Type 1 DM
What are common manifestations for a type 1 diabetic?
3 P's- polyuria, polyphagia, polydipsia
The difference between Type 1 and Type 2 diabetics is that type 2 diabetics _________.
Still produce insulin but have reduced insulin sensitivity or decreased insulin production.
2 conditions that may require additional insulin
Illness, infection, stressful event (surgery)
HHS is associated with which type of diabetes?
Type 2
These type of fluids are utilized to rehydrate a patient in DKA. Name 2 types of IVF.
What are isotonic (normal saline) and hypotonic fluids (drive fluid into cell), .45 NS
5 symptoms of a patient with hypoglycemia
Agitation, 'hangry', tachycardic, diaphoretic, headache, shakiness, fatigue.
You are caring for a T2D who states they feel lightheaded. They last ate 6 hours ago. What intervention is most appropriate?
Check BG via fingerstick, pt could be hypoglycemic.
Normal fasting glucose level, 3 month indicator of glucose control, and targeted glucose range
<100, HgbA1C (< 6.5) and 80-110
3 education points for the patient with neuropathy
Inspect feet daily, wear flat shoes, no lotion between toes, cut nails straight across, no heating pads
Name 3 manifestations of a patient in DKA
Confusion, Disorientation, Thirst, Weight loss, tachycardic, tachypnea, hypotension, dry mucus membranes
Autoimmune illness, body attacks beta cells within pancreas resulting in altered function of pancreas--> unable to produce insulin
Which medications can elevate BG?
Glucocorticoids, (aka, corticosteroids)
What should nurses teach diabetes about drinking alcohol?
Alcohol contains large amounts of glucose, elevating the patient's glucose with subsequent drops in BG. Consume alcohol with food. Limit number of drinks.
What is the best way to prevent diabetes associated complications
Meticulous blood glucose control!
A patient in DKA exhibits dehydration, hyperglycemia, and ____________?
Metabolic acidosis
The Type 1 patient is at home ill with a viral infection. What 3 pieces of nursing education might the clinic nurse provide?
Check BG every 2-4 hours, consume fluids without added sugar, administer ordered insulin, avoid strenuous exercise, monitor for s/s of DKA
Patient's blood glucose level is 62 and they feel lightheaded, shaky, skin cool and clammy. What intervention would you provide?
Give 15 grams of simple carbs and recheck BS in 15 minutes. If not elevated in 15 min, repeat 15 grams carbs and recheck in 15 min.
A Type 2 patient comes to the clinic with an A1C reading of 8.4. What lifestyle modification/education is needed? Name 4 items.
Aerobic exercise 150 min/week, Goal for blood glucose 80-110, Consistent carb diet, low glycemic foods, eat consistent foods, check blood glucose as recommended by MD
How might a patient describe neuropathy?
Tingling, burning, or shooting pain
What is a priority intervention for a patient in DKA?
Start IV fluids and administer insulin, frequent BS checks
A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, and diaphoresis. What is a priority action?
Check BG and administer 50% dextrose IV per protocol or glucagon if no IV.
When might a patient need to check their glucose levels- name 4 incidences
Prior to administering insulin, prior to meals, if they feel 'low'- hypoglycemic, if they feel 'high'- hyperglycemic, before exercising, before bed
Pt teaching for the type 1 DM to prevent DKA from occurring?
Check BG every 2-4 hours when ill, do not skip insulin doses when ill, check urine for ketones when ill, monitor for 3 P's, Sick day plan from endocrinologist
Name 4 types of complications resulting from poorly managed blood glucose levels.
Atherosclerosis, MI, stroke, peripheral vascular disease, nephropathy, neuropathy, retinopathy, wound healing complications
What may be a precipitating cause of DKA
Missing insulin doses, stress, illness, infection