You're killing me smalls
Cool, clammy skin, shakiness, and headache are signs of what?
Hypoglycemia
Cause of DM II
Insulin resistance
Warm, dry skin and acetone breath are signs of what?
Hyperglycemia
The four types of diabetes
DM I, DM II, GDM, late onset
Cause of DM I
Damage to or destruction of beta cells of the pancreas leads to absence of insulin production
What do I do for sick days?
DO NOT STOP insulin unless directed by MD, stay hydrated and monitor urine for ketones.
What position the hand should be in to obtain a glucose sample
Dependent
if your diabetic client has a change in condition (sudden or progressive) what should you do first
Finger stick
What is an intervention for an unconscious hypoglycemia pt?
An Ampule of D50W (dextrose 50% in water)
Lab value that monitors BS over time
Hg A1c
Abdominal obesity + elevated triglycerides + low HDL + HTN + elevated BS
When blood sugars are normally ordered in the hospital
AC and HS
What are three signs of DKA?
Kussmaul's breathing, ketones in urine, pH > 7.3, hyperglycemia, elevated anion gap
How long to wait to recheck a BS after an intervention for hypoglycemia
15 minutes
Two differences between HHS and DKA?
DKA-rapid onset, metabolic acidosis/ketosis, + ketones in urine, sugar may or may not be HIGH
HHS- slower onset, minimal to no ketones in urine, minimal to no metabolic acidosis, more common in 50-70 yr old pts
Considerations when administering insulin (at least three)
Subcutaneous, rotate injection sites, assessing for bruising, smallest syringe available, give in arm if possible since patient cannot do that at home
An order that tells you how much insulin to give based upon the patient's blood glucose reading
Sliding scale
What is the number one priority for DKA and HHS?
FLUIDS!!!!! Treat the dehydration with IV fluids.
Oftentimes the first indicators that a client is diabetic (hint: 3 P's)
Polydipsia (excessive thirst), polyuria (excessive urination, and polyphagia (excessive hunger)
Two types of insulin and their names
Rapid acting-lispro (humalog)
Short acting-Regular
Intermediate acting-NPH
Long acting-Lantus (Glargine)
The two macrovascular complications of diabetes
cardiovascular disease and cerebrovascular disease
The three microvascular complications of diabetes
Kidney, nerve, and vision problems
Which electrolyte should you monitor when providing large amounts of insulin
Potassium
Does alcohol raise the blood sugar? True or false?
True-BUT....watch for the hypoglycemia drop! may need to hold insulin, especially if they are not eating!
Two special considerations for diabetics when exercising
Adjusting insulin and bringing snacks