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50 Cards in this Set
- Front
- Back
Disease characterized by hyperglycemia...
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diabetes mellitis
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Alpha cells produce?
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glucagon
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Beta cells produce?
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insulin
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conterregulatory hormone of insulin
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glucagon, cuases the release of glucose from cell storage sites when glucose is low
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what does insulin do?
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-allows body cells to use and store carbs, fat, protein
-allows glucose to move from blood into cells for energy |
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Three characteristics of hyperglycemia...
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polydispia, polyuria, polyphagia
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what is basal and pradial?
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Basal - before meals
Pradial - post meals |
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glycogenisis
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production and storage of insulin
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glycogenolysis
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inhibit of breakdown of glucose; epinephrine is released and causes increased glucose level
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ketogenesis
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conversion of fat to acid
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gluconeogenisis
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conversion of protein to glucose
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main fuel of the brain
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glucose
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Person who must have insulin is type...why do they need it?
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type 1; beta cells are destroyed, they make no insulin
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Characteristics of type 2
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impaired insulin production, decreased sensitivity, may need oral antidiabeticsq
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clinical manefestations of hyperglycemia...
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3 P's, fatigue, vision changes, tingling hands, decreased wound healing, recurrent infections,
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Type 2 common treatment
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excersize, diet, oral antidiabetics
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acute lifethreatening metabolic crisis, type I, blood glucose 250-500
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DKA - diabetic ketoacidosis
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DKA s/s
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-bld glucose 250-500
-dehydration, lyte embalance -ketones present -fruity breath -low pH -mental status change |
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HHNS - hyperosmolar hyperglycemic state
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acute condition; glucse over 500; absent ketones, no fruity breath, mental status change, severe dehydration
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Lab values indicative of DM...
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-fasting bld - 126 x 2
-oral glucose test 200 after 2 hrs -hgb A1C - 7% or greater |
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leading cause of death of diabetes
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MI; client has extensive CAD, cardiomyopathy, abnormal blood clotting
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most common complication of diabetes (Macrovascular)
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CVD; an increased risk of heart failure and left ventricuar dysfunction as well
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type 2 risks...
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obesity, HTN, dyslipidemia (excess blood levels of cholesterol and fats)
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Common Microvascular complications
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retinopathy, nephropathy, neuropathy, diabetic diarrhea, loss of cardiac reflexes,defective counterregulatory systems
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how does the liver and pancrease work together for glucose control?
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The pancreas secretes a consistent basal amount of insulin to balance the liver glucose production
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insulin resistance
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when client needs 200 or more units due to developed resistance of antibodies binding to insulin
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Dawn phenomenon
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reduced tissue sensitivity to insulin; around 0500 to 0800 becomes hypoglycemic
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insulin waning
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progressive rise in blood glucose level from bedtime to morning
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Meds that increase hypoglycemic effects...
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ASA, alcohol, sulfonomides, oral contraceptives, MAOI
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Meds that increase glucose levels...
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corticosteroids, thiazide diuretics, estrogen
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S/S hypoglycemia
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hunger, nervousness, palpitations, tachycardia, tremor, confusion, emotional sleep
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what effect does corticosteroid have on patient taking insulin
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it will cause blood glucose to increase, so insulin dose will be increased
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what is sick day?
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DM client calls in sick, notifies friend and physician, lets them know instructions, etc.
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What is teaching for Sick Day?
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-increase fluids/sugar free unless N/V; take insulin r/t illness increases bld glucose; check ketones
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Which has ketones present; DKA or HHNS?
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DKA
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Name fast acting insulin...
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Humalog (lispro)
Novalog (aspart) |
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what is fast acting onset, peak, and duration?
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onset - 15 min
peak - 30-1/12 duration - 4-6 |
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What is only isulin used IV
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regular insulin
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Name short acting insulin..
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humulin R
Novalin R |
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What is onset, peak and duration of shortacting insulin?
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onset: 30-60min
peak: 2-5 duration: up to 8 hrs |
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Name an intermediate acting insulin...
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Humulin L
Novalin L Humalin NPH |
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What is onset, peak, and duration of intermediate insulin?
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onset: 1-2hr
peak: 6-12 duration: 14-20 |
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Name a long acting insulin...
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Humalin U
Ultralente Lantus |
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What is onset, peak, and duration of intermediate?
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onset: 4-6hr
peak: 8-20 duration: 24hr |
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Whats the big deal about Lantus?
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-dont mix EVER
-onset: 70min, no peak -Glargine |
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Name an inhaled insulin and its teachings...
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Exubera; use before meals, 18 years, not for smokers (increased hypoglycemia); need pulmonary function tests
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Common side effects of exubra...
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cough, sinusitis, dry mouth
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What Class? Increases insulin production, increased sensitivity to insulin in multi targets
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sulfonylureas
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Name a sulfonylureas
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glipizide (glucatrol)
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Side effects of sulfonylureas
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increased hypoglycemia, renal
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