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NUR 150 1
Chronic-test 1
| Question | Answer |
|---|---|
| Type 1 Features | Immune mediated/Autoimmune, complete insulin deficiency, usually before age 40, DKA |
| Symptoms-type 1 | the 3 P's; polyuria, polydipsia, polyphagia and fatigue, weight loss, irritability |
| Symptoms-type 2 | the 3 P's, fatigue, weight loss, irritability, infections/slow healing, vision changes, numbness in hands/feet, or no classical symptoms |
| Pre-diabetes FPG | 100-126mg/dL |
| Diabetes HbA1c | >6.5% |
| Diabetes FPG | >126 |
| Diabetes random BG | >200mg/dL, w/ symptoms |
| Hypoglycemia S&S | shaky, sweaty, hungry, headache, dizziness, pale, mood change, confusion, nightmares, BG45-60mg/dL |
| Sick Day Rules | insulin as usual, BG more often, ^fluids, rest, contact HCP for persistant S&S/BG >250 |
| DKA S&S | dehydration, excessive urine, thirst, acetone breath, vomiting, abd pain, Kussmaul's respirations, BG>300mg/dL |
| DKA Therapy | insulin, rehydrate, electrolyte replacement, potassium |
| HHNS S&S | similar to DKA except, absence of ketone production, BG >600mg/dL |
| HHNS Therapy | insulin, fluids, monitor electrolytes |
| Neuropathic pain management | Gabapentin(Neurontin)/Pregbalin(Lyrica) |
| BUN (Blood Urea Nitrogen) | 10-20mg/dL |
| Creatinine | 0.7-1.4mg/dL |
| Creatinine Clearance (CrCl) | 75-125mL/min |
| Glomerular Filtration Rate (GFR) | 90-60-30-15-<15 |
| Glucose | 60-110mg/dL |
| Hematocrit | 35%-52% |
| Hemoglobin | 12-18gm/dL |
| INR | 1.0 |
| PT | 9.5-12sec |
| PTT | 20-39sec |
| TSAT | >20% is target for CKD |
| Magnesium | 1.3-2.3mg/dL |
| Calcium | 8.6-10.2mg/dL |
| Phosphorus | 2.5-4.5mg/dL |
| Potassium | 3.5-5mEq/L |
| Sodium | 135-145mEq/L |
| Albumin | 3.5-5.5g/dL |
| What is the highest priority with a permanent dialysis access? | protection of the access |
| Calcium and Phosphorus findings in CKD | retention of Phosphorus, decrease of Calcium--leads to bone disease, metastatic, and vascular calcifications |
| Complications of dialysis | SOB,hypotension, muscle cramping, exsanguination, dysrhythmias, air embolisim, chest pain, dialysis disequilibrium |
| SE of SSRI's | dry mouth, nausea, nervousness, insomnia, h/a, sexual probs |
| Rapid-acting Insulin, administer ? | Humalog(Lispro)/Novolog(Aspart), meals |
| Long-acting Insulin, administer? | Lantus(Glargine)/Levemir(Detemir),1ce or 2ce/day, DO NOT MIX! |
| Regular-Biguanide | Metformin(Glucophage) |
| SE of Insulins | Hypoglycemia, weight gain |
| SE of Biguanides | GI blues, Lactic Acidosis(life-threatening!), no significant weight gain, decrease lipids |
| Biguanides--Impt assessments | check for liver, heart, or renal insufficiency! |
| Addison's features | decreased BS & NA, ^K & WBC's, fluid vol deficit, adrenocorticol insufficiency, autoimmune, muscle weakness, anorexia, GI symptoms, fatigue, dark pigmentation |
| Cushing's features | excessive adrenocorticol activity, pituitary tumors, ^secretion of glucocorticoids, ^sex hormones, buffalo hump, moon face, facial hair, truncal obesity, ecchymosis |
| Orthostatic BP | Take 3 readings in diff positions, retake in same arm |
| OSBP--Addison's findings | sistolic decreases 20, diastolic ^10, heart rate ^20 |
| Addison's Tx | Prednisone--rest of life |
| Cushing's priority concerns | GI Bleeding, ^BG, decreased wound healing, osteoporosis, glaucoma/cateracts |
| Cushing's Tx | Long-term steroid meds, surg therapy if due to pituitary, preventative--GI protectants/BS checks |
| Type 2 features | Insulin Resistance, Obesity |
| Metabolic Syndrome--Type 2 | HTN, Abd obesity, Dyslipidemia, CRP elevation, FPG>110mg/dL |
| Long-term steroid use SE | DM, osteoporosis, peptic ulcer, ^protien breakdown, decreased muscle tissue, decreased wound healing, redistribution of body fat, cataracts |
| Heparin labs & SDR | Ptt, 1.5-2x control |
| Potassium labs & SDR | potassium, 1-4mEq/kg/day, do not exceed 40mEq/day |
| Hospice | prog fo interdiciplinary care provided in the home to terminally ill pts/families |
| Palliative care | comprehensive care for pt's/families whose disease is not responsive to cure |
| Priorities of pt assessment | Pain, life quality, respiratory, constipation, psychosocial |
| CKD diagnostic labs | GFR, BUN, serum creat, 24hr urine, albumin, hgb&hct(decreased), K(^), Na(^), Ca(decreased), Mg(^), P |
| Med SE for Renagel & Phoslp | Phosphate binders, excreted in kidneys, check labs, take w/ meals |
| Nutrition concerns--CKD | Restrict: fluids(1000mL/day, protein(albumin, better=longer life),sodium(fluid follows, kidneys can't excrete),potassium (no oj), phosphorus(no dk colas) Addition: Calcium & Iron |
| Physical assessments--CKD | Neurologic-asterixis,Integumentary-calciphylaxis, Cardiovascular-HTN-Edema, Pulmonary--crackles-SOB, GI--urine breath, Hematologic--anemia, Reproductive, Musculoskeletal--renal osteodystrophy |
| Complications--hemodialysis | Protect the arm, bleeding from site |
| Complications--peritoneal | Infection--peritonitis |
Created by:
neffielewis
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