Diabetes
Obesity, hyperlipidemia, and hypertension are _______ risk factors
modifiable
The main goal of diabetes treatment is to normalize insulin activity and blood glucose levels to reduce the development of vascular and _______________ complications.
neruopathic
Gestational diabetes, Age, and ethnicity are _________ risk factors
non-modifiable
A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called:
polyphagia
Classic clinical manifestations of diabetes include polyuria, polydipsia, and __________________.
polyphagia
Three 'Ps' of Diabetes
polyuria, polydipsia, polyphagia
What is the purpose of the HgbA1c measures fasting blood glucose levels measures total cholesterol levels in the blood reflects the average blood glucose levels over 2 to 3 months reflects kidney function over 2 to 3 months
reflects the average blood glucose levels over 2 to 3 months
Diagnostic Criteria for: 2-hour postload glucose test
≥ 200 mg/dL
Diagnostic Criteria for: Casual Plasma Glucose
≥ 200 mg/dL
Diagnostic Criteria for: A1C
≥ 5.5%
_____ is a progressive process with the end result of gradual tissue destruction and loss of kidney function.
Renal insufficiency
Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)?
Presence of islet cell antibodies
The client with diabetes asks the nurse why shoes and socks are removed at each office visit. The nurse gives which assessment finding as the explanation for the inspection of feet?
Sensory neuropathy
This type of diabetes is related to genetics or immunologic or environmental factors and is most commonly diagnosed before age 30
Type 1
most are diagnosed by DKA
Type 1
Clinical manifestations of LADA shares the features of ________
Type 1 and Type 2 Diabetes
The three main clinical features of diabetic ketoacidosis are hyperglycemia, dehydration with electrolyte loss, and _______________.
acidosis
Type ___ may have sudden weight loss, nausea, vomiting or abdominal pain
1
An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:
10 to 15 g of a simple carbohydrate.
Normal range for Fasting Plasma Glucose: Pre Diabetic
100-125
What is the Fasting plasma glucose level for the diagnosis of diabetes? 120 mg/dl 126 mg/dl 128 mg/dl 130 mg/dl
126 mg/dl
A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. ______________ is most likely to accompany this blood glucose level?
Rapid, thready pulse
What is the duration of regular insulin?
4 to 6 hours
A1C expected range
4-6%
What is the A1C range of Pre-Diabetes
5.7-6.5
_____ of pre-diabetic patients will become diabetic in 5-10 years
50%
The American Dietetic Association recommends that for all levels of caloric intake, the percentage of calories from carbohydrates should not exceed _________%.
50-60
The nurse expects that a type 1 diabetic patient may receive what percentage of his or her usual morning dose of insulin preoperatively?
50-60%
If a patient is on TPN or enteral nutrition, they should be finger sticked every ___ hours
6
Normal range for Fasting Plasma Glucose: Non Diabetic
70-99
How many hours should the patient fast prior to the plasma glucose reading? 4 hours 8 hours 10 hours 16 hours 24 hours
8 hours
What is the target A1C for patients with diabetes
< 7%
Secrete glucagon; stimulates liver to release stored glucose
Alpha
Islets of Langerhans has 3 cell types
Alpha, Beta, & Delta
In the presence of ______, a false decreased hemoglobin A1C can exist
Anemia
You cannot be on _________ meds while pregnant because they cross the placenta
Antidiabetic
secrete insulin; promotes the movement & storage of fat, protein & carbohydrate
Beta
fatigue, weakness, vision changes, tingling or numbness in hands or feet, dry skin, skin lesions or wounds that are slow to heal and recurrent infections are _____________ ______________ of Diabetes
Clinical Manifestations
A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?
Coma, anxiety, confusion, headache, and cool, moist skin
Exercise lowers blood glucose levels. Which of the following is the incorrect physiologic reasons that explain this statement. Increases lean muscle mass Increases resting metabolic rate as muscle size increases Decreases the levels of high-density lipoproteins Decreases total cholesterol Increases glucose uptake by body muscles
Decreases the levels of high-density lipoproteins
Work on GI tract, slows down absorption; inhibit gastric secretion (somatostatin)
Delta
True or False Latent Autoimmune Diabetes of Adults is reversible with changes in diet and lifestyle
False
True or False Type 1 diabetes, which affects approximately 90% to 95% of people with the disease, is characterized by insulin resistance and impaired insulin secretion.
False
True or False glargine insulin can be mixed with any other type of insulin.
False
In Which body system do the most common side effects of Metformin occur? Genitourinary Neurological Gastrointestinal Musculoskeletal
Gastrointestinal
Slows down how you absorb glucose
Gastrointestinal
_____ diabetes occurs during pregnancy and usually occurs during the second or third trimester
Gestational
Secretion of placental hormones causes the insulin resistance
Gestational Diabetes
Glucose latches onto _______, hence why it stays for about 120 days
Hemoglobin
A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which condition when caring for this client?
Hypoglycemia
Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis?
Hypokalemia and hypoglycemia
What is the primary goal for Diabetic patients
Keep blood glucose levels as close to normal as possible
By products of fat break down that accumulate in blood and urine
Ketones
_____ show a deficiency of insulin
Ketones
A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? Select all that apply. Ketosis-prone Little or no endogenous insulin Obesity at diagnoses Younger than 30 years of age Older than 65 years of age
Ketosis-prone Little or no endogenous insulin Younger than 30 years of age
Treated with oral treatments for type 2 diabetes for a certain period of time and then insulin
Latent Autoimmune Diabetes of Adults (LADA)
hyperglycemia; detection of a low C-peptide and raised antibodies against the islets of Langerhans.
Latent Autoimmune Diabetes of Adults (LADA)
nutritional therapy, exercise, monitoring blood glucose levels, monitoring complications, education, foot care, and pharmacological therapy, which may include oral anti-diabetic agents or insulin
Management of diabetes
Dementia, Cancer, Polycystic Ovarian Syndrome, and non-alcoholic fatty liver disease are complications of
Metabolic Syndrome
A cluster of the following symptoms; hypertension, hypercholesterolemia, abdominal obesity, and high fasting glucose levels
Metabolic syndrome
Symptoms of _______ are heart disease, lipid problems, hypertensions, Type 2 (also 1) Diabetes
Metabolic syndrome
Stores glycogen
Muscles & Liver
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?
NPH
A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia?
Nervousness, diaphoresis, and confusion
Organs involved in Blood sugar
Pancreas Liver Muscles Gastrointestinal
Increased thirst
Polydipsia
Increased appetite
Polyphagia
Increased urination
Polyuria
Taking ______ can raise Blood Sugar
Steroids
_______ _________ raise blood glucose levels and interfere with the blood glucose lowering effects of insulin
Stress hormones
A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia?
Sweating, tremors, and tachycardia
True or False "You should take your insulin after you eat breakfast and dinner." is a proper Health teaching for a patient with diabetes who is prescribed Humulin N, an intermediate NPH insulin
True
True or False Antidiabetic drugs are Teratogenic
True
True or False Exercise lowers blood glucose by increasing the uptake of glucose by body muscles and improving how the body uses insulin
True
True or False Latent autoimmune diabetes of adults (LADA) is a subtype of diabetes in which progression of autoimmune beta-cell destruction in the pancreas is slower than in types 1 and 2 diabetes.
True
True or False Metformin may cause nausea, vomiting, abdominal pain, diarrhea, and bloatedness
True
True or False Proliferative retinopathy, a diabetic microvascular disease, represents the greatest threat to vision; it is characterized by the proliferation of new blood vessels growing from the retina into the vitreous.
True
True or False Regular insulin is a rapid-acting insulin that has a duration of 4 to 6 hours.
True
True or False The rising ketones and acetone in the blood can lead to acidosis and be detected as a fruity odor on the breath.
True
True or False The short-acting insulin is withdrawn before the intermediate-acting insulin.
True
True or False Urine testing may not be accurate due to higher renal threshold for glucose. So glucose levels can be higher before glucose spills into the urine
True
True or False When mixing a short-acting insulin and a longer-acting insulin, the ADA recommends the regular insulin be drawn up first.
True
True or False When you are sick your body is under stress which releases epinephrine, norepinephrine, glucagon, cortisol, and growth hormone
True
True or False glargine has no peak action and does not cause a hypoglycemic reaction.
True
True or False the action of insulin in the body is: It enhances the transport of glucose across the cell membrane.
True
Can be hereditary Autoimmune Environmental factors
Type 1
Is the result of Beta cells failing
Type 1
Pancreas is not producing insulin and must take insulin injection
Type 1
Can take an oral antidiabetic
Type 2
If not under control, beta cells can become destroyed
Type 2
Insulin resistance and impaired insulin secretion
Type 2
The greatest percentage of people have which type of diabetes?
Type 2
This type of diabetes is diagnosed in people over the age of 30 and is most commonly related to obesity, heredity, and environmental factors
Type 2
need to stimulate beta cells
Type 2
A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason? increased risk for urologic complications need for exocrine enzymatic drainage underlying problem of insulin resistance need for lifelong immunosuppressive therapy
Underlying problem of insulin resistance
Hoe to test for ketones
Urine dipstick
The __________ phenomenon is an example of morning hyperglycemia that is characterized by a relatively normal blood glucose level until approximately 3:00 AM when blood glucose levels begin to rise.
dawn
The following are risk factors for: Family history, obesity, age (less than 30 years for type 1 & greater than 30 years for type 2(, hypertension, history of gestational diabetes, delivery of babies over 9 pounds and altered HDL cholesterol or triglyceride levels
diabetes
Sick Day Management: if Blood Sugar is below target _______
drink fluids with glucose
Glucose metabolism: blood glucose levels spike more rapidly and take longer to return to normal in the __________
elderly
