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26 Cards in this Set

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normal A+P of the upper
GI tract and endocrine
system related to diabetes
The pancreas is a large organ
located behind the stomach.
W/in the pancreas are the
islets of Langerhans which are
hormone-producing tissue. 2 main
hormones=Insulin (beta) and
Glucagon (alpha). When the
quantity of glucose in blood is sufficient,
the excess is stored as glycogen
in the liver, skeletal
muscle and tissues. When
blood glucose is needed the
glycogen is converted back to
glucose thru glycogenolysis.
Hormone respons fo initiating
this is glucagon.
Discuss incidence,
predisposing factors of DM
Incidence = 17 million people
Type 1 usually under 30 years
Type 2 usually over 40 years (80-90 % overweight)
No one is sure what causes DM - overweight, HTN, autoimmune dz, age, inactive, etc
pathophys of
diabetes
When eating or drinking the
food is brken down into
glucose. Bloodstream
transports glucose from
intestines to the liver (where
it is manufactured/stored),
to where it will be used
(muscles, brain). When the
amt. of glucose in blood
reaches a certain level, the
pancreas releases insulin.
This carries glucose into
appropriate cells, which
lowers blood glucose levels.
3 methods of controlling
adult diabetes
Exercise, diet, weight control
can lead to optimal
level of glucose control
Explain relatiosnhip of
diet and exercise in
controlling diabetes
Diet=increase fiber, complex carbes - leads
to eveness in blood blucose levels.
Exercise= help weight loss,
increase circulation, increase
insulin sensitivity
Sypmtoms of
HYPOGLYCEMIA
low blood sugar <70 too much
medicine, too little food,
staggering, diaphoresis, hunger,
shakiness, confusion, HA,
weakness. pt needs sugar!
Symptoms of
HYPERGLYCEMIA
blood sugar too high >110 not
enough meds, sickness, too
much food, polydipsia,
polyphagia, polyuria, fatigue,
blurred vision, sweet
smelling breath, n/v/cp, pt
needs insulin. can resualt in
dka - coma/death
Diagnostic procedure
in care of adult onset
diabetic
to confirm dx a fasting plasma
glucose will be performed.
norm 70-110. >126 = dm.
Use of combo
hypoglycemic agents
in type 2 dm
sulfonylureas stimulate
insulin secretion help
transport glucose out of
blood. biguanids decrease
glucose production and
increase it's uptake. can be
used together.
Oral hypoglycemic purpose,
class, action, dose,
implication
antidiabetic, controls blood
glucose in type 2, lowers blood
glucose by releasing insulin, PO
varies, observe s+s of
hypoglycemia.
Regular Insulin
antidiabetic, treatmen of dm,
lowers blood glucose by
stimulating uptake. SHORT
ACTING, onset=30-60 min,
peak=2-4 hrs, duration=6-10 hrs
NPH Insulin
antidiabetic, treatment of dm,
lowers blood glucose by
stimulating uptake.
INTERMEDIATE, onset=2 hrs,
peak=6-8, duration=18
Lispro (Humalog)
anti-dm, treats dm, lowers b.s.
by stimulating uptake. RAPID,
onset=5-15 min, peak=60-90 min,
duration=4hrs
Humulin U. Ultralente
LONG ACTING, onset=4 hrs,
peak=10-30 hrs, duration=36 hrs
discuss procedure for
obtaining finger stick
to obtain b.s. wash hands, wipe
finger w/ alcohol swab, prick
side of finger pad, insert strip
into accucheck machine, fill up
window
discuss importance of
using tight control
vs conventional therapy
can prevent/slow progress of
complications due to dm.
getting as close to norm b.s.
as possible, multiple/daily
injections, maybe insulin
pump, check b.s. often
significance of fasting
blood sugar and glycosylated
hemoglobin
norm 70-110 need to know how
much glucose is in at a time.
HgbA1c gives avg blood glucose
control for last 3-4 months.
norm 5% of all Hgb is glycated.
describe site rotation
repeate use of only a few
sites can result in atrophy,
hypertrophy. lipodistrophy=
hard lumps, dents from
repeated injections. Rotate.
Fastest absorption - abd,
arm, thigh, buttock
DM
D/O of pancreas. Occurs when
the pancreas doesn't produce
any or very little insulin. Or
when the body tissues do not
respond appropriately to insulin
(resistance)
Glycogenolysis
glycogen in liver is converted
back to glucose
Gluconeogensis
makin of glucose from amino
acids, non carbs
Glycogenesis
turing glucose into glycogen
for storage in liver
Describe how DM is an
auto-immune d/o
Body starts to attck itself
(can't recognize self). attacks
beta cells of pancreas so they
cannot produce insulin.
When is the best time for
an elderly person to take
an oral hypoglycemic?
in the a.m. before breakfast
Type 1
pancreas makes little or no
insulin. beta cells are damaged.
under age 30. juvenille.
10% of people with dm, abrupt
onset
Type 2
metabolic d/o of pancreas.
some insulin, but either not enough
or cells don't use it correctly
usually at age 40, 90% of people