Term
Which of the following pt's has a diagnosis of diabetes mellitus?
a- fasting blood glucose of 120 mg/dL
b- gylcosylated hemoglobin of 6.3%
c-2-Hr glucose 185 mg/dL, 2-hr plasma glucose 198 mg/dL
d- random blood glucose of 208mg/dL, polyuria, polydypsia |
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Definition
D- Random blood glucose of 208mg/dL, polyuria, polydpsia b/c its above the 200 mg/dL range with signs and symptoms
a-the fasting blood glucose would have to be greater or equal to 126 mg/dL
b- A1C must be greater or equal to 6.5%
c- 2 hr plasma glucose should be below 180 mg/dL |
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Term
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Definition
3 month average of glycosylated hemoglobin
glucose bound to hemeglobin on RBC is directly proportional to average serum glucose
Normal: 4.0-6.0%
Pre- Di: 5.7-6.4%
Diabetes: 6.5% + |
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Term
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Definition
Oral glucose tolerance test
Must show s/s + high reading
Used to test for gestational diabetes around 17-24 weeks
After 2 hrs :
Normal: below 140
Pre: 140-199
Diabetes: 200 + |
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Term
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Definition
Fasting blood glucose
Done after 8 hours w/o food & drink
(usually morning reading)
~~ Want it 70-130mg/dL~~
Normal: less than 100
Pre: 100-125
Diabetes: 126+
**if less than 50 = confusion or unable to operate
**if OVER 400 DKA |
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Term
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Definition
measures 2-3 weeks of any glycoslated protein
Useful for testing pts that have hemolytic disease ( Sickle Cell) b/c A1C doesn't work
Diabetes: 286+ |
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Term
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Definition
Useful to distinguish type 1
Type 1 = LOW
Type 2= High |
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Term
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Definition
Pre diabetes
Type 1
Type 2
Gestational(GDM)
MODY |
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Term
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Definition
10% of diabetes pt's
destruction of pancreatic beta cells
No Insulin Productions
Abrupt
Lean Body
MONO insulin Therapy |
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Term
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Definition
90% of DM pt's
insufficient insulin production from pancreas
Insulin resistance
Gradual
Overweight/obese body type
1+ insulin therapy or other oral therapy |
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Term
| Symptoms of HYPERglycemia |
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Definition
Associated with Type 2:
polyuria -polydypsia - polyphagia
fatigue
blurred vision
dryskin
weight loss |
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Term
| What readings must you have to diagnose type 2? |
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Definition
A1C= 6.5% +
FBG= 126+
2Hr= 200+
s/s + random glucose 200 + |
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Term
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Definition
Increases risk of falling
#1 cause of amputation
damaged small nerve endings
Tingling/burning/numbness |
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Term
| When interviewing a pt prior to a diabetic foot exam what are the 3 questions to ask? |
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Definition
1- have you had any pain in your calf muscles when walking?
2- have you experienced any numbness/tingling/burning?
3- Have you had an amputation, any deformitites, or foot ulcers? |
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Term
| What are things you inspect for during a diabetic foot exam? |
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Definition
1- thin, fragile, shinny, hairless skin, = Decrease vascular supply
2 inspect for thickness, ingrown, length, and fungal infections
3- inspect for calluses, blisters, ulcers |
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Term
| What are recommendations for diabetes self foot care? |
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Definition
inspect feet DAILY
Use powder in between TOES
Cut toenails STRAIGHT across
Use lotion on top and bottom of feet to keep soft
Wear socks and shoes as much as possible ( breathable)
Wash feet daily- but use LUKEWARM water
NO CORN MEDications, razor use, heating pads, hot water bottles, or iodine on feet! |
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Term
| What 2 pulses should you check during a diabetic foot exam? |
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Definition
Dorsalis pedis ( on top of foot )
Posterior tibial ( by Achilles tendon) |
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Term
| How often should a comprehensive foot exam be completed? |
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Definition
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Term
| Order of Diabetic foot exam? |
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Definition
get history
check socks & shoes
inspect feet
check sensation ( monofilament) |
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Term
| Diabetes treatment goals vs. Diagnosis |
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Definition
Diagnosis ------- Treatment Goal
HbA1C 6.5% + less than 7%
FBG 126 + 70-130
2Hr-PPBG: 200+ less than 180 |
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Term
| What are the Rapid Acting insulins? |
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Definition
Humalog
Novalog
Apidra
(Can combine with NPH) |
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Term
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Definition
Glargine (Lantus)
detemir ( Levemir)
(NOT COMPATIBLE w/ other insulin therapy) |
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Term
| What are the 2 Intermediate/ Short acting mixes? |
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Definition
Humalin 70/ 30
Novolin 70 / 30 |
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Term
| What are the 2 Rapid Premixes? |
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Definition
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Term
| Key points to counsel a pt for insulin |
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Definition
Appearance = clear or cloudy?
storage= in use vs not in use
where to inject= rotation and absorption time |
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Term
| List the absorption sites fastest to slowest |
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Definition
Abdomen
upper arm
ant/lat Thigh
buttocks |
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Term
| What are the "CLOUDY" insulins? |
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Definition
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Term
| Symptoms of HYPO glycemia |
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Definition
Shaking
sweating
dizzy
hunger
INC heartbeat
fatigue
HA
irritable |
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Term
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Definition
not enough carbs
DEC glucose
Too much medication
too much exercise w/o enough carb
INC/DEC insulin clearance
B- Blockers ( sweating only) |
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Term
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Definition
more food than usual
illness or infection
less activity than usual
miss/skip insulin
Medications
Emotional/physical stress
expired /improper storage of insulin |
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