DIABETES BASICS
This type of diabetes is characterized by autoimmune destruction of pancreatic beta cells.
What is Type 1 diabetes mellitus?
This blood glucose level is generally considered hypoglycemic and requires immediate intervention.
What is less than 70 mg/dL?
This rapid-acting insulin has an onset of 15 minutes and is often given right before meals.
What is lispro (Humalog)?
Before administering insulin, the nurse must always perform this safety check.
What is “check the patient’s blood glucose level”?
Patients should rotate injection sites to prevent this complication, which affects insulin absorption.
What is lipohypertrophy (or lipodystrophy)?
This hormone, produced by pancreatic beta cells, is deficient or ineffective in diabetes.
What is insulin?
Your patient is diaphoretic, shaky, anxious, and reports feeling lightheaded. These are signs of this glucose emergency.
What is hypoglycemia?
This is the only type of insulin that can be given intravenously.
What is Regular insulin (Humulin R)?
Your patient’s blood glucose is 52 mg/dL and they are conscious and able to swallow. Your priority intervention follows the rule of this.
What is the “Rule of 15” (give 15 grams of simple carbohydrates, recheck in 15 minutes)?
A patient asks, “When should I check my feet?” The evidence-based answer is this.
What is “daily” (every day)?
In Type 2 diabetes, cells become resistant to insulin, causing this metabolic state where the pancreas must produce more insulin to achieve the same effect.
What is insulin resistance?
Kussmaul respirations, fruity breath odor, and confusion are classic signs of this diabetic emergency.
What is diabetic ketoacidosis (DKA)?
Metformin (Glucophage) belongs to this drug class and works by decreasing hepatic glucose production.
What are biguanides?
When mixing NPH and Regular insulin in the same syringe, you should draw up this type first to prevent contamination.
What is Regular (clear) insulin? (“Clear before cloudy”)
You’re teaching a patient about metformin (Glucophage). You emphasize they should stop taking it and notify their provider if they need this type of diagnostic test.
What is a CT scan with IV contrast (or any procedure requiring contrast dye)? (Rationale: risk of lactic acidosis and acute kidney injury)
This life-threatening complication occurs when insulin deficiency causes the body to break down fat for energy, producing ketones and metabolic acidosis.
What is diabetic ketoacidosis (DKA)?
The “TIRED” mnemonic helps identify hyperglycemia: Thirst, Infection, Restroom (frequent urination), Eating (excessive), and _____ (this symptom beginning with “D.”)
What is Dehydration (or Drowsiness)?
This long-acting insulin has no peak, lasts approximately 24 hours, and is often called “basal” insulin.
What is insulin glargine (Lantus)?
Your patient with Type 2 diabetes is NPO for surgery. State TWO important considerations for their diabetes management.
What are “hold oral diabetes medications” AND “monitor blood glucose closely”? (may need ADJUSTED sliding scale insulin, risk for hypo or hyperglycemia)
Your patient on a sulfonylurea states, “I’m going hiking this weekend.” Connect the concepts of metabolism, nutrition, and safety: What teaching must you provide?
What is “carry fast-acting carbohydrates, monitor for hypoglycemia signs, exercise increases insulin sensitivity and lowers blood glucose, may need to eat extra snack or reduce medication per provider”?
These are the classic “3 Ps” of diabetes symptoms.
What are polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger)?
You notice your patient has tremors and confusion. You interpret this as possible hypoglycemia. State the FIRST priority nursing response.
What is “check blood glucose immediately”?
Sulfonylureas like glipizide (Glucotrol) and meglitinides like repaglinide (Prandin) both work by stimulating the pancreas to release insulin, putting patients at risk for this complication.
What is hypoglycemia?
Your patient in DKA is receiving IV regular insulin and IV fluids. You notice their potassium level is 3.2 mEq/L (low). Apply clinical judgment: What is your priority action and rationale?
What is “notify provider before continuing insulin”? (rationale: insulin drives potassium into cells, further lowering serum K+ and risking cardiac arrhythmias)
Using concept-based teaching, connect diabetes (metabolism) to these THREE interrelated concepts (Perfusion, Tissue Integrity, & Infection) and explain one teaching point for each.
A: What are:
- Perfusion: Check BP regularly (cardiovascular complications)
- Tissue Integrity: Inspect feet daily (neuropathy/poor wound healing)
- Infection: Monitor wounds closely (hyperglycemia impairs immune function)