Term
| is a chronic disease of deficient glucose metabolism |
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Definition
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Term
| what is secreted from the beta cells of the islets of Langerhans in the pancreas in response to an increase in glucose |
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Definition
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Term
| what disease is characterized by insufficient to no insulin secretion from the pancreas.. OR insufficient insulin cell receptors.. OR insulin resistance by the body? |
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Definition
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Term
| signs and symptoms of diabetes mellitus (DM) |
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Definition
| called the 3 “polys” polyuria, polydypsia, polyphagia |
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Term
| How many types of Diabetes Malletus are there, and which is the most common? |
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Definition
| 4 types, type2 is the most common. |
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Term
| the most common cause of Type 2 DM |
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Definition
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Term
| what is the most common reason for insulin resistance? |
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Definition
| Crap diet filled with high sugar foods and drinks over a life span |
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Term
| The normal range for serum glucose is |
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Definition
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Term
| what body chemical do they use to measure the average of a patient’s glucose over a three month period – |
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Definition
Hemoglobin A1c (HbA1c)
the hemoglobin not only carries O2, it interacts with glucose |
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Term
| what syrum hemoglobin levels indicate a diagnosis of DM |
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Definition
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Term
| A fasting serum blood glucose of ______ also indicates DM |
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Definition
| A fasting serum blood glucose >200 also indicates DM |
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Term
| Why is normal insulin not given orally? |
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Definition
| It is a protein hormone and would be inactivated by GI enzymes. |
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Term
| What does an insulin's "ONSET" level tell you? |
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Definition
| ONSET tells you “when to feed ‘em”. For example, with the rapid acting insulin Humalog (Lispro) you need that tray right in front of them and the patient needs to say they are going to eat now (ie no N/V). Why? It has an onset of 5 MINUTES. If you give it and the pt doesn’t eat there’s trouble ahead! |
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Term
| what does insulin's "PEAK" level tell you? |
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Definition
| you “when to watch ‘em” And what are you watching for? The s/s of hypoglycemia. |
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Term
| when using a "combination insulin". Which number is for the intermediate insulin? Which would be for the rapid insulin? |
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Definition
| first numeral is the amount of intermediate-acting insulin and the second numeral is the amount of rapid or short-acting insulin. |
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Term
| Lantus is different from other insulin meds because... |
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Definition
| it has no real "PEAK" and therefore is unlikely to cause HYPOglycemia |
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Term
| why cant you mix lantus with other insulin meds? |
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Definition
| It is highly acidic and would destroy the other insulin. |
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Term
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Definition
| a medical condition characterized by abnormal or degenerative conditions of the body's adipose tissue. A lipodystrophy can be a lump or small dent in the skin that forms when a person keeps performing injections in the same spot. |
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Term
| negative affect of injecting medications/insulins into an area affected by lipodystrophy? |
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Definition
| the rejection of the injected medication, the slowing down of the absorption of the medication, or trauma that can cause bleeding that, in turn, will reject the medication. |
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Term
| negative affect of injecting medications/insulins into an area affected by lipodystrophy? |
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Definition
| the rejection of the injected medication, the slowing down of the absorption of the medication, or trauma that can cause bleeding that, in turn, will reject the medication. |
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Term
| which type of DM is from not being able to produce enough (or any) insulin? |
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Definition
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Term
| physiological factors that can increase the need for insulin |
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Definition
| Illness, stress (trauma, surgery, emotional stress) |
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Term
| which medications can raise glucose, and thus should be double careful when giving to a diabetic patient? |
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Definition
| steroids, thiazide diuretics |
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Term
| Hypoglycemia signs and symptoms? |
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Definition
| WET AND CRAZY” – sweating, confused, slurred speech, uncoordination, nervous, agitated |
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Term
| treatment for hypoglycemia? |
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Definition
| ? GLUCOSE. 15gm – wait 15 minutes and recheck. That 15gm of glucose needs to be something FAST ACTING like 4 oz of juice or regular soda (candy works but not as fast).At the 15 min recheck - if the glucose is now at a safe level – anything from 75-100 - we next give a long acting glucose combined with protein and fat: crackers and peanut butter, milk and crackers, milk and half a turkey sandwich. |
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Term
| antihypoglycemia medication? |
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Definition
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Term
| Hyperglycemia signs and symptoms? |
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Definition
| “DRY AND CRANKY” – dry mucous membranes, poor skin turgor, extreme thirst, (polydypsia) fruity breath, tachycardia, polyuria, deep rapid breathing (Kussmaul respirations), fatigue |
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Term
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Definition
| In the hospital insulin(maybe even a regular insulin IV drip), IV hydration. Treatment at home? Contact HCP, take scheduled insulin, increase H20. |
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Term
| diabetic ketoacidosis (hyperglycemic reaction) S&S? |
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Definition
Extreme thirst
Polyuria
Fruity breath odor
Kussmaul breathing (deep, rapid, labored, distressed, dyspnea)
Rapid, thready pulse
Dry mucous membranes, poor skin turgor
Blood sugar level 250 mg/dL |
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Term
| Hypoglycemic reaction (insulin shock) S&S |
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Definition
Headache, lightheadedness
Nervousness, apprehension
Tremor
Excess perspiration; cold, clammy skin
Tachycardia
Slurred speech
Memory lapse, confusion, seizures
Blood sugar level <60 mg/dL |
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Term
| With an inadequate amount of insulin, sugar cannot be metabolized, and fat catabolism occurs. The use of fatty acids (ketones) for energy causes .... |
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Definition
| ketoacidosis (diabetic acidosis or diabetic coma). |
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Term
| When more insulin is administered than needed for glucose metabolism, a hypoglycemic reaction, called what, occurs? |
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Definition
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Term
| first oral antidiabetic drugs |
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Definition
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Term
| what are chemically similar to sulfonamides (so watch out for allergies to these and Sulfa), but have no antibacterial properties. |
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Definition
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Term
| 2nd gen Sulfonylureas (2 drugs) |
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Definition
| are glipizide (Glucotrol) and glyburide (Diabeta). |
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Term
| how do sulfonylureas work in the body? |
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Definition
| they stimulate beta cells to secrete insulin and increase insulin receptor sensitivity. |
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Term
| The nonsulfonylurea classes are what? |
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Definition
| biguanides, alpha-glucosidase inhibitors, thiazolidinediones (the “glitazones”) and meglitinides (the “glitanides”). |
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Term
| what is the most common antidiabetic PO drug class? |
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Definition
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Term
| Thiazolidinediones drug examples? |
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Definition
| pioglitazone (Actos), rosiglitazone (Avandia) |
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Term
| Thiazolidinediones method of action in the body? |
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Definition
| enhance insulin receptor sensitivity decreased insulin resistance |
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Term
| Biguanides method of action in the body? |
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Definition
| increases binding of insulin to cell receptors, increases cell sensitivity to insulin, decreases hepatic production of glucose, reduces absorption of glucose from small intestine |
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Term
| Meglitinides drug examples? |
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Definition
| repaglinide (Prandin), neteglinide (Starlix) |
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Term
| Meglitinides method of action in the body? |
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Definition
| : stimulate release if insulin from beta cells of pancreas; release insulin in quick bursts |
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Term
| Incretin mimetic, exebatude (Byetta), method of action on the body? |
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Definition
enhances insulin secretion from pancreatic beta cells; blocks excess hepatic production of glucose
• Delays gastric emptying reduces appetite |
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Term
| • exebatude (Byetta)is used for which disease? |
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Definition
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Term
| what medication is taken orally and NOT used for Acute HYPOglycemic reaction? |
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Definition
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Term
| what medication is • Used to treat chronic hypoglycemia due to hyperinsulinism, usually caused by islet cell cancer or pancreatic hyperplasia |
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Definition
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Term
| what medication IS used to treat ACUTE HYPOglycemic reaction? |
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Definition
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Term
1. A client is diagnosed with type 2 diabetes mellitus. The nurse is aware that which statement is true?
a. Client is most likely a teenager.
b. Client is most likely a child younger than 10 years.
c. Heredity is a major causative factor.
d. Viral infections contribute most to disease development. |
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Definition
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Term
2. Antidiabetic drugs are designed to control signs and symptoms of diabetes mellitus. The nurse primarily expects a decrease in which?
a. Blood glucose
b. Fat metabolism
c. Glycogen storage
d. Protein mobilization |
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Definition
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Term
3. A client is to receive insulin before breakfast, and the time of breakfast tray delivery is variable. The nurse knows that which insulin should not be administered until the breakfast tray has arrived and the client is ready to eat?
a. Humulin N
b. lispro (Humalog)
c. glargine (Lantus)
d. Humulin R |
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Definition
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Term
4. A client is receiving a daily dose of Humulin N insulin at 7:30 AM. The nurse expects the peak effect of this drug to occur at which time?
a. 8:15 AM
b. 10:30 AM
c. 5:00 PM
d. 11:00 PM |
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Definition
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Term
5. When the client is prescribed glipizide (Glucotrol), the nurse knows that which side effects/adverse effects may be expected? (Select all that apply.)
a. Tachypnea
b. Tachycardia
c. Increased alertness
d. Increased weight gain
e. Visual disturbances
f. Hunger |
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Definition
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Term
6. A nurse who is teaching a client how to recognize symptoms of hypoglycemia should include which symptoms in the teaching? (Select all that apply.)
a. Headache
b. Nervousness
c. Bradycardia
d. Sweating
e. Thirst
f. Sweet breath odor |
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Definition
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Term
7. A client is newly diagnosed with Type 1 diabetes mellitus and requires daily insulin injections. Which instruction should the nurse include in the teaching of insulin administration?
a. Teach the family members to administer glucagon by injection if the client has a hyperglycemic reaction.
b. Instruct the client about the necessity for compliance with prescribed insulin therapy.
c. Teach the client that hypoglycemic reactions are more likely to occur at the onset of action time.
d. Instruct the client in the care of insulin container and syringe handling. |
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Definition
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