1. What is another name for Hyperinsulinism
  2. How soon after eating breakfast will the sugar drop for a diabetic?
    2 hours after eating
  3. what is the function of insulin?
    it puches glucose into the cells
  4. What else do we need to transport glucose into the cell?
    potassion, insulin, ATP
  5. Sings of hyperglycemia?(diabetes mellitus)
    Polyuria, polydipsia, polyphagia
  6. High glucose levels in the blood stream? your urinate a lot
    • Fluid is pulled from inside the cells
    • (intracellulate).

  7. Polyphagia
    cells are starving(no glucose for energy)
  8. polydipsia
  9. when clients are ill or under stress blood glucose
    rises, causing porskin tugor, dry skin, hot, flush
  10. normal blood sugar level
  11. accucheck normal
  12. fasting blood sugar
    NPO after midnight, going early morning, draw blood
  13. normal fasting blood sugar
    less than 100
  14. 2 hour glucose challenge (post paranial)
    after eating
  15. ac
    ante(before meals)
  16. pc
    post comida (after Meal)
  17. known diabetic how do you know the blood sugar is maintainde well.
    HCA1C (Hemoglibin A1C)
  18. normal range of HCA1C
    less than 7%
  19. ketones
    product from fat
  20. DKA(Diabetic ketone acidosis)
    breaks down protein and fats
  21. in order to get rid of the acid
    you need to breath fast (kussmals breathing) to get rid of accid and make it balance PH
  22. before diagnosing a diabetic they need to have 2 consequetive fasting blood sugar of
    125 or more are considered to have diabetic mellitus
  23. goal of diabetics is
    to control the glucose levels
  24. Diabetes type 1
    sudden absolute or relative lack of insulin
  25. main 2 this that brain need to keep you alive is
    oxigen and glucose(not taken well by brain so pt has altered mental status
  26. 3 forms of good glucose control are
    insulin or orall agents or both, diet, nd exercise.
  27. orall agents work only if
    the client has beta cell funtions
  28. orall agents dont work on patient with
    type 1 diabetes
  29. risk factor for type 2 diabetics
    overweight, heredity
  30. type 2 diabetes are seen in
    very young people
  31. along with obesity comes
    elevated cholesterol and triglyserids
  32. a client comes in with a blood glucose level of 800?
    hyperglycemia patient
  33. in addition to the 3 Ps patients are
  34. complications of diabetes that are considered emergencies?
    DKA, Hyperglycemia, HHS (Hyperglysimic hyperosmolar state)
  35. glucogon
    comes in 2 vials need to be reconstrituded.
  36. client says "im feeling shaky" what should you give
    orange juice follow by something to eat,
  37. sings of hypoglycemia
    cold, and clammy
  38. how much juice is given to a pt with hypoglycemia?
    4 onces at least
  39. DKA coma can follow
    an infection, a resent illness
  40. hypoglycemia can occur
    during surgery when the body is under stress
  41. DKA blows out carbon dioxide
    PCO2 is low
  42. not to much carbon dioxide is
  43. sing and sympotms of hypocapnea
    hyperventalations, carpal pedal spasm, CO2 drops making you have respiratory alkalocis
  44. What is the reason when pt have DKA and you give normal saline with insulin and potassion
    potassium forces the glucose into the cells
  45. hyperosmolar hyperglycemic non ketotic sindrome accurs (HHNS, HHS)
    in type 2 diabetes and is non ketonic
  46. main simptom in HHNS or HHS is
  47. first priority in a pt coming in with HHNS is
    fluid replacement
  48. what is the most common cause of death with people with glycemia
    Coranary artery disease (MI)- Heart attack
  49. the earliest clinical sing for diabetic micro nephropathy (damage to the kidneys)
    microalbuminuria, test is done annually for albunim, BUN, creatin
  50. foot care
    • -no lotion between toes
    • -no open toes shoes
    • -no soking feet
    • -diabetic socks
    • -see a podiarits
    • -no walking barefoot
    • -shoes should be half a size bigger than the long toe
    • -if shoes are broken in the have to be in a period of weeks( allitle at a time)
  51. diet for diabetics are all based by counting
  52. if pt is on exchange list is based on
    amount aproved in each category
  53. if you are considering affects on insulin on diet you are going to
    time insulin to coencides with the key action of the insulin
  54. if a diabetic is over weigth the recomended reduction of calories is
    3500 calories per week and increase exercise
  55. insulin is based on eating a surething amount of food at each meal diabetic should not
    skip a meal they need 3 meals
  56. insulin dependent diabetic that does not want to eat you would
    hold the medication
  57. after surgery glucose levels go
  58. abdomen is the best site for glucose injection because of
    better obsorption
  59. give insulin
    2 inches around the unbilicus and rotate injection 1 inch
  60. why do you rotate sites when giving insulin
    to prevent lipodystrophy and better absorption
  61. your given 30 units of NPH to a patient at 8 oclock in the morning when is the insulin going to peak?
    6-10 hour (so it would be between 2 and 10 pm)
  62. you have a client that has an IV of normal salin and pottasium what do you have to whach out for?
  63. client is getting humalin N at 4 pm when is the the peak time
    6-10 hours
  64. Humalin N is
    intermidiate acting insulin
  65. if a patient has an insulin pen what does the patient have to do
    just leard how to dial the number of units that need to be injected
  66. a client was given regular insulin at 7 am it going to peak when
    1-2 hours so patient need to eat by 9 am
  67. client has type 1 diabetes complaints of dry mouth, extreme thirst, increase urination, this are sings of
    hyperglycemia so you would be prepared to give him regular insulin
  68. humalog insulin
    rapid acting, with in 5-10 minutes(make sure patient east right after given insulin)
  69. you are teaching the client about how to store insulin
    usally in refrigerator but if patient has 2 vials he can keep one vial at room temperater for 28 days
  70. which insulin has the most rapid acting insulin
  71. alchohol in a diabetic is a big NO because
    it causes hypoglycemia
  72. what statement worns the nurse for further teaching
    "I usally half one glass of wine for dinner
  73. micronase(Glyburide) is taken with
  74. client with type 2 diabetes ask why the cant take insulin orraly what do you say?
    because it is destroyed by the hydrochloric acid in the stomach or the digestive enzymes
  75. how does glyburide(micronase) work
    forces the beta cells to produce more insuling
  76. glucophage or metformin is a
    prevent the liver from converting glycogen to glucose. keeping blood sugar low
  77. when should the client take byetta
    twice a day 1 hour before morning and evening mea
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