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41 Cards in this Set
- Front
- Back
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1 serving of carbohydrates equals how many grams?
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15
1 CHO = 15 grams of CHO |
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If a diabetic patient has unexplained high blood glucose levels, what should they suspect?
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an illness
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If a diabetic is sick, how often should they be checking their blood glucose levels?
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every 2-4 hours
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If a diabetic is so sick that they can not eat, what should they do?
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replace missed meals or snacks with 50 grams of carbohydrates
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Should a diabetic continue to take ALL of their medicine when they are sick?
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NO. Continue to take the diabetes medicine, especially insulin. DO NOT take metformin or metformin combinations if you are dehydrated or having n/v.
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What (other than checking blood glucose) should a diabetic be monitoring if they are sick?
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ketones
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How do you check ketones?
What BG reading would signal you to start checking for ketones? (sick or not) *If you are sick, you don't have to wait until you reach this level, might want to check earlier. |
urine strip...and definitely check for ketones if your blood glucose is greater than 240 or when you are sick
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This "type" of insulin is long acting and to be given either once or twice a day.
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basal insulin
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What does basal insulin mimic?
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Basal insulin mimics the action of the nonfunctioning pancreas that is characterized by small doses excreted continuously throughout the day.
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How should basal insulin NOT be used?
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It should not be given in response to current blood sugar
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List two examples of basal insulin.
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Lantus and NPH
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What situation would you want to hold or limit the amount of NPH?
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NPO patient. NPH can be given in smaller doses to a patient that is NPO.
(adjust NPH for NPO) (Leave Lantus along...just give Lantus as prescribed regardless of patient NPO status) |
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What is another name for bolus insulin?
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pre meal insulin
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Bolus insulin covers....
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the carbs they are eating, and prevents a rise in blood sugar post consumption
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Your patient takes Lantus every night. She manages her DM1 at home and includes bolus insulin. The purpose of the bolus insulin is to cover her carbohydrates. Name two "ways" she can plan how much bolus insulin she will need.
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set doses (so she eats the same amount of carbs and the insulin will remain the same)
carbohydrate counting (she counts the carbs and then covers them with her bolus insulin ***better plan) |
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List two insulins that would be given as a bolus insulin.
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Humalog
Novolog |
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State the purpose of correction insulin.
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Insulin used to lower blood sugar that is already elevated.
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List two insulins that would be given as a correction insulin.
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Humalog
Novolog Regular insulin |
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What is the sensitivity factor?
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a calculated number based on patient's BMI. The higher the BMI, the higher the insulin resistance. Remember that BMI is figured by patient height and weight.
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What does a sensitivity factor of 30 mean?
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A sensitivity factor of 30 means that 1 unit of insulin is expected to reduce the patient's blood sugar by 30
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A sliding scale for insulin calculation has these three components.
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Current blood sugar
target blood sugar sensitivity factor |
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What type of drug class is metformin? What is the Trade name?
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biguanides (insulin sensitizer)
metformin-Glucophage |
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Your patient receives metformin. How would you administer this med?
When would you inquire about "holding" metformin? |
You would administer WITH FOOD.
Stop med at time of contrast dye procedure or surgery. May resume 48 hours after procedure and once renal function proven normal by lab tests. Also, hold if nausea, vomiting or NPO. |
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Who is contraindicated to receive Avandia/Actos?
What labs would you monitor with Avandia/Actos? |
Use caution with cardiac patients due to FVE
Montior LFTs |
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In regards to footcare, most of the instructions are focused on clean, dry feet. What should a diabetic NEVER do ?
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walk barefood indoors or outdoors
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List four causes of hyperglycemia.
(simple situations, not patho) |
Too much food
too little insulin illness stress |
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What is the usual onset of hyperglycemia?
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gradual.....but can progress to a diabetic coma
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What is the glucose parameter for hyperglycemia?
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above 200mg/dl
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List the characteristics of hyperglycemia.
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extreme thirst
frequent urination dry skin hunger blurred vision drowsiness nausea |
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What are the causes of hypoglycemia?
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too little food
too much insulin extra exercise |
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What is the usual onset of hypoglycemia?
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sudden...may progress to insulin shock
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What are the s/s of hypoglycemia?
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shaking
fast heartbeat sweating anxious dizziness hunger impaired vision weakness, fatigue headache irritable |
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What is the treatment of hypoglycemia?
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15 g of CHO
(1/2 cup of orange juice) |
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After the initial treatment of hypoglycemia with the 15 grams of CHO, you notice that the symptoms have gone away. What do you NOW provide for the patient?
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light snack with peanut butter/meat and milk
(getting protein and fat) |
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Other than the three P's of DM type 1, what are additional manifestations of the disease?
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weight loss
fatigue frequent infections |
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Finish the following jingles:
Hot and Dry..... Cold and Clammy.... |
Hot and Dry=Sugar High
Cold and Clammy=Need some Candy |
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What is the usual onset of diabetic ketoacidosis?
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4-10 hours
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What is a hallmark manifestation of DKA?
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fruity breath
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List the other manifestations of DKA.
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tachycardia
hypotension acidosis high blood sugar hyperkalemia polyuria |
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What are the three treatments that are a MUST for DKA?
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hydration
insulin electrolyte replacement |
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Describe Type 1 diabetes.
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progressive autoimmune destruction of beta cells
peak incidence during puberty family history |
