Type 1
What are common presenting symptoms for a Type 1 diabetic?
3 P's - polyuria, polydipsia, polyphagia
The difference between Type 1 and Type 2 diabetes is that Type 2 diabetics
Still produce insulin but have reduced insulin sensitivity or decreased insulin production
Name two medications/conditions/therapies that may require additional insulin to be administered
Steroids, Dilantin, TPN, stressful even
What labs would indicate nephropathy?
Elevated creatinine, albuminurea, elevated BUN
These types of fluids are utilized to rehydrate a patient with DKA. Name 1 type of IVF.
What is hypotonic fluids (drive fluid into cell.) 0.45%NS
5 symptoms of a patient with hypoglycemia
Agitation, "hangry", tachycardia, diaphoretic, headache, shakiness, fatigue
You are caring for a Type 2 diabetic patient who states they feel lightheaded. They last ate 3 hours ago. What intervention is most appropriate?
Check blood glucose via fingerstick, patient could be hypoglycemic.
Normal fasting glucose level, three month indicator of glucose control, and targeted glucose range
<100, HgbA1C (<6.5%) and 80-100
3 education points for the patient with neuropathy
Inspect feet daily, wear comfortable, flat, closed toed shoes; no lotion between toes, cut nail straight across
Name 3 symptoms of a patient with DKA
Confusion, Disorientation, Thirst, weight loss, tachycardia, hypotension
Explain pathophysiology of Type 1 diabetes
Autoimmune illness, body attacks beta cells within pancreas resulting in altered function of the pancreas, unable to produce insulin
A type 2 diabetic patient is preparing for surgery. What education will be needed?
Do not take insulin/oral diabetic agents the day of surgery. Maintain NPO status.
Why are mixed drinks not encouraged for a diabetic patient?
These drinks contain large amounts of glucose, elevating the patients glucose with subsequent drops in BG. It is preferred to drink a lighter drink, with food.
What is the best way to prevent diabetes associated complications?
Meticulous blood glucose control
What ABG findings would a patient with DKA have?
Metabolic acidosis, low pH 7.2, HCO3 <16, generally low CO2 follows as the respiratory system tries to buffer acidosis in the body
The Type 1 client is at home ill with a viral infection. What 3 pieces of nursing education might the clinic nurse provide?
Check glucose every 3-4 hours, consume fluids without added sugar, administer ordered insulin, avoid strenuous exercise, monitor for S/S of DKA
Patient's blood glucose level is 68 and they feel lightheaded. What intervention would you provide?
Give juice (orange or apple) and recheck glucose in 15 minutes. If not elevated in 15 minutes, repeat juice and recheck in 15 minutes. Once elevated, give complex carb (milk/graham cracker) 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 4 items.
Aerobic exercise 150 min/week, goal for blood glucose 80-100, low glycemic foods, eat consistent foods, check blood glucose as recommended by MD.
How might a patient describe neuropathy? What medications would help treat this condition?
Tingling, burning, shooting pain. Gabapentin (Neurontin), Lyrica (Pregabalin)
What is a priority intervention for a patient with DKA?
Safety, glucose management, hydration with IV fluids, hourly blood glucose checks
A diabetic patient has the following presentation: Unresponsive to voice or touch, tachycardia, and diaphoresis. What is the priority action?
Check blood glucose level. Administer 50% dextrose IV per protocol.
When might a patient need to check their glucose levels - name for incidences.
Prior to administration of insulin, prior to meals, if they feel "low" - hypoglycemic, if they feel "high" - hyperglycemic, before exercising, before bed
Patient teaching for the Type 1 diabetic to prevent DKA from happening?
Check blood glucose every 3-4 hours when ill, do not skip insulin doses when ill, check urine ketones every 3-4 hours, monitor for the 3 P's. Follow MD sick day plan.
Name 4 types of complications resulting from uncontrolled diabetes.
Angiopathy, nephropathy, neuropathy, retinopathy, would healing complications
What may be a precipitating cause of DKA?
Missing insulin doses, stress, illness