Type 1 Diabetes
What are common presenting symptoms for a type I diabetic?
3 P's: polyuria, polyphasic, polydipsia
The difference between Type I and Type II diabetes is Type II diabetes....
Still produce insulin but have reduced insulin sensitivity or decreased insulin production.
A patient with diabetes asks the nurse if she can drink alcoholic beverages. The nurse's response should be:
Alcohol may cause hypoglycemia and should be consumed with food.
What labs would indicate nephropathy?
Elevated creatine, albumin, urea, BUN
This type of fluids are utilized to rehydrate a patient in DKA. Name 1 type of IVF
What is hypotonic fluids, (drive fluid into the cell), .45NS
What are 3 early symptoms of a patient with hypoglycemia?
hunger, fatigue and drowsiness
You are caring for a type II DM patient who states they feel light headed. They last ate 3 hours ago. What intervention is most appropriate.
Check BG via FS, patient could be hypoglycemic.
A patient with DM shares that they wear cowboy boots 10 hours a day. The nurse instructs the patient to:
(name at least 3 educational facts)
Keep feet clean and dry. Cut nails straight across.
Regularly visit a podiatrist.
3 educational facts to share with the patient with neuropathy:
Inspect feet daily, no lotion, no heating pads/hot water, observe for s/s of infection
Name at least 3 symptoms of a patient in DKA
Confusion, thirst, weight loss, tachycardia, hypotensive
Explain the pathophysiology of Type I DM
Autoimmune illness, body attack beta cells within pancreas, resulting in altered function of pancreas-
unable to produce insulin
A patient tells the NP at their outpatient visit that they feel weak after exercising. The NP should tell this patient to:
Consume a carbohydrate snack prior to exercise
Normal fasting glucose level is ______.
3 month indicator of glucose control is _______.
Target glucose range is_________.
<100
Hgb A1C: <6.5
80-110
What is the best way to prevent diabetes-associated complications?
Meticulous blood glucose control!
What ABG findings would the nurse expect for a patient with DKA?
Metabolic acidosis: low pH, low HCO3,
A patient with Type I diabetes is home with a virus. Name at least three important nursing education facts to share with the patient.
Check BG every 2-4 hours, consume fluids without added sugar, administer insulin as ordered, avoid strenuous exercise, monitor for s/s of DKA
A patient's BG level is 68, and they feel lightheaded. What intervention would your provide?
Give juice and recheck BG in 15 minutes. If not elevated in 15 minutes, repeat juice and recheck in 15 minutes. Once elevated, give complex carbohydrate (milk/graham cracker) and evaluate cause of hypoglycemia.
Pt. teaching for a patient with DM to prevent DKA fro occurring includes....Name at least 4 facts for teaching
Check BG every 2-4 hours when ill. Do not skip insulin doses when ill. Check urine for ketones. Monitor for 3 P's, sick day plan from the endocrinologist.
How might a patient describe neuropathy? What medications would help to treat this condition?
Tingling, burning, numbness, shooting pain
Gabapentin (neurotin), Pregabalin (Lyrica)
What is a priority intervention for a patient in DKA?
safety, glucose managment, hydration with IVF, hourly BG checks, hypokalemia
A diabetic patient is unresponsive to voice or touch, tachycardia, and diaphoretic. What is a priority action?
Check BG and administer an injection of glucagon.
Name at least 4 instances when a patient may need to check their glucose levels.
Prior to adm. insulin, prior to meals, if they "feel" hypoglycemic or hyperglycemic, before exercise, before bed.
The nurse expects a patient who has type II diabetes to have a urine ______ for ketones and ______ in the blood
Negative/glucose
Name 4 types of complications resulting from uncontrolled diabetes
Angiopathy, nephropathy, neuropathy, retinopathy, wound healing complications
What may be a precipitating cause of DKA?
Missing insulin doses, stress, illness