General Knowledge
This type of Diabetes occurs at a young age
Type 1
This develops slowly and does not cause immediate changes in level of consciousness
Hyperglycemia
Symptoms of this type are:
polydipsia
polyphasia
weakness
rapid weight loss
Type 1 DM
Metformin
5 different types of treatment options for Diabetics
Medication
Insulin
Diet
Excersize
Surgical interventions
This condition is caused by incomplete metabolism of fats resulting from an absence or insufficient supply of insulin
Diabetic Ketoacidosis DKA
Somogyi Effect is also known as?
(This is DX by checking BS during the night, lowering insulin dosage/moving the time of intermediate -acting insulin to bedtime)
Rebound Hyperglycemia
This type of DM includes people older than 30 years old, obese, poor healing, tingling in feet
Type 2 DM
______This is the amount of insulin that normally is produced by the pancreas throughout the day
Basal Insulin
A patient with type 1 diabetes has received diet instruction as part of the treatment plan. The nurse determines a need for additional instruction when the patient says,
a. "I may have an occasional alcoholic drink if I include it in my meal plan."
b. "I will need a bedtime snack because I take an evening dose of NPH insulin."
c. "I will eat meals as scheduled, even if I am not hungry, to prevent hypoglycemia."
d. "I may eat whatever I want, as long as I use enough insulin to cover the calories."
D
Rationale: Most patients with type 1 diabetes need to plan diet choices very carefully.
Patients who are using intensified insulin therapy have considerable flexibility in diet choices but still should restrict dietary intake of items such as fat, protein, and alcohol.
The other patient statements are correct and indicate good understanding of the diet instruction.
___________Characterized by elevated blood glucose in the morning. Hormones throughout the night raise bodies blood sugar levels.
Dawn Phenomenon
Shortage of glucose in the brain and possibly leading to death is called what?
Happens from untreated fasting hypoglycemia
Neuroglycopenia
Latent autoimmune diabetes (LADA) is a form of which type of DM?
*presence of islet cell bodies in the blood will eventually destroy beta cells and insulin producing will cease.
Type 1 DM
A patient given the medication pramlintide has a black box warning. Has the potential to cause severe _______ within 3 hours of administation. (Hypoglycemia/Hyperglycemia)
Severe Hypoglycemia
If there is doubt about whether the patient is hypoglycemic or hyperglycemic, Treatment is begun for which one (hypoglycemia/hyperglycemia) until the blood glucose determination is obtained
Hypoglycemia
*this helps prevent brain damage from extremely low cerebral glucose levels*
A nurse is preparing a teaching plan for a client with diabetes Mellitus regarding proper foot care. Which instruction is included in the plan?
1. Soak feet in hot water
2. apply a moisturizing lotion to dry feet but not between the toes
3. Always have a podiatrist cut your toenails, never cut them yourself
4. avoid using mild soap on the feet
2. The client is instructed to use a moisturizing lotion on the feet and to avoid applying the lotion between the toes.
Severe Hypoglycemia in the older adult can precipitate these major health problems
(4 possible answers)
Myocardial infarction
Angina
Stroke
Seizures
This occurs in people with Type 2 DM who experience High BS levels b/c of illness or added stress, such as infection.
Glucose levels >600mg/dL to over >1000mg/dL
Hyperglycemic Hyperosmolar State (HHS)
1. Lantus is ___________acting insulin.
2. NovoLog is _________acting insulin
3. HumaLog is _______acting insulin
4. Humulin R is _________acting insulin
1. Long-acting Insulin
2. Rapid-acting Insulin
3. Rapid-acting Insulin
4. Short-acting Insulin
"1. A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what ""type 2"" means in relation to diabetes. The nurse explains to the patient that type 2 diabetes differs from type 1 diabetes primarily in that with type 2 diabetes
a. the pt is totally dependent on an outside source of insulin
b. there is a decreased insulin secretion and cellular resistance to insulin that is produced
c. the immune system destroys the pancreatic insulin-producing cells
d. the insulin precurosr that is secreted by the pancreas is not activated by the liver
Answer B - Rationale: In type 2 diabetes, the pancreas produces insulin, but the insulin is insufficient for the body's needs or the cells do not respond to the insulin appropriately. The other information describes the physiology of type 1 diabetes
Improperly treated or untreated DM is the leading cause of these long term complications
(3 possible answers)
Blindness
Renal Failure
Lower limb amputation
"A frail elderly patient with a diagnosis of type 2 diabetes mellitus has been ill with pneumonia. The cliet's intake has been very poor, and she is admitted to the hospital for observation and management as needed. What is the most likely problem with this patient?
"A. Insulin resistance has developed.
B. Diabetic ketoacidosis is occuring.
C. Hypoglycemia unawareness is developing.
D. Hyperglycemic hyperosmolar non-ketotic coma.
D.Illness, especially with the frail elderly patient whose appetite is poor, can result in dehydration and HHNC. Insulin resistance is indicated by a daily insulin requirement of 200 units or more. Diabetic ketoacidosis, an acute metabolic condition, usually is caused by absent or markedly decreased amounts of insulin.
When taking a health history, the nurse screens for manifestations suggestive of diabetes type I. Which of the following manifestations are considered the primary manifestations of diabetes type I and would be most suggestive of diabetes type I and require follow-up investigation?
a. Excessive intake of calories, rapid weight gain, and difficulty losing weight
b. Poor circulation, wound healing, and leg ulcers,
c. Lack of energy, weight gain, and depression
d. An increase in three areas: thirst, intake of fluids, and hunger
D. An increase in three areas: thirst, intake of fluids, and hunger
The primary manifestations of diabetes type I are polyuria (increased urine output), polydipsia (increased thirst), polyphagia
You are doing some teaching with a client who is starting on a sulfonylurea antidiabetic agent. The client mentions that he usually has a couple of beers each night and takes an aspirin each day to prevent heart attack and/or strokes. Which of the following responses would be best on the part of the nurse?
a. As long as you only drink two beers and take one aspirin, this should not be a problem
b. The aspirin is alright but you need to give up drinking any alcoholic beverages
c. Aspirin and alcohol will cause the stomach to bleed more when on a sulfonylurea drug
d. Taking alcohol and/or aspirin with a sulfonylurea drug can cause development of hypoglycemia
D. Taking alcohol and/or aspirin with a sulfonylurea drug can cause development of hypoglycemia
Alcohol and/or aspirin taken with a sulfonylurea can cause development of hypoglycemia.
A client with diabetes mellitus demonstratees acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client's anxiety would be to
1. administer a sedative
2. make sure the client knows all the correct medical terms to understand what is happening
3. ignore the signs and symptoms of anxiety so that they will soon disappear
4. convey empathy, trust, and respect toward the client
4. The most appropriate intervention is to address the client's feelings related to the anxiety