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Med/Surg 1 Exam 2 > Diabetes > Flashcards

Flashcards in Diabetes Deck (41)
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1
Q

Types of rapid acting insulin

A

Aspart (Novolog)
Glulisine (Apidra)
Lispro (Humalog)

2
Q

Types of short acting insulin

A

Regular

3
Q

Types of long acting insulin

A

Glargine (Lantus)

Detemir (Levemir)

4
Q

What is the onset time of rapid acting?

A

5-15 mins

5
Q

What is the onset time of short acting?

A

30-60 mins

6
Q

What is the onset time of NPH?

A

2-4 hrs

7
Q

What is the onset time of Glargine (Lantus) and Detemir (Levemir)?

A

2-4 hrs

8
Q

What is the peak time of rapid acting?

A

30-90 mins

9
Q

What is the peak time of short acting?

A

2-3 hrs

10
Q

What is the peak time of NPH?

A

8hrs

11
Q

What is the peak time of Glargine (Lantus) and Detemir (Levemir)?

A

No peak

12
Q

What is the effective duration time of rapid acting?

A

Less than 5 hrs

13
Q

What is the effective duration time of short acting?

A

6-8 hrs

14
Q

What is the effective duration time of NPH?

A

10-16 hrs

15
Q

What is the effective duration time of long acting insulin?

A

20-24 hrs

16
Q

S/S of Type 1 diabetes:

A
Polyuria 
Polyphagia (appetite)
Polydipsia (thirst)
Unexplained weight loss 
Dehydration 
Fatigue
17
Q

S/S of Type 2 diabetes:

A

Fatigue
Recurrent infections
Prolonged wound healing
Visual changes

18
Q

What is the targeted HbA1C level for someone with diabetes?

A

6.5-7%

19
Q

What are the two type of complications?

A

Acute

Chronic

20
Q

What is the an acute complication for Type 1?

A

DKA

21
Q

What is the acute complication of Type 2?

A

HHS

Hyperglycemic Hyperosmolar Syndrome

22
Q

S/S of HHS

A
Coma
Confusion
Convulsions
Dry mouth, dry tongue
Fever
Increased thirst
Increased urination (at the beginning of the syndrome)
Lethargy
Nausea
Weakness
Weight loss
Abdominal distension
23
Q

What is the treatment for HHS?

A

Aggressive rehydration
Monitoring and replacement of electrolytes
Correction of hyperglycemia with insulin (addition of glucose to IVF when blood sugar reaches 250)

*Potassium should be corrected (if needed) before insulin

24
Q

What will hyperglycemia, hypertension, and hyperlipidemia cause when presented together?

A

Impaired sensation/perception
Nervous system dysfunction
Impaired perfusion
Impaired oxygenation

25
Q

What is macrovasuclar disease?

A

Disease of large and medium sized blood vessels

26
Q

What is microvascular disease?

A

Specific to diabetes

Result from thickening of vessel membranes in capillaries and arterioles

27
Q

Microvascular disease is in response to what?

A

Chronic hyperglycemia

28
Q

What are the areas most noticeably affected by microvascular disease?

A

Eyes (retinopathy) (blindness)
Kidneys (nephropathy) (kidney failure)
Skin (dermopathy)

29
Q

What is critical for preventing or delaying small vessel disease?

A
Tight glucose control 
BP management 
ACE inhibitors (used even when not hypertensive) (prevent nephropathy)
Angiotensin II receptor antagonists 
Yearly screening (eye and urine)
30
Q

What are characteristics of diabetic neuropathy?

A

Loss of sensation
Abnormal sensations
Pain
Paresthesias

31
Q

What can diabetic neuropathy affect in the autonomic nervous system?

A
Gastroparesis 
Delayed gastric emptying 
Cardiovascular abnormalities 
Sexual function 
Neurogenic bladder
32
Q

What are key educational considerations?

A

Control your glucose, BP, and cholesterol
Early treatment of foot, eye, kidney, and heart problems
No
Smoking
Education about diabetes, nutrition, and exercise

33
Q

What is a common long term complication of diabetes affecting 50%?

A

Peripheral neuropathy

34
Q

Peripheral neuropathy affects what?

A

Functioning sensory, motor, and autonomic nerve fibers

35
Q

What is the most common form of peripheral nerve dysfunction and the form most closely associated with ulcer aetiology ?

A

Sensory neuropathy

36
Q

What are some chronic complications of diabetes?

A
Retinopathy 
Nephropathy 
Cardiac failure 
Neuropathy 
Amputation
37
Q

What is a main difference between DKA and HHS?

A

Speed of symptom development

DKA is faster than HHS

38
Q

In people with Type 1 diabetes, DKA can be precipitated by what?

A

Infection such as UTI or respiratory
Insulin errors and omissions
MI
Diarrhea and vomiting (Illness)

39
Q

DKA is a result of what?

And increases the production of what counter-regulatory hormones?

A

Relative or absolute lack of insulin

Glucagon
Catecholamines
Cortisol
Growth hormone

40
Q

What are some examples of food that contains 15g?

A
Apple 
1 slice of bread
Bran cereals 1/2 cup
Cookie, fat free, 2 small
Cupcake no frosting 
Ice cream (light) 1/2 cup
Milk 8oz
Orange juice 1/2 cup
Potato 
Rice 1/3 cup
Saltine crackers (6)
Sugar/honey 1 Tsp
Yogurt, fat free, with sugar substitute 1 cup
41
Q

Type of intermediate acting insulin ?

A

NPH