Type I Diabetes
What is Type I Diabetes?
A condition where the body cannot make insulin. (Autoimmune destruction of Beta cells of the pancreas)
You are advancing your patients diet from NPO to regular diet. They are on a sliding scale. You anticipate the patient will be placed on what type of insulin?
What is Lispro (Humalog) or Aspart (Novolog). Mealtime insulin/rapid acting insulin.
These organs are often adversely affected by diabetes and may cause a person to require dialysis or transplant.
What are the kidneys
What is administer the Lantus.
What age group is most affected by Type I Diabetes?
What is children and young adults.
What is the main problem in a person's body if they have type II diabetes?
What is insulin resistance.
Name a long acting insulin and it's duration.
What is glargine (Lantus) or detemir (Levemir)
16-24hours.
You assess Kussmaul respirations in your patient who has diabetes. What type of diabetes do you suspect your patient has?
What is Type I diabetes.
Your patient becomes confused, sweaty, and lightheaded. What action will you carry out first?
What is obtain a blood glucose fingerstick
What medicine must someone with Type I Diabetes use?
Insulin.
What medicine must someone with Type II Diabetes use?
What is none.
How do we know when to deliver insulin based on sliding scale and/or carb counting?
What is a doctor's orders
What does hemoglobin A1C tell us?
What is the average glucose level over the last 2-3 months, more specifically, the percentage of hemoglobin coated with sugar.
You get a blood glucose fingerstick on your patient. You know you need to treat your patient for hypoglycemia if their reading is ≤ _____?
What is 70.
Your patient is NPO and taking the Sulfonylurea Glucotrol. Are you comfortable with this and why?
What is "no" due to risk for hypoglycemia
Your patient calls you into the room to tell you they finished eating. You notice they've eaten 1/2 of their bacon, egg, and cheese sandwich and 2 cups of black coffee. How many grams of carbs is this?
What is 15g.
(1 slice of bread = 15g; eggs=0, bacon=0, cheese=0, black coffee=0).
Is it possible to "cure" type II diabetes?
What is "no." The damage is already done, but it is possible to control diabetes and prevent medication use with proper diet and exercise.
Your patient was admitted yesterday for IV antibiotics for a UTI. Your patient has type II diabetes and is receiving Lantus (glargine) and Humalog (lispro). You notify the doctor that the patient's blood glucose has been elevated and you think their insulin should be adjusted. How do you expect the insulin orders to change?
What is an increase in their short acting Humalog (lispro).
What causes DKA?
What is a build up of ketones in the blood. In Type I diabetes, the body cannot use glucose without insulin. If the body can’t use glucose it turns to fat for energy. Ketones are a byproduct of fat metabolism.
Your 78 year old patient was recently admitted with Pneumonia and has a history of Type II diabetes. The most recent glucose level was 632. What emergent life threatening condition are you concerned about?
Hyperosmolar Hyperglycemic Syndrome (HHS)
Your patient has lantus (Glargine) and regular insulin (Humulin r) due at the same time. How do you prepare and administer these medications?
What is in two separate syringes and two separate injections.
What electrolyte imbalance are you worried about when treating DKA or HHS?
What is hypokalemia
Your patient takes metformin for their Type II diabetes B.I.D. Their next dose of metformin is due at 0900. At 0600 the doctor places an order for a chest CT with contrast. What is your best response?
Hold the metformin and call the provider.