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68wm6 p2 Dia Mel

Diabetes Mellitus

What are the classic clinical manifestations of Diabetes Mellitus? *Polyuria *Polydipsia *Polyphagia
What viruses can cause Diabetes Mellitus? *Coxsackievirus B *Rubella *Mumps
What does the liver convert to glucose? glycerol and fatty acids
What does the liver convert glucose to? triglycerides as needed
What does the liver store glucose as? glycogen
What are the ONLY organs that can use free serum glucose without insulin? Brain and Kidneys
What does the body of a PT with diabetes mellitus use for energy since Carbohydrates and Glucose can not be used properly? Body’s fat and protein sources are broken down for energy
What is Type-1 Diabetes Mellitus? Little or no endogenous insulin produced (insulin dependent). Requires injections of insulin
What causes Type-1 diabetes? Progressive destruction of beta cell function
What is Type-2 Diabetes Mellitus? *Non-insulin dependent *Decrease tissue responsiveness to insulin *Decrease secretion of insulin from beta cells *Abnormal hepatic regulation
What is Type-2 diabetes associated with? Obesity (80% of cases)
Type-2 diabetes is found primarily in who? adults > 30 years old
What are the cardinal manifestations of diabetes? Glycosuria, polyuria, polydepsia, and polyphagia
Which type of diabetes has Muscle wasting, weight loss, and thin PTs? IDDM Type-1
What common visual impairment will PTs with IDDM Type-1 experience? Halos around lights
Which type of diabetes involves slow wound healing, boils, and other infections? NIDDM Type-2
PTs with untreated NIDDM Type-2 will have a random blood glucose of what? >200 mg/dL
What is the normal fasting blood glucose? 60-120 mg/dL
How long must PTs fast before an Oral Glucose Tolerance Test? 8 hours
When is Blood and Urine collected during a Oral Glucose Tolerance Test (OGTT)? 30 min, 1 hour, 2 hour, 3 hour
What are the findings for a non-diabetic client following a Oral Glucose Tolerance Test (OGTT)? *Blood glucose levels return to normal in 2 – 3 hours *Urine is negative for glucose
What is a Postprandial blood sugar (PPBS) test? Fasting client is given a measured amount of carbohydrate solution orally, followed by a blood glucose test 2 hours later to determine glucose metabolism.
A blood Glucose of what following a Postprandial blood sugar (PPBS) test indicates Diabetes Mellitus? Blood glucose > 160 mg/dl
What does the Glycosylated hemoglobin (HbgA1c) test measure? Measures the amount of glucose bound to hemoglobin within the RBC
What is the normal % of glucose bound to hemoglobin? 4% - 6%
What is the average Glycosylated hemoglobin (HbgA1c) value in a hyperglycemic PT with a blood glucose of approximately 200 mg/dl? > 8%
What are the long term complications of Diabetes Mellitus? *Renal disease *Neuropathy *Hypertension *Cardiovascular disease
What percentage of the daily intake of kcals should come from protein in the diabetic diet? 10 – 20 % total kcals from protein
What percentage of the daily intake of kcals should come from fat in the diabetic diet? No more than 30 % total kcals from fat
What should diabetic PTs carry while excersizing? Client should carry a form of “easy to eat” Carbohydrates in case hypoglycemia occurs during exercise
Fill in the blanks: All PTs with _____ Diabetes require insulin. Type-1 IDDM
How must insulin be given for Type-1 IDDM? Subcutaneously
What are the types of insulin given? *Beef *Pork *Biosynthetic
Which type of insulin has a more identical action to that of human insulin? Biosynthetic
What are the short acting forms of insulin? *Regular *Humulin *Novulin
What is the intermediate acting form of insulin? NPH
What is the long acting form of insulin? Lantus
What is the only insulin that can be given I.V.? Short acting
What is the onset, peak, and duration of short acting insulin? *(Onset: 30 – 60 min) *(Peak: 3 – 6 hours) *(Duration: 6 –8 hours)
What is the onset, peak, and duration of intermediate acting insulin? *(Onset: 60 –90 minutes) *(Peak: 8 – 12 hours) *(Duration: 24 hours)
What is the onset, peak, and duration of long acting insulin? *(Onset: 4 – 8 hours) *(Peak: 16 – 19 hours) *(Duration: 36 hours)
What times during the day is NPH/Regular insulin taken? *Usually take NPH/Regular insulin BID at Breakfast and Dinner *Regular insulin is used at lunch and bedtime to cover meal/snack
In the case of mixed insulin, which insulin is ALWAYS drawn first? Regular insulin
What must the Diabetic PT have in order for oral hypoglycemics to be effective? Client must have some functioning insulin production for these medications to be effective
What do Oral Hypoglycemics do to reduce blood glucose? stimulate the beta cells to produce insulin
Why should regular insulin NOT be injected into the muscle? enters the bloodstream too quickly and could cause hypoglycemia
What subcutaneous injection site provides the fastest, least variable absorption? Abdomen
Rotating injection sites prevents what? lipodystrophy
True or False: Due to reduced nerve sensation and susceptability to infection, a PT with Type-2 diabetes should keep their feet dry and barefoot as much as possible to reduce blisters and stagnation. False. Client should NOT go barefoot at any time.
What is neuropathy? Any abnormal condition characterized by inflammation and degeneration of the peripheral nerves
In the PT suffering ketoacidosis, what kind of resperations are demonstrated? Kussmaul respirations
How quick is the onset of ketoacidosis? Hours to days
In the PT with diabetic ketoacidosis, medical management with insulin is done to maintain a blood glucose of what? IV Insulin infusion to maintain BG 200 – 250mg/dl
List 5 early S/Sx of ketoacidosis: *Weakness *Drowsiness *Vomiting *Thirst *Abdominal pain *Dehydration *Hot, dry skin *Flushed cheeks *Dry mouth
What is the initial Tx to restore glucose level in a unconsious hospitalized hypoglycemic PT? IV bolus of 20 ml of 50% glucose or 50 ml of 20 % glucose
Created by: Shanejqb
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