Type 1 DM
What are common presenting symptoms for a type 1 diabetic?
3 P's- polyuria, polyphagia, polydipsia
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
2 Medications/conditions/therapies that may require additional insulin be administered
Steroids, Phenytoin (Dilantin), TPN, stressful event (surgery)
What labs would indicate nephropathy?
Elevated creatinine, albuminurea, elevated BUN
Difference between DKA and HHS
What is DKA presents with ketoacidosis, and HHS with minimal or none
5 symptoms of a patient with hypoglycemia
Agitation, 'hangry', tachycardia, diaphoretic, headache, shakiness, fatigue
You are caring for a type 2 DM patient who states they feel lightheaded. They last ate 3 hours ago. What intervention is most appropriate?
Check BG via fingerstick, patient could be hypoglycemic
Normal fasting glucose level, 3 month indicator of glucose control, and targeted glucose range
<100, HgbA1C (< 6.5) and 80-110
3 education points for the patient with neuropathy
Inspect feet daily, wear flat shoes, no lotion between toes, cut nails straight across, etc.
Name 3 symptoms of a patient in DKA
confusion, disorientation, thirst, weight loss, tachycardia, hypotension, etc.
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.
5 components of diabetes management
Nutritional therapy, Exercise, Monitoring, Pharmacologic therapy, Education
What is the best way to prevent diabetes associated complications
Meticulous blood glucose control!
What glucose findings would a patient with DKA have?
Blood glucose level of 300 mg/dL or higher
Check BG every 2-4 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 min, repeat juice and recheck in 15 min. 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 80-110, Consistent carb diet, low glycemic foods, eat consistent foods, check blood glucose as recommended by MD
How might a patient describe neuropathy? What medications would help to treat this condition?
Tingling, burning, shooting pain, Gabapentin (Neurontin), Pregabalin (Lyrica)
A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardic, and diaphoretic. What is a priority action?
Check BG and administer 50% dextrose IV per protocol
When might a patient need to check their glucose levels- name 4 incidences
Prior to administering insulin, prior to meals, if they feel 'low'- hypoglycemic, if they feel 'high'- hyperglycemic, before exercising, before bed
Pt teaching for the type 1 DM to prevent DKA from occurring?
Check BG every 2-4 hours when ill, do not skip insulin doses when ill, check urine for ketones when ill, monitor for 3 P's, Sick day plan from endocrinologist
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