T1DM vs T2DM
The type of diabetes caused by an autoimmune disorder that destroys beta cells.
What is T1DM
A rapid-acting insulin. (name 3)
What is Lispro (Humalog), aspart (Novolog), Glulisine
For exam purposes, you only need to worry about memorizing the generic names. Even the NCLEX will only use generic.
Rapid-acting insulin should be administered at this time.
What is 5-15 minutes before meals or immediately after eating.
Instruct the client to do this to prevent feet complications.
What is Inspect the feet daily, wash with warm water, do not soak feet, do not apply lotions between the toes, wear socks, wear well fitting shoes, do not go barefoot, cut toenails straight or file?
Education provided regarding complications of insulin therapy.
The type of diabetes that is more likely to be managed with oral medications first.
What is T2DM?
Medication to know for test:
Metformin (Glucophage) is and oral hypoglycemic.
Works by decreasing the production of glucose by the liver and increasing tissue sensitivity to insulin and slows carbohydrate absorption.
Kidney and liver function should be assessed before starting anyone on this medication.
Metformin is suspended during hospitalizations and diagnostic procedures to reduce the risk of lactic acidosis. Do not take metformin before receiving contrast for something like an MRI.
This insulin is long-acting and provides basal coverage. (name 2)
What is Glargine (Lantus) or Detemir (Levemir)
Regular insulin be given this long before a meal?
What is 30-60 minutes before eating?
The nurse will administer this for a critically low blood glucose level to an unconscious client.
What is 50% dextrose (D50W) via IV push?
If the client is unconscious they cannot drink juice and you need to get sugar in their system, the nurse will administer D50W.
This is the best insulin to give for a client experiencing severe hyperglycemia.
What is lispro or aspart (rapid-acting insulins)
This client has very high blood sugar levels and needs a correctional dose of insulin for high BS that will work quickly to reduce blood sugar levels. Lispro and Aspart are rapid acting and used to correct high blood sugar.
The diabetes type that is strongly associated with obesity and metabolic syndrome.
What is T2DM
This type of insulin is cloudy and must be mixed before administration.
What NPH (Humulin N, Novolin N) (intermediate-acting insulin)
This is the peak time for NPH insulin.
What is 4-12 hours?
If NPH was administered at noon what time would the client most likely experience hypoglycemia? anywhere from 4pm - midnight.
A chronic complication of uncontrolled diabetes that affects the kidneys.
What is diabetic neuropathy?
The best way to prevent complications of diabetes.
What is maintain good glucose control?
Maintaining blood glucose levels is the client’s best protection against long-term complications of diabetes, since increased blood sugar contributes to neuropathic disease, and microvascular complications.
The diabetes type that has a higher risk for diabetic ketoacidosis (DKA).
T1DM.
Humulin 70/30 is this type of insulin.
What is NPH + regular insulin.
For the exam, you only need to know that Humulin 70/30 is a mix of NPH and regular and that it is given for daily maintenance not correcting high blood glucose levels. You do not need to know any other combinations.
This insulin does not have a peak.
What is Long-acting insulins such as Glargine?
A complication of insulin therapy that causes shakiness, sweating, and rapid pulse.
What is hypoglycemia? Clinical manifestations for hypoglycemia include shakiness/tremors, dizziness/lightheadedness, tachycardia, diaphoresis, hypotension, blurred vision, confusion, even seizures
What should the nurse do first? Assess FSBG
If the FSBG is less than 70mg/dL. What should the nurse do next? offer 15g of carbohydrate (i.e. juice)
Prevents hypoglycemia caused by exercise.
What is:
Patients should exercise moderately and regularly (same time each day) Being on a schedule will ensure blood sugar control and prevent highs and lows. Ensure adequate fluid intake, especially water is essential to reduce the risk of dehydration. May also need to eat a snack before exercise. The risk for hypoglycemia is greater exercising before meals and at peak insulin times, not after meals. Patients should check BS before and after exercise.
Exercise is an important part of diabetes management.
Obesity; BMI of 30; age > 45; Hypertension; High HDL Cholesterol; giving birth to an infant >9lbs; Ethnicities (Asian, Black American, or Native American)
What are examples of Type 2 DM?
Is a short-acting insulin.
What is regular insulin?
The nurse should do this if a patient skips a meal after taking rapid-acting insulin?
What is monitor blood sugar, provide a snack if needed to prevent hypoglycemia?
A macrovascular complication of diabetes.
What is Peripheral disease (PAD), Coronary Artery Disease (CAD), Hypertension, Stroke.
DM causes both microvascular complications and macrovascular complications.
Retinopathy, nephropathy and neuropathy are all microvascular complications.
CAD, PVD, Hypertension and stroke are all macrovascular complications usually caused by atherosclerosis.
Lifestyle modifications help prevent Type 2 diabetes.
What is a healthy diet, exercise, weight management?