Exam (elaborations)
NUR 283 Transition To Registered Nursing Practice Exam_3_Med Surg Review Questions and Answers
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- Galen College Of Nursing
NUR 283 Transition To Registered Nursing Practice
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EXAM 3 CLASS NOTES/ STUDY GUIDE TORRIE HATTAWAYDiabetes
- Type 1 and Type 2
- Pancreas does not produce insulin
- Chronic Hyperglycemia resulting from problems with glucose regulations
- What are the signs and symptoms of hypoglycemia/hyperglycemia?
- Hypoglycemia- Profuse Perspiration Priority! Shakey, Diaphoretic, weak, confused, diplopia
- Hyperglycemia- Warm skin, Kussmaul, rapid RR, DKA, Dehydration
- Complications: Neuropathy, Retinopathy, cardiovascular disease
- High glucose = leads to plaque in vessels
Type 1 – History, cannot control whether you get it, Weight loss
Type 2- Diet, history, obesity, around 50yr, Cultures, Weight gain, decrease protein and carbs
Both present with: 3 Ps – Polyuria, polydipsia, polyphagia (excessive hunger, thirst, and peeing)
Therapeutic Management
1- Insulin dependent, diet, blood sugar monitor, education, burnout
2- Diet, exercise, blood sugar monitor, education
Lab and Diagnostics
- Blood glucose
- Hemoglobin A1C - 6.5% or above
- Fasting glucose?? 126
- Glucose tolerant test
- Postprandial – after you eat
- Urine screening – sugar and ketone
Education – When they get sick, more frequent blood sugar checks, low carb diet, caution when
exercising, how to count carbs, buy shoes later in the day because your feet could be swollen toward the
end of the day, Diabetes can cause blindness so Pt should see ophthalmologist yearly, Avoid NSAIDs
Never exercise when insulin is at its peak, or within 1 hour, have snack before, do not work out at night,
Swimming is a good option for diabetic with neuropathy
Sick Day rules SICK– Sugar (Check 2-3hr), Insulin (Always take), Carbs (Drink lots of fluid manage carbs),
Ketones (Check urine, blood ketones Q4 hrs.)
Foot Care! Avoid injury and infection
Exercise – prevent hypoglycemia or DKA (Type 1)
This study source was downloaded by 100000890074950 from CourseHero.com on 09-12-2024 21:46:14 GMT -05:00
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, DKA- Increased rate of respirations, decreases blood pH, Kussmaul (Administer IV Insulin) Tachycardia,
Orthostatic Hypotension, Increase Urine Output (Severe), Crackles/edema would NOT occur because of
diuresis
Can you explain DKA ???
Types of Insulin
Onset/Peak is important
Onset is when it begins, Peak is at its best work = Risk for Hypoglycemia
- Make sure it is insulin syringe not normal syringe
- Rotate injection sites
Human Lispro (Humalog), Insulin Aspart (Novolog) & Insulin Glulisin (Apidra) *Only IV Insulin
Onset is 5-15mins
Peak is about of hour
Use for sliding scale
Short acting – given SubQ & IV
(Humulin R, Novolin R)
Onset (30-60min)
Peak (2-4hrs)
Immediate acting- SubQ
NPH
Onset-1-2 hours
Peak 4-12 hours
Duration 18-24 hours
Between meal snacks may be ordered for patients to prevent hypoglycemic
Long acting-
Lantus – Cannot be mixed with any Insulin, ordered twice a day within 30 mins
Do you know how to administer, mix, store, pump considerations ??
Alcohol with a meal if they are going to drink – risk for hypoglycemia
Liver’s job is to store glucose and releasing it when needed
Abdomen has fastest rate of absorption through blood vessels not location
This study source was downloaded by 100000890074950 from CourseHero.com on 09-12-2024 21:46:14 GMT -05:00
https://www.coursehero.com/file/234561466/Exam-3-MedSurg-Class-AutoRecovereddocx/
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