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MED SURG NURS 330 Exam 1
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MED SURG NURS 330 Exam 1
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MED SURG NURS 330 Exam 1DM Pre-OP metformin is stopped how many hours before surgery - correct answer-24 hours
before surgery & restarted only after kidney fucntion is documented as normal
the process if maintaining optimal blood glucose levels - correct answer-glycemic control
what is euglycemic - correct answer-normal range blood glucose
normal fasting glucose - correct answer-74-106
beta cell destruction leading to absolute insulin deficiency
autoimmune
idiopathic - correct answer-type 1 dm
ranges from insulin resistance with relative insulin deficiency to secretary deficit with insulin
resistance - correct answer-type 2 dm
not autoimmune problem
inherited mutation in one of at least six known genes that result in the loss of insulin function
and hyperglycemia - correct answer-maturity onset diabetes of the young (MODY)
glucose intolerance with onset in pregnancy - correct answer-gestational diabetes
two types of cells - correct answer-beta & alpha
what does a beta cell do - correct answer-secretes insulin and amylin
what does a alpha cell do - correct answer-secrete glucagon
what does the pancreas do - correct answer-ensures glucose regulation
production and storage of glycogen - correct answer-glycogensis in the liver
breakdown of glycogen to glucose - correct answer-glycogenolysis in the liver
conversion of proteins to glucose - correct answer-gluconeogenesis in the liver
other balancing hormones that increase blood glucose - correct answer-epinephrine
norpeinephrine
growth hormone
cortisol
what is released in response to food in the stomach - correct answer-increase insulin
secretion
Inhibit glucagon secretion
,slows rate of gastric emptying (prevents hyperglycemia after meals)
When the stomach is emptying (fasting glucose) what should it be - correct answer-60-150
mg/dL
prediabetes is 110
Your brain needs what to survive - correct answer-glucose and oxygen
what to know about brain and glucose - correct answer-very sensitive to glucose
must have it for metabolism
cant store it or synthesize it
always dependent on glucose levels
3 p's for hyperglycemia - correct answer-polyuria, polydipsia, polyphagia
pathophysiology of glycosuria - correct answer-hyperglycemia surpasses renal glucose
reabsoption threshold
pathophys of polyuria - correct answer-glycosuria induces osmotic diuresis
pathophys of polydipsia - correct answer-polyuria leads to depleted water and electrolyte
stores
pathophys of polyphasia - correct answer-insulin deficiency produces chronic catabolic state
conversions of fats to acids & leads to ketone bodies which disturbing the acid base balance
- correct answer-ketogenesis
(which causes metabolic acidosis)
what does dehydration from DM lead to - correct answer-hemoconcentration (increased Hgb
& hct)
hypovolemia
poor tissue perfusion
hypoxia
these cells do not metabolize glucose efficiently and lactic acid production increases causing
more acidosis - correct answer-hypoxic cells
normal anion gap - correct answer-8-12 (if without potassium )
12-16 (if potassium given)
kussmaul respirations and exhaling acetone - correct answer-metabolic acidosis in
hyperglycemia
increased hydrogen ion and co2 levels in the blood cause anion gap metabolic acidosis
which triggers the brain to increase rate and depth of resp to blow off co2 - correct
answer-kussmaul respirations
,acetone in metabolic acidosis hyperglycemia - correct answer-exhaled to rid of acid
breath will smell like a rotting citrus fruit
why do you give calcium glucinate over calcium chloride - correct answer-if it goes into the
tissue it can cause necrosis
what to give when abscence of insulin and potassium - correct answer-calcium glucinate to
stabalize
10 units of insulin after
absence of insulin and K+ first causes - correct answer-potassium depletion - poluria
as acidosis occurs in absence of insulin and K+ what happens - correct answer-potassium
levels increase
level will be dependent on severity
what are the 3 glucose related emergencies that can be fatal if treatment is delayed or
incorrect - correct answer-DKA
HHS
hypoglycemia
examples of macro-vascular that can lead to complications of poor perfusion - correct
answer-coronary heart disease
cerebrovascular disease
peripheral vascular disease
all increased risk for heart attack & stroke
nephropathy
neuropathy
retinopathy (proliferative diabetic retinopathy)
cognitive dysfunction
increased risk for dementia - correct answer-exmaples of microvascular
wbc activity reduces and chronic inflammation increases risk of - correct answer-diabetes
and heart attacks
autoimmune destruction of beta celss
associated with viral infections (mumps/coxsackie virus)
genetic predisposition (most poeple with gene dont develop type 1) - correct answer-type 1
DM
insulin resistence that develops from obesity
heredity plays major role
metabolic syndrome - correct answer-type 2 DM
those at risk for type 2 DM based on waist cirumcfrence - correct answer-men 40 in
women 35 in
, exmaples of metabolic syndrome - correct answer-abdominal obesity
hyperglycemia
HTN
hyperlipidemia
adopting a healthy lifestyle - correct answer-low calorie
increased physical activity w/ weight loss
smoking cessation
etoh avoidance
goal interventions for adopting a healthy lifestyle - correct answer-increase heart rate
variability between resting and exercise rate
increase high density lipoprotein and reduced low density lipoproteins - cholesterol
keep blood glucose levels within target ranges
eyes and vision tested yearly by opthalmotogist
urine tested annually for albumin
maintain appropriate weight rane for height and body build
engage in physical activity 150 min per week
daily foot inspection - correct answer-patient teaching for DM
collaborative care team for DM - correct answer-PCP
endocrinologist
diabetic educators
RN
pharmacist
RDT
podiatrist
PT
wound care specialist
DM assessment - correct answer-HX:
ask women about large birth weight neonate
gestational DM
assess weight/height change
SX:
fatigue
polyuria
polydispsia
polyphagia
immunity - recent minor or major infections
A1C target levels - correct answer-normal <5.6
prediabetes 5.7-6.4
diabetes 6.5+
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