Diabetes Mellitus and Child Development Quiz
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Questions and Answers

What is the primary cause of Diabetes Mellitus?

The primary cause of Diabetes Mellitus is a lack of insulin or insulin resistance.

How does Diabetes Insipidus differ from Diabetes Mellitus in terms of urine output?

Diabetes Insipidus leads to polyuria with low ADH and dehydration, while Diabetes Mellitus also causes polyuria but is due to high glucose levels.

What characterizes the treatment plan for Type I Diabetes Mellitus?

The treatment plan for Type I Diabetes Mellitus primarily includes insulin therapy, along with diet and exercise.

What dietary approach is recommended for managing Type II Diabetes Mellitus?

<p>The recommended dietary approach for Type II Diabetes Mellitus is calorie restriction and smaller, frequent meals.</p> Signup and view all the answers

Describe the relationship between urine output and specific gravity in conditions like DM and DI.

<p>In Diabetes Mellitus and Diabetes Insipidus, increased urine output results in lower specific gravity; conversely, lower urine output (as seen in SIADH) results in higher specific gravity.</p> Signup and view all the answers

What is the significance of Regular insulin's onset, peak, and duration parameters?

<p>Regular insulin has an onset of 1 hour, peaks at 2 hours, and lasts for 4 hours, which helps in planning dosing schedules.</p> Signup and view all the answers

What are the key symptoms of Diabetes Mellitus?

<p>The key symptoms of Diabetes Mellitus are polyuria, polydipsia, and polyphagia.</p> Signup and view all the answers

How does the treatment for Type I Diabetes Mellitus differ from that for Type II?

<p>Type I Diabetes Mellitus treatment focuses on insulin therapy due to dependency, while Type II emphasizes dietary changes and oral medications.</p> Signup and view all the answers

What are the primary characteristics of play in preschoolers aged 3-6 years?

<p>Preschoolers exhibit cooperative play, engage in imaginative pretend play, and develop fine motor skills.</p> Signup and view all the answers

Outline the three C's that characterize play for school-age children aged 7-11 years.

<p>The three C's are Creative, Collective, and Competitive play.</p> Signup and view all the answers

At what age do children typically transition from parallel play to cooperative play?

<p>Children transition from parallel play to cooperative play around the age of 3 to 6 years.</p> Signup and view all the answers

What are some of the restrictions for adolescents following a laminectomy?

<p>Adolescents are restricted from lifting objects over 5 lbs, driving, and engaging in activities like horseback riding or jarring amusement rides for a recovery period.</p> Signup and view all the answers

How does peer group association influence adolescent behavior?

<p>During adolescence, individuals desire to associate more with their peers and engage in social interactions, often wanting to hang out in each other's rooms.</p> Signup and view all the answers

What is the digestive effect of protein compared to carbohydrates?

<p>Protein bulks gastric content and takes longer to digest than carbohydrates.</p> Signup and view all the answers

How do hypokalemia and hyperkalemia differ in terms of muscle reaction?

<p>Hypokalemia leads to muscle flaccidity and hyporeflexia, while hyperkalemia causes spasticity and hyperreflexia.</p> Signup and view all the answers

What are the signs of hypercalcemia?

<p>Signs of hypercalcemia include bradycardia, lethargy, and hypoactive reflexes.</p> Signup and view all the answers

What symptom should be associated with hypernatremia?

<p>Hypernatremia is associated with dehydration symptoms, such as hot, flushed skin and rapid heart rate.</p> Signup and view all the answers

What does the Trousseau sign indicate?

<p>The Trousseau sign indicates hypocalcemia, shown by hand spasms when a BP cuff is inflated.</p> Signup and view all the answers

How should hyperkalemia be monitored in patients?

<p>When monitoring hyperkalemia, focus on heart-related symptoms such as bradycardia and elevated ST.</p> Signup and view all the answers

What should be the nursing diagnosis for a patient with hyponatremia?

<p>The nursing diagnosis for hyponatremia should be fluid volume excess.</p> Signup and view all the answers

What electrolyte imbalance could accompany DKA besides high potassium?

<p>Besides high potassium, low sodium (hyponatremia) may occur in DKA.</p> Signup and view all the answers

What is the onset time for NPH insulin?

<p>6 hours</p> Signup and view all the answers

Which type of insulin is best administered with meals, and what is its onset time?

<p>Lispro/Humalog, with an onset time of 15 minutes.</p> Signup and view all the answers

What should be done when an insulin vial is opened?

<p>Write a new expiration date and store it without refrigeration.</p> Signup and view all the answers

What are the two primary health issues a sick diabetic faces?

<p>Hyperglycemia and dehydration.</p> Signup and view all the answers

List two common causes of hypoglycemia in diabetics.

<p>Not enough food and too much insulin.</p> Signup and view all the answers

Describe the symptoms associated with hypoglycemic shock.

<p>Drunk-like behavior and vasomotor collapse.</p> Signup and view all the answers

Which treatment is recommended for unconscious hypoglycemic patients?

<p>Glucagon IM or Dextrose IV.</p> Signup and view all the answers

What is the primary cause of diabetic ketoacidosis (DKA)?

<p>Acute viral upper respiratory infection within the last 2 weeks.</p> Signup and view all the answers

What signs indicate dehydration in DKA patients?

<p>Dry mucous membranes and poor skin turgor.</p> Signup and view all the answers

Which insulin is indicated for administration during DKA treatment?

<p>Regular insulin IV.</p> Signup and view all the answers

What condition is characterized by high blood glucose in Type II diabetes without ketosis?

<p>HHNK or HHS (Hyperglycemic Hyperosmolar Nonketotic State).</p> Signup and view all the answers

How does exercise affect insulin needs in diabetic patients?

<p>Exercise lowers glucose levels, requiring less insulin.</p> Signup and view all the answers

How long is the duration of action for long-acting insulin like Glargine?

<p>12-24 hours.</p> Signup and view all the answers

What dietary combination is recommended for treating hypoglycemia?

<p>Sugar plus starch or protein.</p> Signup and view all the answers

What initial action should be taken for a COPD patient with low oxygen saturation levels, and why?

<p>Elevate the head of the bed (HOB) to help improve ventilation and oxygenation.</p> Signup and view all the answers

What is the range for oxygen saturation in patients, and what action should be taken if it falls below 93?

<p>The normal range for oxygen saturation is 93-100; if it falls below 93, assess, give oxygen, and call the HCP.</p> Signup and view all the answers

In cases of elevated BNP levels, what should be assessed in the patient and what action should be prepared for?

<p>Assess for fluid overload or dehydration and prepare for administering furosemide or IV fluids as appropriate.</p> Signup and view all the answers

What are the definitions and significance of the Five Deadly D's in patient assessment?

<p>The Five Deadly D's are critical levels of potassium, pH, CO2, O2, and platelets, which indicate life-threatening conditions requiring immediate intervention.</p> Signup and view all the answers

Describe the implications of a CD4 count below 200 in an HIV patient.

<p>A CD4 count below 200 indicates severe immunosuppression, necessitating neutropenic precautions to prevent infections.</p> Signup and view all the answers

What distinguishes a non-psychotic person from a psychotic person in terms of insight?

<p>A non-psychotic person has insight and recognizes their problems, while a psychotic person lacks insight and believes others are at fault.</p> Signup and view all the answers

List the three types of delusions.

<p>The three types of delusions are paranoid, grandiose, and somatic.</p> Signup and view all the answers

What is the main difference between hallucinations and illusions?

<p>Hallucinations are sensory experiences with no external referent, while illusions involve misinterpretations of real sensory stimuli.</p> Signup and view all the answers

Describe the first step in the four-step process of dealing with psychotic patients.

<p>The first step is to acknowledge the patient's feelings by expressing empathy and understanding.</p> Signup and view all the answers

What is the main role of a nurse when working with functional psychotic patients?

<p>The nurse's main role is to teach reality to the patient, helping them find a balance in their perceptions.</p> Signup and view all the answers

What types of psychosis can individuals with functional psychosis typically maintain?

<p>Individuals with functional psychosis can maintain jobs, relationships, and daily self-care despite their condition.</p> Signup and view all the answers

What is the significance of setting limits when dealing with psychotic patients?

<p>Setting limits helps maintain the therapeutic environment by preventing discussions that reinforce their non-reality.</p> Signup and view all the answers

What is an example of a hallucination that a psychotic individual might experience?

<p>An example of a hallucination is hearing voices that instruct the person to harm themselves.</p> Signup and view all the answers

What are the four diseases that comprise 90% of functional psychosis?

<p>The four diseases are schizophrenia, schizoaffective disorder, major depression, and mania.</p> Signup and view all the answers

Why are bipolar individuals only psychotic during the mania phase?

<p>Bipolar individuals experience psychotic symptoms specifically during episodes of mania, not during depressive phases.</p> Signup and view all the answers

What is a common auditory hallucination experienced by patients?

<p>A common auditory hallucination is hearing voices that comment on or critic the person's actions.</p> Signup and view all the answers

What type of feeling should be present when communicating with a psychotic patient?

<p>Empathy and understanding should be present to help the patient feel heard and supported.</p> Signup and view all the answers

Explain the concept of grandiose delusions.

<p>Grandiose delusions are false beliefs where an individual believes they possess extraordinary abilities or are important figures.</p> Signup and view all the answers

What does it mean when a patient exhibits somatic delusions?

<p>Somatic delusions involve false beliefs about one's body, such as believing one has a serious medical condition.</p> Signup and view all the answers

Provide an example of a tactile hallucination.

<p>A tactile hallucination could involve feeling bugs crawling on one's skin when no such sensation is present.</p> Signup and view all the answers

Flashcards

Non-psychotic Person

A person with intact reality testing who recognizes their own problems and understands how they impact their life.

Psychotic Person

A person lacking insight and reality testing, often believing their problems are caused by external factors.

Delusions

False, fixed beliefs that are not based on reality and resistant to change.

Paranoid Delusions

A type of delusion characterized by the belief that others are trying to harm or persecute you.

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Grandiose Delusions

A type of delusion characterized by an inflated sense of self-importance, power, or ability.

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Somatic Delusions

A type of delusion involving beliefs about one's own body or its functions.

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Hallucinations

False perceptions of sensory experiences without an external source.

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Auditory Hallucinations

A type of hallucination involving hearing sounds that are not real.

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Visual Hallucinations

A type of hallucination involving seeing things that are not real.

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Tactile Hallucinations

A type of hallucination involving feeling sensations in the absence of a real stimulus.

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Illusions

A misinterpretation of real sensory stimuli.

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Functional Psychosis

Psychotic disorders that allow individuals to function in everyday life, like holding a job or caring for themselves.

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Therapeutic Communication

A communication technique used to validate a patient's feelings and create a safe space for communication.

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Re-orientation to Reality

A four-step process aimed at helping patients with functional psychosis re-orient to reality.

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Bipolar Disorder

A type of psychosis characterized by periods of mania and depression.

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Protein Digestion

Protein slows down gastric emptying, increasing the time it takes to digest and move through the gut.

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Hyperkalemia

Hyperkalemia is a high potassium level in the blood. It can cause a variety of symptoms, including heart rhythm problems, muscle weakness, and breathing difficulties.

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Hypokalemia

Hypokalemia is a low potassium level in the blood. It can cause a variety of symptoms, including muscle weakness, fatigue, and heart rhythm problems.

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Hypercalcemia

Hypercalcemia is a high calcium level in the blood. It can cause a variety of symptoms, including muscle weakness, fatigue, and constipation.

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Hypocalcemia

Hypocalcemia is a low calcium level in the blood. It can cause a variety of symptoms, including muscle spasms, cramps, and seizures.

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Hypernatremia

Hypernatremia is a high sodium level in the blood. It is often caused by dehydration.

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Hyponatremia

Hyponatremia is a low sodium level in the blood. It is often caused by fluid overload.

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DKA and Electrolytes

DKA (Diabetic Ketoacidosis) is a serious complication of diabetes. It can cause a variety of electrolyte imbalances, including hyperkalemia.

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Parallel Play: Toddlers

Toddlers play alongside others without interacting directly.

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Cooperative Play: Preschoolers

Preschoolers engage in collaborative play activities.

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3 C's: School Age

School-aged children demonstrate creativity, collaboration, and a competitive spirit during play.

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Peer Group Association: Adolescents

Teenagers prioritize social interaction and spending time with friends.

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Laminectomy Lifting Restrictions

Patients who have undergone laminectomy should avoid lifting objects by bending at the waist.

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What are the '5 Deadly D's'?

This is a term used when a patient exhibits dangerous vital signs that need immediate action. The '5 Deadly D's' indicate critical levels of potassium (K+), pH, carbon dioxide (CO2), oxygen (O2), and platelets (Plt) that require immediate medical attention.

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What are typical blood gas levels in COPD patients?

COPD patients often have elevated carbon dioxide (CO2) levels and low oxygen (O2) levels. This is due to their compromised respiratory system.

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What is BNP and what does it indicate?

Brain Natriuretic Peptide (BNP) is a hormone released by the heart in response to stretching from increased blood volume. It is a strong indicator of heart failure (CHF).

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What is the critical SpO2 level requiring immediate action?

When assessing a patient's oxygen saturation (SpO2), a level below 93% is considered critical and requires immediate action. In children, even a saturation of 95% can be concerning due to their faster desaturation rate.

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What is the priority in patient care: Assess or Act?

Before administering treatments, it's essential to assess the patient's vital signs to ensure that treatment is indicated. However, if delaying treatment poses a higher risk to the patient's safety, then you should act first and assess later.

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NPH Insulin

Intermediate acting insulin with an onset of 6 hours, peak of 8-10 hours, and duration of 12 hours. It is cloudy due to precipitates and cannot be given intravenously.

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Lispro/Humalog Insulin

Fast acting insulin that has an onset of 15 minutes, peak of 30 minutes, and duration of 3 hours. It is often given as the patient begins to eat with meals.

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Glargine/Lantus Insulin

Long acting insulin with a duration of 12-24 hours. It has no peak due to its slow absorption, making it safe for bedtime administration. It carries a low risk of hypoglycemia.

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Insulin Expiration Date

The date after which the insulin is no longer considered stable and effective. For unopened vials, this date is set by the manufacturer. For opened vials, the expiration date is 30 days from the opening date.

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Opening Insulin

The process of opening the insulin vial or package, which invalidates the manufacturer's expiration date.

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Insulin Refrigeration

When insulin is opened, it does not need to be refrigerated in the hospital. However, it should be refrigerated at home.

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Exercise and Insulin

The effect of exercise on insulin sensitivity, causing the same effect as taking an additional dose of insulin. More exercise leads to more insulin sensitivity, requiring less insulin, and vice versa.

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Diabetic Illness

A condition where the blood glucose levels rise due to illness in diabetics. It is important to continue taking insulin even if the patient is not eating.

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Hypoglycemia

A condition marked by low blood sugar levels, also known as hypoglycemic shock or insulin shock/reaction. It is caused by insufficient food, excessive insulin, or excessive exercise.

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Too Much Insulin

The primary cause of hypoglycemia in diabetics, which can lead to permanent brain damage.

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Hypoglycemia Symptoms

A group of symptoms associated with hypoglycemia, including impaired judgment, slurred speech, staggering gait, and decreased social inhibition.

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Hypoglycemic Shock

A state of circulatory collapse due to low blood pressure, rapid heart rate and breathing, cold and clammy skin, and pallor, often associated with hypoglycemia.

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Diabetic Ketoacidosis (DKA)

A condition characterized by high blood glucose and ketones in a person with type I diabetes. It is often triggered by a recent viral upper respiratory infection.

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Administering Sugars

The process of rapidly metabolizing carbohydrates to raise blood sugar levels in the treatment of hypoglycemia.

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Unconscious Hypoglycemia

A severe condition where the patient is unconscious due to hypoglycemia. Treatment typically involves administering glucagon intramuscularly or dextrose intravenously.

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Hyperosmolar Hyperglycemic State (HHS)

A condition characterized by high blood glucose in type II diabetes patients, not accompanied by ketones or acidosis.

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Dehydration in HHS

A condition characterized by dehydration in type II diabetes patients, often associated with HHS. It is important to address the dehydration through intravenous fluids.

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Diabetes Mellitus

A condition where the body cannot properly regulate blood sugar due to lack of insulin or insulin resistance. Cells are starved for energy.

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Diabetes Insipidus

A condition characterized by the inability to produce adequate antidiuretic hormone (ADH), leading to excessive urination and thirst.

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Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

A condition where the body releases too much ADH, leading to water retention, decreased urine output, and potentially low blood sodium.

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Type 1 Diabetes

Type of diabetes where the body does not produce insulin. Requires insulin injections to regulate blood sugar.

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Type 2 Diabetes

Type of diabetes where the body becomes resistant to insulin, meaning the cells don't respond as well to the insulin produced. Often controlled by diet and exercise.

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Regular Insulin (R)

The rapid-acting insulin that has an onset time of about 1 hour, peaks in 2 hours, and lasts for 4 hours. It is a clear solution that can be administered intravenously.

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Diet for Type 2 Diabetes

A diet for Type 2 diabetics that aims to keep blood sugar levels stable and prevent excessive hunger. It involves consuming smaller, more frequent meals throughout the day.

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Calorie Restriction for Type 2 Diabetes

A primary dietary modification for Type 2 diabetics that focuses on reducing overall calorie intake.

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Study Notes

Key

  • bold (titles)
  • red (important letters or mnemonics)
  • yellow (highlighted info)

Acid Base Balance

  • Convert lab values to words & interpret
  • Rule of the B's
    • If the pH & the Bicarbonate are Both in the same direction then it's metabolic
    • otherwise it's respiratory (since it has no B in it)
  • pH = 7.35-7.45
  • HCO3 = 22-26
  • CO2 = 35-45
  • Principles
    • As the pH goes, so goes my patient – except for K+
    • alkalotic - hyper & irritable
    • pH goes up → pt needs suctioning cause they could seize & aspirate
    • pH goes down – acidosis – low & slow → pt needs Ambu bag cause they could go into respiratory arrest
  • MAC Kussmaul
    • only acid base balance to cause Metabolic Acidosis with Kussmaul respirations
    • Example: Pt has respiratory acidosis. SATA
    • +1 reflexes !!
    • Diarrhea – high X
    • Adynamic ileus !! (Without movement)
    • Spasm - high X
    • Urinary retention !!
    • Paroxysmal atrial tachycardia – high X
    • Hypokalemia – would be hyperkalemia due to exclusion of K+
  • First ask "Is it LUNG?" → respiratory problem
  • Second ask "Are they over ventilating or under ventilating?"
    • OVERventilating = alkalosis (OVER 7.45)
    • UNDERventilating = acidosis (UNDER 7.35)
    • Ventilation is about gas exchange not respiratory rate (not about RR), It's about the SAO2

Ventilators

  • High pressure alarms – always triggered by increased resistance to air flow
  • Machine is having to push too hard to get the air into the lungs
  • Caused by obstructions!
    • Kinks → unkink it
    • Water condensing in the tube → empty it
    • Mucus secretions in airway → change position, turn, cough, deep breathe, & then suction (more suction = more secretions problems)
    • Mobilize secretions after they turn, cough, & deep breathe
  • Low pressure alarms – always triggered by decreased resistance to air flow
  • Machine works too little/too easy to get air into lungs
  • Caused by disconnections!
  • Main tubing = reconnect
  • O2 sensor tubing (measures FIO2; oxygen delivered) = plug it back in
  • Only reconnect unless tube is on floor – bag pt & call RT
  • Settings
    • Overventilated = setting too high = respiratory alkalosis - panting
    • Underventilated = setting too low = respiratory acidosis - retaining CO2

Alcohol (Lecture 2)

  • Number one problem in all abusive situations = Denial
  • Abusers have an infinite capacity to deny in order to continue the behavior – allows them to keep doing it without having to answer for it/deny that they have a problem
  • Why is this a problem? → can't treat someone who denies they have a problem
  • Definition – refusal to accept the reality of a problem
  • How to treat? Confrontation attacks problem while aggression attacks person
  • When dealing with psychodynamic issues with staff, use the “I” statements not "You”
  • Denial is okay in loss & grief support not confront!
  • Stages of grief – DABDA
  • Dependency/codependency
    • Dependency – abuser asks partner to do things for them
    • Codependency – partner gets positive self-esteem from doing things for abuser
  • How to treat? Set limits & enforce them
  • Teach partner to say no
  • Work on self-esteem of codependent person

Manipulation

  • When abuser gets partner to do things that are not in the best interest of partner (dangerous & harmful)
  • Like dependency – getting partner to do things
  • Manipulation = dangerous & harmful
  • Dependency = not inherently dangerous & harmful
  • How to treat? Set limits & enforce them

Wernicke (Korsakoff) Syndrome

  • Go together
  • Wernicke – encephalopathy
  • Korsakoff - psychosis
  • Psychosis induced by Vit B1, thiamine deficiency (lose touch with reality due to deficiency)
  • Primary S/Sx

Antabuse & Revia (Disulfiram)

  • Aversion therapy - develop a gut hatred for habit
  • When you take alcohol, you will get super sick
  • Doesn't work as well as they say it does – just in theory
  • Onset & duration = 2 weeks
  • Patient teaching: avoid all forms of alcohol to avoid N/V, death

Overdose & Withdrawal

  • Every abused drug is either an Upper or Downer
  • Laxatives are abused by the elderly
  • Upper

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Description

Test your knowledge on the causes and treatments of Diabetes Mellitus, as well as the characteristics of play in preschoolers and school-age children. This quiz covers various aspects of diabetes types, their management, and important developmental milestones in childhood. Challenge yourself to understand the differences between diabetes types and the impact of play on child development.

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