Exam (elaborations)
RPNCE PART 3 (MED- CONDITIONS) STUDY GUIDE
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RPNCE PART 3 (MED- CONDITIONS) STUDY GUIDE
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RPNCE PART 3 (MED- CONDITIONS) STUDY GUIDEdiabetes mellitus - Answers- Disorder of carbohydrate metabolism that involves either a
deficiency of insulin, a resistance of tissue to insulin or both
pre-diabetes - Answers- blood glucose levels that are higher than normal but not high
enough to be diagnosed yet. Ex: 7.
Metabolic syndrome (increased BP, LDL and low HDL) is a risk factor for this
Type 1 diabetes - Answers- Abrupt onset
Common in children
Due to destruction of beta cells
Prone to diabetic ketoacidosis without insulin
3 Poly's!
Fasting BG >7
Needs exogenous insulin
DKA IS COMMON IN THIS TYPE!
type 2 diabetes - Answers- the pancreas usually continues to produce some
endogenous (self-made) insulin; however, the insulin produced is either insufficient for
the needs of the body, is poorly utilized by the tissues, or both.
Slower onset
more common
exercise & diet management is essential
OHAs are effective but sometimes exogenous insulin is needed.
resistant to DKA but HHS is common
hyperglycemia - Answers- Can be caused by stress
BG levels above 6 (in non-diabetic) and 7 (in diabetic person)
hyperglycemia symptoms - Answers- · Polydipsia
· Polyphagia
· Polyurea
· Weight loss
· Blurred vision
· Fatigue
hypoglycemia - Answers- low blood sugar
below 4
Due to too much insulin, too little food, exercising too much and drinking too much
hypoglycemia symptoms - Answers- · Sweating
· Anxiety
· Pale skin
· Irritability
· Dry mouth
,· Blurred vision
· Difficulty speaking
· perspiration
· Polyphagia
· Heart palpitations
· Tingling around the mouth
hypoglycemia treatment - Answers- oral glucose, IV glucose, Glucagon IM/SC
normal BG levels - Answers- non diabetic: 4-6mmol/L
diabetic: 4-7mmol/L
what is the biggest side effect of insulin - Answers- hypoglycemia
why must injection sites be rotated for insulin - Answers- Insulin can cause
lipodystrophy which is small nodules/scar tissue within the skin due to not rotating
insulin injection sites!
secondary causes of diabetes - Answers- genetics (down syndrome related), related to
a disease (hypothyroidism), drug/metabolic related
rapid insulin - Answers- glulisine (apidra), aspart (novorapid), lispro (humalog)
onset=10-15mins
peak=60-90 mins
duration=3-5 hrs
short acting insulin - Answers- humulin R, novolin, toronto
onset=30 minutes
peak=2-3 hours
duration=6.5 hours
intermediate insulin - Answers- insulin N, insulin NPH
onset= 1-3 hours
peak=6-8 hours
duration=up to 18 hours
long acting insulin - Answers- glargine (lantus), detemir (levemir),
onset=90 mins
peak=none
duration=up to 24 hours
lipodystrophy - Answers- small nodules/scar tissue within the skin due to not rotating
insulin sites
protagonists of insulin - Answers- anabolic steroids, sulpha antibiotics, MAOIs, salicytes
, mixing insulins - Answers- Can't mix regular and long acting!
-Ex: Mixed 30/70 (first number is long; second number is short). Mixed is cloudy
-LONG, SHORT, SHORT, LONG
-CLOUDY, CLEAR, CLEAR, CLOUDY
Alpha-glucosidase inhibitors - Answers- glucobay (acarbose)
must be given with food
does not cause hypoglycemia
slows down digestion and absorption of insulin glucose post meal
alpha glucosidase inhibitors side effects - Answers- flatulence, diarrhea, abdo pain,
constipation, headache
sulfonylureas - Answers- must have functioning beta cells
stimulate insulin secretion from beta cells, improves receptor sensitivity, decreases
glucagon production
causes hypoglycemia
sulfonylureas examples - Answers- gliclazide (diamicron, glyburide (diabeta),
glimepride (amary)
sulfonylureas side effects - Answers- nausea, epigastric fullness, dispepsia,
photosensitivity, weight gain
biguanide - Answers- decreases glucose production by liver, decreases intestinal
absorption of glucose, improves insulin receptor sensitivity in liver, and increases
glucose uptake in skeletal muscle and adipose tissue
doesn't cause hypoglycemia
hold 24 hours before/after giving iodine
biguanide side effects - Answers- abdo bloating, epigastric fullness, metalic taste in
mouth, decr vitamin B12, diarrhea, flatulence
thizolidinediones - Answers- enhance receptor sensitivity to insulin, stimulate peripheral
glucose uptake and storage, inhibit production of triglycerides and glucose
thizolidinediones example - Answers- avandia (roziglitizone)
diabetic ketoacidosis - Answers- Complication of DM that occurs when the body
produces high levels of ketones.
Develops when body doesn't make enough insulin. Without insulin, the body breaks fat
as fuel which builds up acids
Most common in type 1 DM
Ketosis: alters pH balance, causing metabolic acidosis to develop.
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