Term
| What structure does diabetes damage? |
|
Definition
|
|
Term
Early signs of hypoglycemia: select all that apply
a) coma
b) confusion
c) headache
d) hunger
e) pallor
f) palpitations
g) seizures
h) sweating
i) tremor
|
|
Definition
C) headache.
D) hunger
E) pallor
F) palpitations
G) sweating
H) tremor
|
|
|
Term
| DM symptoms (the 3 Ps): Explain why they happen |
|
Definition
- polyphagia
- Cells don't get glucose, go hungry
- polyuria
- excess suger gets flushed out
- polydipsia
- need to replace water lost to polyuria
|
|
|
Term
| What are the six "lists" of the ADA exchange lists? |
|
Definition
- starch
- fruit
- milk
- vegetable
- meat
- fat
|
|
|
Term
| From food pyramid: number of daily servings from fats, oils and sweets group |
|
Definition
|
|
Term
| What does the Glucose Tolerance Test involve? |
|
Definition
- Client ingests a concentrated carbohydrate drink.
- Blood glucose measured 2 hrs later
- result over 200 indicates DM
- result 140-199 indicates impaired glucose tolerance (IGT) |
|
|
Term
| Fruity breath: sign of? Who can get it? |
|
Definition
- DKA
- Type 1 DM only (for now) |
|
|
Term
| Foot care for the diabetic: What NOT to do. |
|
Definition
- Don't soak feet
- Don't put lotion between the toes
- Don't wear rubber shoes |
|
|
Term
|
Definition
- Tremors,
- diaphoresis,
- change LOC quickly,
- irritable,
- weakness,
- cold and clammy skin |
|
|
Term
| Metabolic syndrome, sometimes called syndrome X, is diagnosed when at least three of what criteria are met? |
|
Definition
- abdominal obesity
- triglycerides 150 or more
- HDL < 40 (men) or <50 (women)
- BP 130/85 or higher
- FBS 100+ |
|
|
Term
| Examples of macrovascular complications |
|
Definition
- arthersclerosis
- arteriosclerosis
- hyptertension
- elevated LDL and trigs
- stroke
- heart attack |
|
|
Term
| How do we determine if diabetes is under control? |
|
Definition
- blood glucose is "normal" for the patient
- patient feels good. |
|
|
Term
|
Definition
- brings down glucose levels
- reduces need for insulin |
|
|
Term
| Purpose for rotating insulin injection sites |
|
Definition
- decreases irritation
- increases absorption rate. |
|
|
Term
|
Definition
- energy
- helps metabolize CHO |
|
|
Term
| Where NOT to stick patient for glucoscan |
|
Definition
- pads of fingers
- thumb
- index finger
Reason: pads painful. Thumb/index finger often used - also painful |
|
|
Term
|
Definition
- pancreas doesn't make enough insulin
- insufficient or ineffective insulin receptors |
|
|
Term
| Two chronic illnesses that damage islet cells |
|
Definition
- pancreatitis
- cystic fibrosis |
|
|
Term
| Examples of microvascular complications |
|
Definition
- retinopathy
- cataracts
- nephropathy
- ESRD
- neuropathy
- impotence |
|
|
Term
| Reasons for recommending 5-6 meals per day |
|
Definition
| - stable input, maintains constistent glucose levels |
|
|
Term
| Four types of meds that may impair insulin action |
|
Definition
- steroid hormones
- Dilantin
- thyazide diuretics
- thyroid hormone |
|
|
Term
| Give the steps for mixing 10 units regular insulin and 20 units NPH insulin |
|
Definition
1- Inspect both bottles for proper type, expiration date, etc.
2- wipe off both bottle tops with alcohol wipe
3- Insert syringe into NPH bottle and inject 20 units air. withdraw needle
4- insert needle into regular bottle and inject 10 units air. DO NOT remove needle.
5- invert bottle and draw 10 units regular insulin. withdraw needle
6- re-insert needle into NPH bottle and withdraw 20 units insulin. Withdraw needle.
NOTE: If you withdraw too much from the second bottle, you CANNOT inject it back in. Discard the syringe and start over. |
|
|
Term
| According to the carb exchange list, how much rice equals one slice of bread |
|
Definition
|
|
Term
| Client takes regular insulin, but does not eat enough. When is he at risk for hyperinsulinism? |
|
Definition
| 2 hrs later - at the peak of the insulin cycle. |
|
|
Term
| Exchange list: 1 cup rice can be exchanged for what |
|
Definition
|
|
Term
| From food pyramid: number of daily servings from meat, poultry, fish, dry beans, eggs and nuts group |
|
Definition
|
|
Term
| From food pyramid: number of daily servings from milk, yogurt, and cheese group |
|
Definition
|
|
Term
| From food pyramid: number of daily servings from fruit group |
|
Definition
|
|
Term
| Postprandial glucose test: diabetes diagnosed at what limit? |
|
Definition
|
|
Term
| From food pyramid: number of daily servings from vegetable group |
|
Definition
|
|
Term
| When to check client after giving regular insulin |
|
Definition
|
|
Term
| Proper glucose testing schedule |
|
Definition
30 min before meal
AND
2 hrs after meal |
|
|
Term
| How soon after giving INSULIN will you check BLOOD SUGAR? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Percentage of diabetics with type 1 |
|
Definition
|
|
Term
| Food pyramid: number of daily servings from bread, cereal, rice, and pasta group |
|
Definition
|
|
Term
| normal preprandial plasma glucose |
|
Definition
|
|
Term
| Normal postprandial plasma glucose per ADA |
|
Definition
|
|
Term
| you administer LISPRO @ 0730, what time should BREAKFAST be served? |
|
Definition
|
|
Term
|
Definition
|
|
Term
Signs of progressed (severe) hypoglycemia: select all that apply
a) coma
b) confusion
c) headache
d) hunger
e) pallor
f) palpitations
g) seizures
h) sweating
i) tremor |
|
Definition
A) coma
B) confusion
G) seizures
I) tremor |
|
|
Term
| How long can insulin be stored after being opened? |
|
Definition
|
|
Term
|
Definition
| Alpha adrenergic blocker - anti HTN |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Desmopressin acetate (DDAVP) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| potassium iodide (lugol's solution) |
|
Definition
|
|
Term
| radioactive iodine(sodium iodide) |
|
Definition
|
|
Term
| If lispro is given at 7:30 am, when should breakfast be given? |
|
Definition
| As soon after as possible |
|
|
Term
When administering insulin to a type 1 diabetic, what is the most important thing the nurse needs to know?
A) duration of insulin
B) accuracy of the dose
C) site of injection
D) technique of injiction |
|
Definition
|
|
Term
Some experts distinguish LADA patients by the characteristics of disease as they may differ slightly based on the patient's
A) gender
B) body fat
C) race
D) diet |
|
Definition
|
|
Term
The nurse reviews the lab tests of a DKA patient. Which is an expected finding?
A) BS=250
B) pH=6.9
C) HCO3=19
D) PCO2=40 |
|
Definition
B) pH=6.9
Indicates acidosis |
|
|
Term
| If the abdomen is not available, what is the next choice for insulin injection |
|
Definition
Anterior thigh
HCO3 is only slightly low, not quite low enough to indicate the kind of acidity expected from DKA |
|
|
Term
| where is the PREFERRED site for SHORT and INTERMEDIATE acting Insulin? |
|
Definition
|
|
Term
| Which drug inhibits glucose production by the liver? |
|
Definition
|
|
Term
|
Definition
|
|
Term
Which would be included in teaching about foot care?
A) Wash feet in hot water daily
B) Use razor to remove cysts or calluses
C) Apply moisterizer daily
D) wear well-fitting comfortable rubber shoes |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Most important diabetic dietary consideration |
|
Definition
| Calories: consistent intake |
|
|
Term
|
Definition
| Carbonic Anhydraxe Inhibitor |
|
|
Term
| Sugars are the digested result of what? |
|
Definition
|
|
Term
|
Definition
| Centrally acting sympatholytic |
|
|
Term
| When recommending frequent small meals, what instruction should be included about those meals? |
|
Definition
| Choose complex carbs over simple sugars |
|
|
Term
| Most recognizable symptom of possible diabetes. |
|
Definition
| Constant infections (slow healing). |
|
|
Term
Major factor in type diabetes
A) high-fat diet
B) diet high in carbs
C)
D) Obesity |
|
Definition
|
|
Term
Which is appropriate for insulin
A) Deltoid
B) forearm
C) lateral gluteus
D) anterior thigh |
|
Definition
|
|
Term
| What nurse typically give to unconscious pt for low BS |
|
Definition
|
|
Term
| Hyperglycemia in a DM 1 patient can lead to what? |
|
Definition
| DKA - Diabetic ketoacidosis |
|
|
Term
Which of the following is NOT advised as part of diabetic foot care? Select all that apply
A) Using lotion
B) Daily soaking
C) Filing nails straight across
D) Keeping feet warm
E) Daily foot inspection
F) Wearing tight-fitting shoes and socks |
|
Definition
DO NOT
B) soak feet
F) wear tight-fitting shoes and socks |
|
|
Term
|
Definition
| Caused by autoimmune destruction of beta cells |
|
|
Term
| most important intervention to tell DM patients: |
|
Definition
| Do Not skip meals, CONSISTENCY, eat all meals at consistent times. |
|
|
Term
| Something to remember that exercise does NOT do. |
|
Definition
| Doesn't control weight gain. |
|
|
Term
| What advice is given to the client regarding exercise when glucose is above 250 and keytones are present? |
|
Definition
Don't exercise. This indicates insufficient insulin is present, and glycogen may be released during exercise, making the problem worse instead of better.
(Also true if BS>300 without ketones) |
|
|
Term
| DM 1 patients who get sick should do what? |
|
Definition
| Drink juice to bring up glucose. |
|
|
Term
After teaching a group of students about DKH, and HHNK, more teaching needed if which is identified as HHNK
A) glucose over 500
B) elevated potassium
C) decreased sodium
D) ph 7.35 - 7.45 |
|
Definition
Elevated potassium
lytes elevate in DKA, not HHNK |
|
|
Term
| Why does exercise lower blood sugar levels? |
|
Definition
| Exercising muscle cells do not need insulin to help absorb glucose |
|
|
Term
|
Definition
FPG (Fasting plasma glucose): normal <100
CPG (casual {non-fasting} plasma glucose): normal <200 |
|
|
Term
| While there is a variety of meal plans used in diabetes management, all plans limit intake of what? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Type of diabetes that develops during pregnancy |
|
Definition
| Gestational diabetes mellitus |
|
|
Term
| DM client complains of symptoms, but is stable. What to do first |
|
Definition
|
|
Term
| Patient is shaky, anxious, tremolos. What is the first thing the nurse should do? |
|
Definition
|
|
Term
| Releases stored glucose from the liver and muscles when needed |
|
Definition
|
|
Term
| triamcinolone (Aristocort) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Prednisone (orasone,Deltasone,meticorten) |
|
Definition
|
|
Term
|
Definition
Glucose tolerance test (GTT)
client must fast 12 hrs before test. |
|
|
Term
| What test is used to monitor progress of diabetes control? |
|
Definition
|
|
Term
| What are macrovascular complications |
|
Definition
|
|
Term
| Responsible for up to 90% of diabetes 2 |
|
Definition
|
|
Term
| Rapid-acting insulin: give onset, peak and duration |
|
Definition
Humalog:
- Onset 15-30 min
- Peak 30-90 min
- Duration up to 5 hrs
NovoLog:
- onset 10-20 min
- peak 1-3 hr
- duration 3-5 hr |
|
|
Term
| 70/30 is a mixture of what two types? |
|
Definition
|
|
Term
| long-acting: give onset, peak and duration |
|
Definition
Humulin U:
onset 4-6 hr
peak 14-24 hr
duration 26-36 hr
Glargine (lantus):
- onset 70 min
- no peak
- 24 hr |
|
|
Term
| High blood glucose complication in type 2 client. |
|
Definition
| Hyperosmolar, hyperglycemic, NONketotic syndrom |
|
|
Term
|
Definition
| Impaired glucose tolerance |
|
|
Term
| When mixing insulins (NPH and Regular), into which bottle do you inject air first? |
|
Definition
| Inject air into NPH bottle first. |
|
|
Term
| Where are beta cells found? |
|
Definition
| Islets of Langerhans, in the pancreas. |
|
|
Term
| Why glucophage is a preferred treatment med. |
|
Definition
It rarely causes hypoglycemia
(although it could cause lactic acidosis) |
|
|
Term
|
Definition
|
|
Term
| High blood glucose complication in type 1 client. |
|
Definition
|
|
Term
| unconscious patient with severe hyperglycemia and dehydration. Diagnosis? |
|
Definition
|
|
Term
| Side effect of Desmopressin (DDAVP) to watch for |
|
Definition
|
|
Term
| Glycogen is stored where? |
|
Definition
|
|
Term
| An inherited defect in insulin secretion that usually occurs under age 25 |
|
Definition
| Maturity-onset diabetes of the young (MODY) |
|
|
Term
| Diabetics of all types should have what sort of protection |
|
Definition
|
|
Term
| Drug that helps tissue use insulin more effectively |
|
Definition
|
|
Term
| what medication is an Alpha Glucosidase Inhibitor??? |
|
Definition
|
|
Term
| flurocortisone (Florinef Ac..) |
|
Definition
|
|
Term
WHERE is INSULIN made?
What does it do? |
|
Definition
PANCREAS, BETA CELLS, islets of Langerhans
LOWERS blood sugar |
|
|
Term
| Why would a type 2 diabetic NOT be a candidate for pancreas transplant? |
|
Definition
| Problem may not be the pancreas, but rather insulin resistance by the cells. |
|
|
Term
| _______ and ______ can indirectly provide smaller amounts of glucose. |
|
Definition
|
|
Term
|
Definition
| Pt. ate too much, missed insulin injection |
|
|
Term
| Lispro/Aspart/Exubera/Humalog/Novalog: insulin type: |
|
Definition
|
|
Term
| What kind of insulin can be given via the pump? |
|
Definition
|
|
Term
| What is the only type of insulin that can be given by IV? |
|
Definition
|
|
Term
| Short-acting: give onset, peak and duration |
|
Definition
Short-acting
- Onset 30 - 60 min
- Peak 2-5 hr
- duration 3-5 hr |
|
|
Term
| Erectile dysfunction is a sign of what? |
|
Definition
| Sign of autonomic neuropathy |
|
|
Term
| Patient wakes up in the middle of the night from nightmares, and has a headache in the morning. What's the condition? |
|
Definition
|
|
Term
| Doctor is monitoring progress of diabetes management with a client and orders a glycohemoglobin test. Lab results show Hgb=11.1, Hct=37% What do you do? |
|
Definition
| Suggest a glycated serum protein test instead. Anemia hinders accuracy of the HbA1c. |
|
|
Term
| Chlorpropamide (Diabinese) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| How do we know patients know how to check glucose or give insulin? |
|
Definition
| The patient demonstrates it back to you. |
|
|
Term
|
Definition
|
|
Term
All are symptoms of hypoglycemia except
A) Shaking
B) Feeling cold
C) Dizziness
D) Excessive thirst |
|
Definition
Thirst:
This is hyperglycemia |
|
|
Term
| Who would most likely need the following advice: "avoid exercising at the time of day when your blood sugar is at its lowest." |
|
Definition
| Those on intermediate-acting insulin |
|
|
Term
| How to know if a cut or injury is healing? |
|
Definition
| Through documentation. Comparing size and appearance from shift to shift. |
|
|
Term
| levothyroxine (Synthroid) |
|
Definition
|
|
Term
| levothyroxine sodium (synthroid,levothroid,levoxyl) |
|
Definition
|
|
Term
| After delivery, a mother who had GDM is at an increased risk for what? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Clients with neuropathy or foot problems should limit what kind of exercise? |
|
Definition
| Weight-bearing exercise should be limited. |
|
|
Term
| Why the type 2 diabetic cannot take oral insulin? |
|
Definition
| Won't work - stomach won't absorb it. |
|
|
Term
|
Definition
| Young, skinny, athletic, tall males |
|
|
Term
| What to avoid when on glyburide |
|
Definition
|
|
Term
| Condition that hinders the accuracy of a glycohemoglobin test |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
A patient with type 1 has glucose 324. Usually <150. What does he do first
A) Drink OJ
B) Call MD
C) Check urine for ketones and drink water
D) Lie down and recheck glucose in 2hr |
|
Definition
|
|
Term
| If diabetec has MILD symptoms, what do do first |
|
Definition
|
|
Term
| Teaching regarding meals and snacks |
|
Definition
|
|
Term
| Best way to prevent nephropathy |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Methylprednisolone (medrol dose pack,Depo-medrol,Solu-medrol) |
|
Definition
|
|
Term
| What should an exercising diabetic bring to the workout? |
|
Definition
|
|
Term
| Pt's on GLYBURIDE should avoid what? |
|
Definition
|
|
Term
| If SICK and/or FEBRILE, how often should you monitor your BS level ? |
|
Definition
|
|
Term
| prednisolone (Delta-cortef,prelone,oraped,pediapred) |
|
Definition
|
|
Term
| Triamcinolone (aristocort) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| when administering HUMULOG, what precaution must be taken? |
|
Definition
| have FOOD TRAY readily available (this insulin is fast acting) |
|
|
Term
| Describes condition in which client has low blood sugar due to excess insulin |
|
Definition
|
|
Term
| low, bounding pulse is a sign of what? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What client can do to reduce risk of ketoacidosis |
|
Definition
|
|
Term
| NPH Humulin N/Novalin N: insulin type |
|
Definition
|
|
Term
| Intermediate-acting: give onset, peak and duration |
|
Definition
intermediate-acting:
onset 1-2 hr
peak 6-12 hr
duration 18-26 hr |
|
|
Term
| Patient's wife asks why his dm has fruity odor |
|
Definition
|
|
Term
| Humulin U/Ultralente/glargine/lantus/Levemir: insulin type |
|
Definition
|
|
Term
|
Definition
| make proper insulin adjustments |
|
|
Term
|
Definition
| moves glucose into body cells for use |
|
|
Term
| Unconscious patient with severe hyperglycemia and dehydration, AND elevated osmolarity. What is the diagnosis? |
|
Definition
| nonketotic hyperosmolar coma |
|
|
Term
| Glimepride (amaryl):sulfonylureas |
|
Definition
|
|
Term
| Biguanides: metformin(glucophage) |
|
Definition
|
|
Term
|
Definition
| pancreas stops making insulin |
|
|
Term
|
Definition
|
|
Term
| Lack of sensation and tingling/numbness in the fingers are signs of ________ |
|
Definition
|
|
Term
| A client has peripheral neuropathy. How is this manifested? |
|
Definition
| peripheral neuropathy - tingling, numbness, and a general lack of sensation in the fingers. |
|
|
Term
|
Definition
|
|
Term
| Activities that causes eye straining is a risk of complication for the client with what? |
|
Definition
|
|
Term
| Humulin R/Novalin R: insulin type |
|
Definition
|
|
Term
| Preferred site for intermediate or short-acting insulin |
|
Definition
|
|
Term
| Foot care for the diabetic: how to file nails |
|
Definition
|
|
Term
| liothyronine sodium (cytomel) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What type of diabetic would be prescribed Diabeta? |
|
Definition
|
|
Term
| Age of onset for type 1 DM |
|
Definition
|
|
Term
|
Definition
|
|
