Diabetes
It is the test that measures the 3 month average glucose level in the body.
What is... glycosylated hemoglobin (hemoglobin A1C) test.
Microvascular changes that may occur with diabetes mellitus.
What are... neuropathy, nephropathy, and retinopathy.
Teach clients to maintain tight glycemic control to prevent these.
Education for a client with a history of diabetic neuropathy and decreased sensation.
What is... always wear shoes and inspect feet daily for s/s of ulcers or infection.
This characteristic respiratory pattern is indicative of DKA (Diabetic ketoacidosis)
What is... What is Kussmaul respirations?
In metabolic acidosis, rate and depth of respirations are increased to compensate, and remove CO2.
This is an adverse effect of Sulfonylureas (eg: Glipizide)
What is... hypoglycemia
This may be potentiated by NSAIDs or alcohol so teach client to avoid these to prevent hypoglycemic episodes.
True or false
The nurse should teach clients to significantly reduce or eliminate carbohydrates from their diet.
False.
Teach clients to consume complex carbohydrates and whole grain foods, along with adequate protein intake. Fats should come from omega-3 and monosaturated fats, limiting trans fats.
Clients diagnosed with diabetes should see the eye doctor yearly to prevent this.
What is... blindness.
The recommended frequency may change based on retinopathy and other risk factors.
Treatment for a client experiencing an episode of hypoglycemia.
What is... consuming 15g of fast acting carbs (juice, soda, glucose tablets.)
Repeat until hypoglycemia is corrected.
For lethargic/confused treatment may include glucagon or IV dextrose
These are the three priority treatments for DKA.
What are... fluids to hydrate the cells, insulin, and restoration of electrolytes.
Monitor potassium!
This oral antidiabetic medication commonly causes GI side effects like n/v/d, flatulence, and abdominal discomfort, which can decrease compliance with the prescribed treatment regimen.
What is... Metformin (Biguanide)
Teach patients that they should hold this medication if they are undergoing tests involving contrast dye.
Collectively, high blood pressure, high blood sugar, high triglycerides, low HDL, and a large waist circumference are known as this.
What is... metabolic syndrome.
This test alerts the nurse that the client is experiencing altered kidney function related to diabetic nephropathy.
What is... urinalysis.
Albumin (protein) will be present in the urine for this client. Also monitor BUN and creatinine in patients with suspected renal dysfunction.
True or false
Insulin requirements decrease for clients during times of illness.
What is.... False
Check blood sugar more frequently when sick (every 4 hours), insulin requirements may increase. also stay hydrated and check for ketones.
This is the first step of treatment for a client diagnosed with hyperglycemic hyperosmolar state.
What is... Fluid resuscitation.
Ensure the client has IV access and administer fluids to restore fluid volume, followed by electrolyte replacement and insulin therapy.
This medication is administered when a patient cannot safely consume carbohydrates orally to correct a hypoglycemic episode.
What is... Glucagon
Medication can be give IV, IM, SQ, or intranasally
At 11:30, you notice the following symptoms in your patient: diaphoretic, irritable, tachycardic. The appropriate initial nursing action is...
What is... check finger stick blood glucose?
This organ relies heavily on glucose for energy.
Hypoglycemia can significantly impair cognitive function.
These include subcutaneous tissue in the abdomen, thighs, upper arms, and buttocks.
What are... insulin injection sites.
Teach client to rotate insulin injection sites to prevent lipohypertrophy, which impairs insulin absorption.
DKA/Ketosis signs and symptoms
What are... Kussmaul respirations, tachycardia, dehydration, orthostatic hypotension, hyperglycemia, ketones in urine
This insulin mimics basal insulin.
What is... insulin glargine (Lantus)
Onset 3-4 hrs, Peak none, Duration ~24hrs
This type of diabetes mellitus is typically caused by autoimmune destruction of the beta cells of the pancreas.
What is... type 1 diabetes mellitus.
Also caused by viral infections.
Inheritance of certain genes and tissue types increases the risk for T1DM, however most people do not develop T1DM
Macrovascular complications related to diabetes results in diseases of this body system
What is... the cardiovascular system?
Do this after meals to help maintain blood glucose levels.
What is... exercise! (walk, bike, swim, etc.)
Exercise improves blood flow and makes muscles more sensitive to glucose, increasing cellular uptake and use of glucose.
Always monitor this electrolyte when treating DKA/HHS with IV insulin.
What is... potassium.
Remember, when replacing low potassium, IV potassium is never given via bolus. Always administer 10-20 mEq/hr
The onset of insulin lispro (Humalog) and insulin aspart (Novolog).
What is... 15-30 minutes
Peak 1-3 hours
Duration 3-5 hours