Type 1 DM
What are common presenting symptoms for a type 1 diabetic?
4 Ts- toilet, thin, tired, thirsty
The difference between Type 1 and Type 2 diabetes is that with type 2 diabetes _________.
produce some insulin but have reduced insulin sensitivity
2 Medications/conditions/therapies that may require additional insulin be administered
Steroids, TPN, illness, surgery
What labs would indicate nephropathy?
Elevated serum creatinine & elevated BUN
5 symptoms of a patient with hypoglycemia
Agitation, 'hangry', tachycardia, diaphoretic, headache, shakiness, fatigue, tachycardia, palpitations, nervousness, disorientation, seizures, loss of consciousness
You are caring for a patient with type 2 DM who states they feel lightheaded. They last ate 3 hours ago. What intervention is most appropriate?
Check capillary blood glucose
Normal fasting glucose level and Normal HgbA1C
60-100, HgbA1C <5.7
1 education topic for the patient with neuropathy
Inspect feet daily, wear shoes, see podiatrist for nail care
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 client with Type 2DM 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 alcohol drinks not encouraged for a client with diabetes?
These drinks can contain large amounts of glucose, elevating the patient's glucose. It is preferred to drink a lighter drink, with food.
What is the best way to prevent diabetes associated complications
Tight blood glucose control!
Client with Type 1 is at home ill with a viral infection. Name at least one piece of nursing education to provide?
Check BG every 2-4 hours, consume fluids without added sugar, administer ordered insulin, avoid exercise, check for ketones, monitor for s/s of DKA
Patient's blood glucose level is 68 and they feel lightheaded. What intervention would you provide?
Give 15grams carbs and recheck glucose in 15 minutes. If not elevated in 15 min, repeat. Once elevated, give complex carb and evaluate cause of hypoglycemia.
A Type 2 patient comes to the clinic with an A1C reading of 8.4. What lifestyle modification/education is needed? Name at least 2 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, shooting pain, numbness
A client with diabetes has the following presentation: unresponsive to voice or touch, tachycardia, and diaphoresis. 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, when ill
Pt teaching for the type 1 DM to prevent DKA from occurring? Name at least two teachings.
Check BG every 2-4 hours when ill, do not skip insulin doses when ill, stay hydrated, try to eat, check urine for ketones when ill, monitor for 3 P's,
Name 4 types of complications resulting from uncontrolled diabetes
nephropathy, neuropathy, retinopathy, wound healing complications, infections, stroke, heart attack,