Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Diabetes.Type1&2
| Question | Answer |
|---|---|
| Where is 60% of glucose stored? | Liver |
| Where is 40% of glucose stored? | Fat |
| Where do glycogenolysis and gluconeogenesis occur? | Liver |
| In what form does the body store glucose? | As glycogen |
| Process where glycogen converted back into sugar (glucose) to give body energy | Glycogenolysis |
| Process where glucose is made from non-carbohydrate sources such as protein and fats (amino acids, lactates) | Gluconeogenesis |
| 2 features of pancreas | Exocrine and endocrine |
| Exocrine function of pancreas | Secretes enzymes for digestion (amylase and lipase) |
| Location of endocrine activity in pancreas | Islets of Langerhans |
| 3 Types of cells in Islets of Langerhans | Alpha, Beta and Delta |
| Function of Alpha cells | Secrete glycogen |
| Function of Beta cells | Secrete insulin |
| Function of Delta cells | Secretes gastrin |
| Approximately how much insulin do Beta cells produce daily? | 35-50 units |
| Anabolic hormone that regulates metabolism and storage of carbs, fats and proteins | Insulin |
| How does glucose exit the bloodstream and enter cells? | Via insulin |
| What does insulin signal for once blood sugar levels are at a safe level? | Signals liver to stop release of glucose |
| What are some counterregulatory hormones that oppose the effects of insulin? | Epinephrine, cortisol, glucose, growth hormone |
| How is blood sugar homeostasis maintained? | Insulin and counterregulatory hormones |
| What does the pancreas do during fasting periods? | Releases basal insulin |
| What do Alpha cells do during fasting periods (due to low bloood glucose)? | Release glucagon/glycogen |
| What is the action of glucagon during fasting periods? | Stimulates liver to release stored glucose |
| Other names for Diabetes Mellitus | Type I, juvenile onset, IDDM |
| 2 Causes of DM | Abnormal insulin production, impaired insulin utilization |
| What lab values constitute hypoglycemia? | >110 |
| What other scenario can cause hypoglycemia other than diabetes? | Pt on steroids |
| What happens to glucose if there is a lack of insulin? | Not transported into cells - Remains in bloodstream |
| What does the body breakdown when there is a lack of insulin (low glucose levels in cells)? | Breakdown of glycogen from liver and muscle |
| What does the breakdown of fats lead to? | Ketones in the urine and increased triglycerides which diabetics cannot breakdown |
| What is oral or diet controlled diabetes called? | Type II Diabetes |
| What is the term for hyperglycemia induced by meds or another disease? | Secondary diabetes |
| What are two common symptoms of DM? | Polyuria, polydypsia |
| True/False: All DM pt.s require injected insulin source (exogenous)? | True |
| Rapid, acute onset is usually found in which type of diabetes: I or II? | Type I |
| Etiology of DM | Autoimmune destruction of beta cells |
| What are 2 risk factors for development of DM | Virus that destroys B cells or genetic predisposition |
| What are the 3 Ps experienced in the rapid, acute onset of DM? | Polyuria, polydypsia, polyphagia |
| What is another common symptom of DM at onset? | Rapid weight loss |
| Why is urinary output increased with DM? | Glucose is pulling water from cells into bloodstream causing fluid excess |
| Why is thirst increased with DM? | Water being pulled out of the cells and excreted |
| What is the TEMPORARY remission of DM that occurs soon after treatment begins? | Honeymoon period |
| What labs will be elevated due to target organ damage with prediabetes? | BUN and Creatinine |
| Most common type of diabetes | Type II |
| Most common risk factor for type II diabetes | Obesity |
| Pathophysiology of type II diabetes | Beta cells do not produce enough insulin and it is poorly utilized |
| 2 main metabolic abnormalities in type II diabetes | Insulin resistance and decreased B cell insulin production |
| Collection of risk factors for development of type CV disease and diabetes (3 of 5 must be present) | Metabolic syndrome |
| 5 risk factors for metabolic syndrome | Central obesity, elevated triglycerides, low HDL cholesterol, elevated fasting glucose, diagnosed HTN |
| What lab values indicate elevated triglycerides? | 150< mg/dl |
| What value constitutes elevated blood glucose? | Greater than or equal to 100 mg/dl |
| What is the onset like for type II diabetes? | Gradual, progressive, often asymptomatic |
| S&S of type II diabetes | Fatigue, irritability, impaired wound healing, yeast infections, visual disturbances as well as the s&S for type I (3 P's) |
| What is the criteria for diagnosing diabetes with fasting plasma glucose levels(FPG)? | Greater than or equal to 126 mg/dl |
| What is the criteria for diagnosing diabetes with random plasma glucose level(RPG)? | Greater than or equal to 200 mg/dl plus diabetes S&S |
| What is the criteria for diagnosing diabetes with the 2 Hr glucose tolerance test(OGTT)? | Greater than or equal to 200 mg/dl |
| **For FPG, what levels are normal and what indicates prediabetes and diabetes? | Normal: <100 Prediabetes: 100-125 Diabetes: 126 and above |
| **For OGGT, what levels are normal and what indicates prediabetes and diabetes? | Normal: <140 Prediabetes: 140-199 Diabetes: 200 and above |
| What test measures the glucose attached to Hgb and determines glucose control over a 3 month period? | Glycosylated hemoglobin (Hgb A1C) |
| Is the A1C used to diagnose diabetes? | No. Only used to change med regimens and assess compliance. |
| What level is goal for A1C? | Less than or equal to 7 |
| Are type II diabetics given insulin? | Only as short term treatment. If pt progresses to needing insulin, they have become type I. |
| Pancreas provides _______ insulin, while injecting insulin is ________. | Endogenous, exogenous |
| **Exogenous insulin is based on what 3 factors? | Onset, peak, duration |
| **What are the 4 types of exogenous insulin? | Rapid-acting, short-acting, intermediate-acting and long-acting |
| What color is rapid acting insulin? | Clear |
| What are the 3 types of rapid acting insulin? | Lispro (Humalog Aspart (Novalog) Glulisine (Apidra) |
| What is the onset, peak and duration of rapid acting insulin? | Onset: 15 minutes Peak: 60-90 minutes Duration: 3-4 hrs |
| When is rapid acting insulin given? | Typically with meals |
| What are the 2 types of short acting insulin (AKA Regular)? | Humulin R Novolin R |
| What color is short acting or regular insulin? | Clear |
| What is the onset, peak and duration of short acting or regular insulin? | Onset: 1/2-1 hr Peak: 2-3 hrs Duration: 3-6 hrs |
| What is the only type of insulin that can be given IV? | Short acting or regular |
| What are the 2 types of intermediate acting insulin or NPH? | Humulin N Novolin N |
| What color is NPH insulin? | Cloudy |
| What is the onset, peak and duration for NPH insulin? | Onset: 2-4 hrs Peak: 4-10 hrs Duration: 10-16 hrs |
| When is NPH typically given? | In the AM and BID |
| What can you mix NPH insulin with? | Rapid and short acting insulin |
| What is basal insulin? | The standard dose you take daily: NPH or long acting. Short and rapid are given on a sliding scale to cover breakthrough levels throughout the day. |
| What is another name for long acting insulin? | Glargine (Lantus) |
| What color is long acting insulin? | Clear |
| What is the onset, peak and duration of long acting insulin? | Onset: 1 hr Peak: No peak Duration: 24 hrs |
| What are 2 disadvantages to long acting insulin? | Can't be mixed with other insulins and can't be prefilled in a syringe. |
| What types of insulins are mixed in the same syringe for combination therapy? | Short or rapid mixed with NPH Humulin or Novolin 70/30 30% R and 70% N |
| How are 100 unit insulin syringes measured? | In 10's |
| How are 50 unit insulin syringes measured? | In 5's |
| Where is the best location to use insulin pens? | ABD |
| What is manifested by nocturnal hypoglycemia followed by morning hyperglycemia and how is it managed? | Somogyi effect- ensure nighttime snack |
| What is manifested by hyperglycemia that is present upon awakening due to release of growth hormone and how is it managed? | Dawn phenomenon- Give evening dose of NPH |
| What types of insulin are used in insulin pumps? | Rapid or short acting |
| How do you store unopened insulin? | Refrigerate |
| How do you store opened insulin? | Room temperature |
| When do you discard insulin? | After 30 days |
| What is one complication with oral agents used in drug therapy for diabetics? | Tolerance can build and dose needs adjusted |
| What is the first line oral agent for type II diabetes? | metformin (Glucophage) |
| What complication can occur with metformin? | Kidney failure |
| What oral agent has a black box warning due to high rate of heart failure or MI? | Avandia (ploglitizone, rosiglitizone) |
| What is a significant dual effect of metformin aside from regulating blood sugar? | Lowers triglycerides and cholesterol |
| What scale measures the rise in blood glucose after consumption of CHO? | Glycemic index |
| What percentage of daily intake should consist of fats? | 25-30% |
| How many grams of CHO does 1 unit of insulin handle? | 15g |
| How does exercise benefit diabetics? | Increases insulin receptor sites in tissues |
| What values constitute acute hypoglycemia? | <70 |
| S&S of hypoglycemia from mild to severe | Sweaty, tremors, confusion, unresponsive |
| What is the rule of 15's for hypoglycemia? | Give 15g simple CHO (OJ, milk, crackers) and recheck glucose in 15 minutes |
| What are the two severe types of hyperglycemia? | DKA and HHNS |
| Which type of hyperglycemia is prevalent in type I diabetics, and is accompanied by ketones and Kussmaul respirations? | DKA |
| What type of hyperglycemia is prevalent in type II diabetics, with blood sugar greater than 400 and manifests in neurologic symptoms? | HHNS (Hyperosmolar hyperglycemic nonketotic syndrome |
| What is an example of a macrovascular angiopathic complication of diabetes? | Stroke/CVA |
| What is an example of a microvascular angiopathic complication of diabetes? | Nerve damage |
| What type of angiopathic complication can result in amputations? | Macrovascular (peripheral vascular disease) |
| What type of angiopathic complication can result in retinopathy and nephropathy? | Microvascular- Leading causes of blindness and ESRD in diabetics |
| What type of diabetic is more at risk for nephropathy and how is it managed? | Type I: With ACE inhibitor therapy ('pril's) |
| 2 most common nursing diagnoses for diabetics | Knowledge deficit and Risk for injury/infection |
| Compare and contrast hypo/hyperglycemia | Hypo Hyper Cool,clammy skin Hot, dry skin Sweating No sweating Anxious,irritable Stuporous |
Created by:
mm318
Popular Nursing sets