Type 1 DM
What are "the 4 " common presenting symptoms for a type 1 diabetic?
4 Ts- Thin, Thirsty, Toilet, Tired
The difference between Type 1 and Type 2 diabetics is that type 2 diabetics still produces_________, but has a reduced________.
Still produces some insulin but has reduced insulin sensitivity
2 Medications/conditions/therapies that may require additional insulin be administered
Steroids, Thiazides, Antipsychotics, Parenteral Nutrition, stressful event (hospitalized), illness, dehydration, infection
Name 3 symptoms of a patient in DKA
fruity breath, N, V, dry mouth, SOB, confusion, coma, hungry, thirsty, abdominal pain, increased urination, fatigue
5 symptoms of a patient with hypoglycemia
Agitation, hungry, tachycardia, diaphoretic, headache, shakiness, fatigue, palpitations, nervousness, difficulty concentrating, speech problem, coordination impairment, vision problems, tired, disoriented, seizure
You are caring for a type 2 DM patient who states they feel a little shaky sweaty. What intervention is most appropriate?
Check BG via fingerstick; could be hypoglycemic
Normal fasting glucose level, and normal 3 month indicator of glucose control
<100 (<126), HgbA1C <5.7 (<6.5)
1 symptom of neuropathy
tingling, numbness, pain/burning, weakness, changed sensitivity to temperature/pain, wound not healing
Explain the pathophysiology of Type 1 DM
Autoimmune illness, body attacks beta cells within pancreas resulting in altered function of pancreas--> unable to produce insulin
A Type 2 DM patient is preparing for surgery. What education will be needed?
Do not take insulin/oral anti-diabetic agents the day of surgery. Maintain NPO status.
Why are mixed alcoholic drinks not encouraged for a diabetic patient?
These drinks can contain large amounts of glucose
What is the best way to prevent diabetes associated complications
blood glucose control
The Type 1 patient is at home ill with a viral infection. Name at least one piece of nursing education might the clinic nurse provide?
Check BG & ketones every 3-4 hours, consume small portions of carbs, drink fluids every hour, administer ordered insulin, monitor for s/s of DKA
Patient's blood glucose level is 68 and they feel lightheaded. What intervention would you provide?
Give 15 grams of carbs (juice) and recheck glucose in 15 minutes. If not elevated in 15 min, repeat juice and recheck in 15 min. Once elevated, give complex carb + protein and evaluate cause of hypoglycemia.
A Type 2 patient comes to the clinic with an A1C reading of 8.4. What are 2 lifestyle changes that need to be recommended?
Diet and exercise
What may be a precipitating cause of DKA
Missing insulin doses, stress, illness
A diabetic patient has the following presentation: tachycardic and diaphoretic; Extreme fatigue- unable to remain alert. What is a priority action?
Check BG and administer glucagon per protocol
When might a patient need to check their glucose levels- name at least 2 incidences
Prior to administering insulin, prior to meals, if they feel 'low'- hypoglycemic, if they feel 'high'- hyperglycemic, before exercising, before bed
What is 2 recommendations for foot care for a diabetic client?
Check feet everyday, wear shoes, see podiatrist for nail care
Name 2 types of complications resulting from uncontrolled diabetes
nephropathy, neuropathy, retinopathy, wound healing complications, vascular