Diabetes

DM 1

100

Able to produce insulin; but cells may not be sensitive to insulin.

What is Type II Diabetes.

Non-insulin dependent diabetes mellitus

200

4 risk factors for diabetes.

-age >45

-family hx

-obesity

-race/ethnicity

300

5 ways insulin is available.

-pens

-pumps
-inhlation

-vails

-transdermal patches

400

Normal blood sugar range.

70-100

500

s/s of hyperglycemia.

polydipsia (increased thirst)

polyuria

dry, flushed skin

DM 2

100

Absorbs insulin more quickly than other sites.

abdomen

200

a nurse goes to give their pt a regular insulin shot at 8:30am. When the nurse gets in the room he notices a breakfast tray and most of it is eaten. What is the problem with this situation. 

Regular insulin should be given 30 mins BEFORE a meal.

300

Fasting blood sugar reading that is indicative of DM

126 or higher

400

Insulin that you can't mix?

Detimir and Glargine (NEVER mix with other insulins)

500

3 treatments for DM.

-Diet

-Exercise

-Medication (oral meds; insulin)

DM 3

100

Why is first drop of blood wiped in capillary blood sugar?

First drop is diluted. 

Stick lateral side of finger.

200

Diabetic men may suffer from erectile dysfunction due to ________.

Neuropathy 

(Diabetes due daily foot inspections)

300

How to mix and store insulin?

Roll insulin (DO NOT SHAKE) 

Store in refrigerator before opening, then store at room temp.DO NOT FREEZE INSULIN

Draw up "clear" insulin 1st, followed by "cloudy" insulin

400

Pancreas supplies little to no insulin production.

Type I DM

Insulin Dependent Diabetes Mellitus (IDDM)

500

Exercise ________ insulin, so insulin doses need to be __________. 

increases/decreases

*Do not give in arms or legs 

-b/c movement of the extremity increases insulin absorption and causes hypoglycemia

DM 4

100

s/s of hypoglycemia

increased appetite (polyphagia)

cool pale skin

diaphoretic/sweating; cool and clammy give them candy

tremors/shakiness

blurry vision

tachycardia

lightheadedness

headache

200

Hemoglobin A1C evaluates blood sugar control over 2-4 months. What are the stages?

5.7-6.4 = prediabetes (5.7 equivalent to BS of 154)

6.5 = diabetes

7= diabetic patients with blood sugar under control (you want to keep them under 7)

300

A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patient’s labs are the following: pH 7.25, Glucose 455, potassium 2.5. What is the most appropriate nursing intervention to perform next?

Hold the insulin and notify the doctor of the potassium level of 2.5

Normal k+ range is  3.5-5

They got the reg insulin and iv fluid so the potassium is the most concern they need electrolytes. 

400

• Which of the following patients is MOST LIKELY experiencing Hyperglycemic Hyperosmolar Nonketotic Syndrome based on their symptoms?*
  •  A 72 year old with a health history of diabetes who has a blood glucose of 300 mg/dL and is complaining of thirst and frequent urination.
  •  A 66 year old with type I diabetes that has ketones present in their urine.
  •  A 69 year old admitted with an infection of the right foot with a health history of diabetes that reports missing several doses of Metformin and has a blood glucose of 600 mg/dL.
  •  A 6 year old that is presenting with polyuria, polydipsia, abdominal pain, and vomiting.

A 69 year old admitted with an infection of the right foot with a health history of diabetes that reports missing several doses of Metformin and has a blood glucose of 600 mg/dL.

*Hallmark of HHNS is an EXTREME high blood glucose (>600 mg/dL), is precipitated by infection, and is more common in type 2 diabetics. The 69 year old is a type 2 diabetic due to the clue that the option states the patient has missed doses of Metformin (which is an oral type 2 diabetic medication). DKA presents with elevated blood glucose >300 mg/dL and ketones which HHNS does not.

500

why is it important to rotate injection sites?

to prevent lipodystrophy (lipoatrophy/lipohypertrophy); fatty deposits that affect insulin absorption. 

Types of insulin

100

Rapid-acting insulin

types

onset

peak

duration

aspart;lispro;glulisine

onset-15mins

peak-1hour

duration-3-5 hours

200

short-acting insulin

type

onset

peak

duration

humulin R ; Novolin R

onset-30-60 mins

peak-2-4 hours

duration 5-8 hours

300

intermediate-acting insulin

type

onset

peak

duration

Humulin N; Novolin N

onset- 1.5-4 hours

peak- 6-10 hours (average is 8hrs)

duration- 14hrs

400

long-acting insulin

type

onset

peak

duration

DEtimir;Glargine

onset- 1hr

peak- 9hrs, glargine has no peak

duration- 24hrs

500

2 Oral diabetic therapy options

Metformin (glucophage)

glipizide (glucotrol)