NUR 504 Exam 5 Practice Questions and Correct Answers
1 view 0 purchase
Course
NUR 504
Institution
NUR 504
Diabetes: a metabolic disorder affecting insulin production and insulin resistance
Type I DM: -an autoimmune disease with an acute onset -most prominent in children, teens, and adults <30 -*beta cells in the pancreas are destroyed*, causing an inability to produce a sufficient amount of insulin...
NUR 504 Exam 5 Practice Questions and
Correct Answers
Diabetes: ✅a metabolic disorder affecting insulin production and insulin resistance
Type I DM: ✅-an autoimmune disease with an acute onset
-most prominent in children, teens, and adults <30
-*beta cells in the pancreas are destroyed*, causing an inability to produce a sufficient
amount of insulin or none at all
-cannot be prevented or cured
-requires insulin injections for life
Type II DM: ✅-has a gradual onset
-NOT autoimmune
-*insulin resistance* and beta cell dysfunction occurs preventing cellular uptake of
glucose (it takes more insulin to reach the tissues d/t the resistance barrier)
-most prominent in adults > 30, but can develop at any age
-can be prevented through lifestyle modifications
-may require insulin but oral glycemics are usually tried first
risk factors for type I DM: ✅-family hx
-autoimmune dz
risk factors for type II DM: ✅-family hx
-obesity
-more prevalent in African American, Hispanic, and Native Americans
-sedentary lifestyle
-Hx of gestational DM
Labs for diabetes: ✅Fasting Blood Sugar (FBS) --> representative of the bodies
baseline rate
-w/ out diabetes --> 70-90
-w/ diabetes --> 80-130
Random Blood Sugar:
-gives a view of how the body is responding to food
HBA1C: measures BG over the past 3 months (the lifecycle of RBCs)
-normal non diabetic: <6
-prediabetes: 5.7-6.4
-diabetes: >7 (we don't want them to be super low because that means they are
frequently hypoglycemic)
,Oral Glucose Tolerance Test (GTT):
-blood is checked at 1,2, & 3 hours to see how insulin production is responding to
carbohydrate and glucose intake
DX testing for diabetes: ✅Ongoing monitoring for complications of the disease
Eye exam:
-they are at risk for diabetic retinopathy (sugar damages the vasculature in the eye and
is irreversible)
Cardiovascular health:
-CAD is the biggest risk for diabetic patients which can lead to MU
-we use an EKG to monitor baseline cardiac function
Foot care:
-they will have neuropathy
S/S of diabetes: ✅*new onset of diabetes will always present with symptoms
consistent with high blood sugar or hyperglycemia*
-polyphagia, polyuria, polydipsia
-always hungry
-always tired
-dizziness
-frequent urination (good red flag is children who have been potty trained wetting the
bed or adults waking up in the middle of the night with urgency)
-sexual problems
-blurry vision
-tingling in hands or feet
-always thirsty
-unexplained weight gain in type II --> type I there will be weight loss m
-wounds that wont heal
Bolus insulin: ✅*Carb coverage*
-patients do not need this coverage if they don't eat
-extra amounts of insulin in the pancreas would naturally make in response to glucose
consumption through meals
-the amount of bolus insulin given depends on the size of the meal
-Humalog
-Novolog
-Regular
Basal Insulin: ✅Insulin given at any time regardless of meals or not
-given for the insulin that is normally supplied by the pancreas and is present 24 hrs/day
whether or not the patient eats
Lantus or Levemir: doesn't have a set peak
,-within 24 hrs the way its secreted 1 unit will be secreted each hr for 24 hrs
-1 unit/hr x 24 hrs
Humalog or Novolog via insulin pump
Rapid acting insulin: ✅Lispro (Humalog) & Aspart (Novolog)::
-Route: subcut
-Onset: within 15 min
-Peak: 1-2 hrs
-Duration: 3-4 hrs
-highest risk for hypoglycemia: 1-2 hrs
Short acting/ regular insulin: ✅regular (Humulin R or Novolin R):
-Route: subcut
-Onset: 30-60 min
-Peak: 2-4 hrs
-Duration 5-7 hrs
-High risk for hypoglycemia: 2-4 hrs
-Route: IV
-Onset: 10-30 min
-Peak: 15-30 min
-Duration: 30-60
-High risk for hypoglycemia: ALL THE TIME
Long Acting Insulin: ✅Glargine (lantus):
-Route: subcut
-Onset: 3-4 hrs
-Peak: No peak
-Duration: 24 hrs
-High risk for hypoglycemia: 3-24 hrs
Detemir (levemir):
-Route: subcut
-Onset: 3-4 hrs n
-Peak: 3-4 hrs
-Duration: up to 24 hrs
-High risk for hypoglycemia: 3-14 hrs
, Blood glucose monitoring and insulin injections: ✅-only fast acting insulin is used in
insulin pumps
-work with the client to develop compliance
-we need to know their level of activity
-PATIENT PREFERENCE
Insulin Delivery: ✅target BG is individualized and typically between 100-130
Sliding Scale:
-*reactive* approach
-we intervene once BG is already elevated --> does not prevent it from getting high
-roller coaster effect --> letting the BG go high and then rapidly down many times
-given B4 meals based upon ac BG
Fixed method:
-patients are given the same insulin dosage everyday
-doesnt account for variations in meal carbs or time of eating
Basal Bolus Correction:
-*proactive* approach
-Requires insulin and good carb coverage
-mimics natural insulin delivery
-can be given via insulin syringe/ insulin pump
-insulin carb ratio --> I:C (helps does how much rapid acting insulin they'll need to
"cover" the carbohydrate they'll at with a meal or snack)
-correction factor/ sensitivity factor: used to calculate the amount of insulin you need to
bring your BG into target range
-requires complex carb counting and frequent BG monitoring to determine dosage of
insulin
S/S hypoglycemia: ✅Can result from too much insulin or not enough carb intake
-BG <70
-cool, clammy skin
-diaphoretic
-shakiness/ mild tremors, dizziness
-anxious/ confusion
-seizures
-weakness
-double vision
-blurred vision
-hunger
-tachycardia
-palpations
-*negative for urine ketones*
Treatment for hypoglycemia: ✅Safety!
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller twishfrancis. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
