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Diabetes Test Study
Study Guide
| Question | Answer |
|---|---|
| Hypoglycemia is caused by | Abnormal low blood glucose level (<60mg)Causes: too much insulin or hypoglycemic agents, too little food and excessive physical activity |
| Hyperglycemia is caused by | elevated blood glucose level >110mg: Causes: not enough insulin,eating too many carbohydrates, eating too many calories, infection,Increased stress,strenuous physical activity |
| Glycemic index describes what? | How much a given food increases the blood glucose level |
| Foods high on the glycemic index will raise your blood sugar fast or slow? | Raise it faster, carbohydrates,simple sugars |
| Foods low on the glycemic index will raise your blood sugar faster or slower? | Raise it slower, complex carbohydrates, proteins, sugar free |
| What is the treatment for a patient with hypoglycemia if they are unconscious? | Sub Q or IM glucagon 1mg; 25-50ml 50% dextrose solution IV |
| What is the treatment for hypoglycemia if they are conscious? | treatment is immediate 15g of fast acting concentrated carb;3-4 glucose tabs;4-6 oz juice or regular soda;6-10 hard candies; 2-3 tsps of honey; Retest blood sugar in 10-15 min |
| What are the 3 P's pf diabetes? | Polyuria-excessive urination 2)Polydipsia-excessive thirst 3)Polyphagia-excessive hunger |
| Polyuria | blood sugar levels rise, body tries to get rid of excess sugar by passing it in the urine |
| Polydipsia | bloodstream is concentrated with "glucose", so now your body's thirst mechanism kicks in |
| Polyphagia | occurs because the glucose is in the bloodstream and not inside the cell where it needs to be, due to lack of insulin |
| How does stress/illness affect your blood sugar? | Increases blood sugar, adrenal and cortisteroids. Epinephrine is released into your bloodstream attaches to the Alpha and Beta receptors of organs |
| How do you educate you pt if they are ill in relation to blood sugar checks and insulin dose? | Drink more fluids, Check BS more often, Call MD if still feeling bad |
| A1C (HbA1C) is a test of what? | it is the average blood glucose over the past 3 months |
| A1C normal results | 4-5.9% is a normal result |
| What raises your blood sugar the fastest? | 50ml50% glucose IV- Glucose raises your blood sugar the fastest |
| Exercise has what effect on blood sugar? | lowers blood sugar;with consistant exercise they can decrease insulin injections because it will increase the insulin receptors sensitivity and the body will start making insulin on its own. |
| What items should a diabetic carry with them in case of a hypoglycemic or hyperglycemic emergency? | Hypo-glucose tabs,oj or regular soda,hard candies, glucagon injector. Hyper-water or some type of electrolyte replacement; |
| DKA(diabetic ketoacidosis) | Life threatening condition occuring in TypeI, resulting in metabolic acidosis, Excess amount of ketones lowers the pH and anything lower than 6 cannot sustain life(this occurs when there is no insulin for a period of time) |
| S/S od DKA | Anorexia,headache,fatique; Progressive-3P's, Increased respirations,fruity breath;Late-Kussmals |
| Causes of DKA | Undiagnosed Diabetes,pt doesn't take enough insulin,pt w/uncontrolled diabetes TypeI, too much exercise, stress |
| Treatment of DKA | 1) Rehydration with IV fluid 0.9% NaCl-eliminates excessive glucose 2)COntinuous infusion of regular insulin 3)reverse acidosis and restoration of electrolyte balance |
| What do you expect to see with a pt respirations in DKA? | Increased respirations-because of the acidosis; Kussmals-deep |
| Which electrolyte would you need to assess in DKA? | Potassium-hyperkalemia;Na deficiency |
| When insulin is given to a pt with DKA what would you assess? | Potassium-Hypokalemia-cardiac arrythmias |
| What route is glucagon given? | SQ or IM= emergency or unconscoius diabetic patient. It will make the liver release glucose into the bloodstream. Medical attention within 90 minutes.Regain consciousness. |
| Nursing assesment for a pt that has not eaten in a few days would be? | Hypoglycemic,nervousness, sweating,intense hunger,trembling,weakness and palpitations. The body is starving, and there isn't enough available glucose, so fat will burn for energy and the by-product, ketones, may show in the urine or blood |
| What are the S/S of Hyperglycemia? | Polydipsia,Polyuria,Polyphagia,blurred vision,weakness,lethargy,malaise,N/V,gastroperesis |
| What are the S/S of Hypoglycemia? | Tachycardia,shakiness,nervousness,irritability,anxiety,lightheadedness,hunger,tingling or numbness of lips or tongue, diaphoresis |
| Nephropathy | diabetes is the most common cause of renal disease;renal impairment due to renal disease;damage to vessels that supply the filtering system of the nephrons |
| S/S of Nephropathy | protenuria,HTN,progressively impaired kidney function,hematuria,oliguria, anuria, BUN>20,weight gain, edema,low O2sats,crackles |
| Foot care in diabetics-the do's and don'ts | 1)Inspect your feet everyday 2)Make sure that your MD checks your feet at least once a year 3) call your MD if you have cuts or breaks in the skin, or have an ingrown nail 4)tell MD if your foot changes shape, color, or just feels different. |
| Foot care | Corns and calluses should be trimmed by MD 2) MD can also trim your toenails if you cannot do it safely 3)Wash yor feet daily, dry carefully;especially between toes;Keep skin smooth and soft, apply lotion on tops and bottoms of feet but not on toes. |
| Foot care | Trim toenails straight across;Wear shoes and socks at all times; Do not go barefoot;Protect feet from hot and cold; Do not put feet in hot water; Keep blood flowing in your feet; Do not smoke!! |
| (NCS) diet | no concentrated sweets |
| (NCS) diet | is the simplest dietary approach.This diet eliminates all concentrated sources of "sugary" foods, such as cake, cookies, ice cream,and table sugar |
| “ADA diet-American Diabetes Association | The ADA does not even endorsethe “ADA diet”; it no longer recommendsany single meal plan or any specifiedpercentages of macronutrients for people with diabetes. |
| DKA Fat metabolism | fats are broken down in FATTY ACIDS-which causes meatabolic acidosis |
| DKA causes you to be: | Hypertonic-pulls water into teh blood stream, which increases the blood volume, pee more, then become dehydrated |
| As a diabetic if you are exercising | Eat before you exercise- low on glycemic index |
| First thing to assess in a pt with DKA? | Potassium level, heart |
| Lack of insulin | Hyperglycemia |
| Lack of glucagon | Hypoglycemia |
| Why does a patient get Polyphagia? | Because their cells are starving for fluids and glucose |
| If you found a diabetic unconscious what would you do? | Assess them/ take their blood sugar |
| Glucagon is a what? | It is a hormone, not a sugar |
| What is one thing a diabetic should avoid as far as eating? | Simple sugars |
| When taking a blood sugar reading, what should you not do to the finger and why? | You should not milk the finger, because it will dilute the BS reading |
| What is the first thing that you do as a nurse? | ASSESS!!! |
| What is a postive result after giving a pt a glucagon injection? | The patient wakes up! |
| What happens to your blood sugar when you have a lack of insulin or glucagon? | Blood sugar goes up. DKA-no insulin-glucose has no way of gettin into the cells;Hyperglycemia occurs |
| What are the risk factors for Diabetes? | Obesity, sedentary lifestyle,family history of DM, age 40 and older,History of Gestational DM,History of 10lb baby,African-American(33%) |
| Complications of Diabetes | arterial problems,intermittent clauddication;retinopathy;nephropathy;decreased wound healing;amputations;neuropathy |
| Arterial Problems | heart & arteries at risk. Hyperglycemia affects arteries-sugar forms plaque in your veins and arteries |
| Macrovascular Complications-CAD,PVD,CVA | happen when atherosclerosis changes are accelerated by DM |
| Intermittent Claudication | blood supply of the legs are blocked, muscles do not get enough blood |
| Intermittent Claudication S/S | painful,cramping sensation,affects the calf muscles,but may also affect the thighs or buttocks depending on blockage |
| Retinopathy | changes in the retina that are associated with diabetes |
| Retinopathy S/S | can lead to blindness;has no early warning signs;2 forms of retinopathy;both may be present at same time |
| Nonproliferative | small hemorrhages in the retina |
| Proliferative | growth of abnormal capillaries on the retina |
| S/S of both | vessels can penetrate the vitreous humor and rupture,hemorrhaging cauases it to become cloudy and vision is lost, gloucoma, scarring |
| Nephropathy | renal impairment due to renal disease |
| Nephropathy S/S | proteinuria;urinary output<30ml;hematuria;oliguria;anuria;BUB>20;edema;crackles;low O2 sats |
| Decreased wound healing | poor circulation, nerve damage, immune system issues,infection |
| Amputations | Necrotic tissues, death of a limb,arterial bloodflow is not going to the limb |
| Diabetic Neuropathy | nerve damage,damage to the tissue |
| Mononeuropathy | Single nerves;inadequate blood supply |
| polyneuropathy | involves both sensory and autonomic nerves |
| Autonomic Neuropathy | affects the sympathetic & parasympathetic. Can affect functions of cardio, GI,GU systems |
| The Pancreas is? | a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon. |
| The Pancreas is? | as well as an exocrine gland, secreting pancreatic juice containing digestive enzymes that pass to the small intestine. These enzymes help in breakdown of the carbohydrates, protein, and fat in the chyme. |
| Alpha cells in the Islets of Langerhans? | Within the pancreas, the alpha cells are located in areas called the islets of Langerhans. Alpha cells make and release glucagon which raises the level of glucose (sugar) in the blood. |
| Beta cells in the Islets of Langerhans? | A type of cell in the pancreas that makes insulin. Degeneration of the beta cells is the main cause of type I (insulin-dependent) diabetes mellitus. |
| Hyperglycemia | or high blood sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood glucose level of 10+ mmol/L (180 mg/dl) |
| Hypoglycemia | is a condition that occurs when your blood sugar (glucose) is too low. |
| What is Insulin? | is a hormone. And like many hormones, insulin is a protein.Insulin is secreted by groups of cells within the pancreas called islet cells. The pancreas |
| Oral Hypoglycemics | Oral hypoglycemic drugs are used only in the treatment of type 2 diabetes which is a disorder involving resistance to secreted insulin. Type 1 diabetes involves a lack of insulin and requires insulin for treatment. |
| Glucagon | is an important hormone involved in carbohydrate metabolism. Produced by the pancreas, it is released when blood glucose levels start to fall too low |
| Glucagon | The action of glucagon is thus opposite to that of insulin, which instructs the body's cells to take in glucose from the blood. However, glucagon also stimulates the release of insulin |
| Glycogen | is the body's main source of stored energy.Made from glucose (from excess carbs), glycogen is stored primarily in liver and muscle cells. It is stored with water, in the ratio 1 gram of carbohydrates to 3 grams of water. |
| Ketones | are a by-product/or waste product when your body burns stored fat for energy. Ketones can be measured in the urine with a visually read strip |
| If you don't eat for several days | the stored glucose in the liver is depleted, and your body is in a starvation state. In this situation, the body will break down stored fat to get energy, (and ketones can show in the urine, indicating that fat was burned) |
| Fasting is when you | is primarily the act of willingly abstaining from some or all food, drink, or both, for a period of time. A fast may be total or partial concerning that from which one fasts, and may be prolonged or intermittent as to the period of fasting. |
| Post-prandial | means after eating a meal |
| Fasting blood glucose level | specifically before eating anything in the morning must be between 70mg/dl and 99 mg/dl. If it is126mg/dl or higher then it means that person is suffering from diabetes. |
| Post-prandial blood sugar | means "after a meal." For people with diabetes, it refers to blood glucose measurements taken 1-2 hours after a meal |
| Random blood sugar | measures the blood glucose level any time of day without regard to drinking or eating |
| Diabetic ketoacidosis | is a complication of diabetes that occurs whensugar (glucose) is not available as a fuel source by the body and fatis used instead. Byproducts of fat breakdown, called ketones |
| kussmaul's respirations | Kussmaul breathing is respiratory compensation for a metabolic acidosis, most commonly occurring in diabetics in diabetic ketoacidosis. ... |
| Glucosuria | is the excretion of glucose in the urine in the presence of normal blood glucose levels. |
| Glucosuria | The inherited form usually involves a reduction in the glucose transport maximum (the maximum rate at which glucose can be resorbed) and subsequent escape of glucose in the urine. |
| Ketonuria | A condition in which abnormally high amounts of ketone bodies (a byproduct of the breakdown of cells) are present in the urine. |
| Lipodystrophy | A lipodystrophy can be a lump or small dent in the skin that forms when a person keeps performing injections in the same spot. To avoid them rotate the injection site. |
| Lipohypertrophy | is a medical term that refers to a lump under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin. It may be unsightly, mildly painful |
| Alpha cells secrete GLUCAGON when | blood glucose decreases (raise your blood sugar) |
| Beta cells secrete INSULIN when | blood glucose increases (lowers your blood sugar) |
| What is the most important action of the Pancreas? | Assist in glucose transport |
| Insulin is said to have a hypoglycmeic effect | it causes glucose to leave the blood and serum glucose to fall-Lowers your blood sugar |
| When insulin is absent,glucose remains where? | In your bloodstream |
| Type I DIABETES | Oral Hypoglycemics are not effective, they need insulin injections |
| People with Type II are usually overweight why? | Pancreas is working OT,can't keep up |
| Ketones | Are waste products of fat metabolism |
| Why can insulin not be given orally? | it is rendered usless in the gastrointestinal tract |
| All insulins can be given how? | Subqutaneous(SQ) |
| What is the only insulin that can be given by IV? | Regular Insulin (short-acting HumulinR,Novolin R) |
Created by:
vlgerard10
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