to be called?
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Adult onset diabetes
or Non insulin dependent diabetes |
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What is the deal with Type 2 diabetes?
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insulin resistance that develops into relative insulin deficiency
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What body type is directly related to insulin resistance?
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central abdominal obesity
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Which diabetes is more genetic than the other?
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Type 2 is more genetic. Related to family history of diabetes, weight gain, and sedentary lifestyle
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What are some tell tale signs of diabetes type 1 and type 2?
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obesity, family history and acanthosis nigricans may indicate type 2
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Which type of diabetes produces more insulin?
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type II has more insulin - remember that type 2 is insulin resistance and type I has no insulin coming out
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What test can detect how much insulin you produce?
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C-Peptide
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How does type 1 diabetes usually present?
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acute illness and results in diabetic ketoacidosis (DKA) due to lack of insulin
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What are the characterisitcs of DKA?
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hyperglycemia
ketoacidosis dehydration electrolyte imbalance |
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What number is hyperglycemia?
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over 300 blood sugar
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What types of situation would you expect to find a diabetic in a hyperglycemic state?
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new diagnosis
illness and infection mismanagement of sick days too little insulin or omission of insulin stress |
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What are some signs and symptoms of hyperglycemia/DKA?
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polyuria, polydypsia, polyphagia
weight loss, dehydration blurred vision n/v, abdominal pain Kussmaul respirations (fast/deep) Acetone (fruity) breath Weakness, lethargy, mental changes, decreased reflexes |
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With low insulin, what happens to the muscles?
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sugar does not get to the muscle, so muscle starts breaking down fat for energy, producing ketones which are STRONG ACIDS.
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What is the kidney's situation with ketones?
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Kidneys work to eliminate the sugar and the ketones from the blood....you would check ketones if bs is over 300
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How quickly can profound dehydration and electrolyte depletion happen from insulin deficiency?
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12-24 hours
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If BS is over 300, what are the interventions?
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FLUIDS !!!! Push IV fluids if can't drink
Ketone testing Rapid acting insulin |
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What is the purpose of the fluids during hyperglycemia/DKA/BS over 300?
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hydration reduces blood sugar concentration and insulin shuts off the fat breakdown process which lowers ketones
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What is the purpose of insulin and water during hyperglycemic event?
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fluid reduces blood sugar concentration and insulin stops the ketones from being made from fat breakdown...
insulin + fluids = no ketones |
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What is basic idea for insulin replacement?
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insulin has to be balanced with food intake (especially carbs) and physical activity
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What is common with type 1 diabetics after initial treatment?
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honeymoon phase
2 weeks to 2 years requiring reduced insulin dosages |
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How much of the total dose may be used for basal insulin?
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50%
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What is blood glucose target for children aged:
0-4 years 5-11 years over 11 years |
0-4 years 80-200
5-11 years 80-180 over 11 years 80-150 **infants and toddlers have a higher target because they can not verbalize the s/s of hypoglycemia |
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Where are injection sites for children for insulin?
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legs, arms, buttocks; the abdomen may be used as the child gets older and has subcutae
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Which insulin is peakless?
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Lantus...you can eat whenever
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Which insulin is rapid?
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Humalog, Novolog
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What type of reaction is NPH insulin?
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intermeditate/long acting
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Ideally, when should you give insulin?
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15-20 minutes before a meal
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What is the basal/bolus thing for insulin therapy standing orders?
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bolus insulin for carbs and bs correction
basal insulin for background 24 hour coverage Eventually will be close to a 50 50 split between basal and bolus |
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Basal insulin is usually what kind? given when?
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basal insulin for background insulin
bedtime Lantus |
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What are the examples of carb groups?
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carb=carb=carb
starch group=fruit group=milk group |
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What is the most frequently used med to increase insulin sensitivity in type 2 diabetes in kids?
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metformin or Glucophage
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What is blood glucose level for hypoglycemia?
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70
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What are the signs and symptoms of low blood sugar?
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hunger
shakiness diziness sweatiness fast heart beat drowsiness feeling irritable, sad or angry nervousness pallor |
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What will exercise do to blood sugar levels?
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lower it. when you are active you can eat anything you want....almost.
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What are the treatments for hypoglycemia?
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2-4 glucose tabs
4 ounces of apple or orange juice 4-6 ounces of soda 4-8 lifesavers 2 tablespoon of raisins 3-4 teaspoons of sugar or syrup 1 cup low fat milk 1 tube of cake gel |
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What is medical treatment for hypoglycemia?
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Glucagon
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What is main intervention to remember when administering Glucagon (which is IM)?
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lay patient on side b/4 administration b/c they will puke
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What are the three situations that can cause hyperglycemia?
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Too little insulin
Too much food Too little exercise |
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When someone is ill or has a cold, what is situation with insulin?
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They may need more insulin b/c they are hyperglycemic
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What are s/s of hyperglycemia?
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frequent urination
extreme hunger extreme fatigue unusual thirst irritability blurred vision |
