Podcast
Questions and Answers
Which of the following is NOT a clinical manifestation of Diabetic Ketoacidosis (DKA)?
Which of the following is NOT a clinical manifestation of Diabetic Ketoacidosis (DKA)?
- Kussmaul respirations
- Hyperglycemia
- Hypertension (correct)
- Acidosis
What nursing intervention is essential for a patient with DKA?
What nursing intervention is essential for a patient with DKA?
- Monitor fluid and electrolyte status (correct)
- Avoid monitoring vital signs frequently
- Administer antidepressants as needed
- Limit intravenous fluid administration
Which of the following represents a macrovascular complication of Diabetes Mellitus?
Which of the following represents a macrovascular complication of Diabetes Mellitus?
- Coronary artery disease (correct)
- Diabetic retinopathy
- Diabetic neuropathy
- Diabetic nephropathy
What is a common feature of both DKA and HHNS compared to hypoglycemia?
What is a common feature of both DKA and HHNS compared to hypoglycemia?
Which preventive measure does NOT relate to macrovascular diseases?
Which preventive measure does NOT relate to macrovascular diseases?
What is a common clinical manifestation of Diabetes Mellitus?
What is a common clinical manifestation of Diabetes Mellitus?
Which of the following is a modifiable risk factor for Type 2 Diabetes Mellitus?
Which of the following is a modifiable risk factor for Type 2 Diabetes Mellitus?
What is the purpose of rotating insulin injection sites?
What is the purpose of rotating insulin injection sites?
What is Kussmaul respiration indicative of?
What is Kussmaul respiration indicative of?
Which of the following actions should be taken for a patient experiencing hypoglycemia?
Which of the following actions should be taken for a patient experiencing hypoglycemia?
Flashcards
DKA clinical manifestations
DKA clinical manifestations
Four signs of Diabetic Ketoacidosis (DKA) are hyperglycemia, dehydration, acidosis, and Kussmaul respirations.
DKA nursing interventions
DKA nursing interventions
Nursing care for DKA includes monitoring fluids/electrolytes, giving IV fluids/insulin, closely watching vital signs and blood sugar, and checking urine output.
Macrovascular DM complications
Macrovascular DM complications
Macrovascular complications of Diabetes Mellitus (DM) are coronary artery disease, cerebrovascular disease, and peripheral arterial disease.
Macrovascular prevention
Macrovascular prevention
Controlling blood glucose, managing obesity/high blood pressure with diet and exercise, using medications for high blood pressure/cholesterol, and quitting smoking are methods to prevent Macrovascular diseases.
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Microvascular DM complications
Microvascular DM complications
Microvascular DM Complications include diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy.
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Hypoglycemia vs. DKA vs. HHNS
Hypoglycemia vs. DKA vs. HHNS
Hypoglycemia: sudden onset, low blood sugar, high insulin, potentially bizarre behavior or confusion. DKA: slow onset, high blood sugar, low insulin, fruity breath, and potentially coma. HHNS: slow onset, very high blood sugar, low insulin, confusion but no fruity breath.
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DM discharge instructions: Diet
DM discharge instructions: Diet
Follow a balanced diet tailored to individual needs, monitoring carbohydrate intake.
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DM discharge instructions: Exercise
DM discharge instructions: Exercise
Incorporate regular physical activity into daily routine.
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DM discharge instructions: Monitoring
DM discharge instructions: Monitoring
Regularly check blood glucose levels as advised, keeping a detailed log.
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DM discharge instructions: Education
DM discharge instructions: Education
Understand signs/symptoms of hypoglycemia/hyperglycemia and management strategies.
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DM discharge instructions: Follow-up
DM discharge instructions: Follow-up
Schedule regular appointments with healthcare provider.
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DM discharge instructions: Medications
DM discharge instructions: Medications
Adhere to prescribed medication regimens and understand their purpose.
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Type 1 DM
Type 1 DM
A type of diabetes where the body doesn't produce insulin.
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Type 2 DM
Type 2 DM
A type of diabetes where the body doesn't use insulin properly.
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Gestational DM (GDM)
Gestational DM (GDM)
Diabetes that develops during pregnancy.
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Borderline Diabetes
Borderline Diabetes
High blood glucose, not yet full-blown diabetes.
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Non-modifiable Type 1 DM risk factors
Non-modifiable Type 1 DM risk factors
Factors you can't change, like genetics and autoimmune issues
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Modifiable Type 2 DM risk factors
Modifiable Type 2 DM risk factors
Factors you can change, like diet and lifestyle.
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Polyuria
Polyuria
Excessive urination.
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Polydipsia
Polydipsia
Excessive thirst.
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Polyphagia
Polyphagia
Excessive hunger.
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NPH insulin onset
NPH insulin onset
Starts working 1-2 hours after injection.
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Humulin R insulin onset
Humulin R insulin onset
Starts working 30 minutes after injection.
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Insulin Injection Sites
Insulin Injection Sites
Abdomen, thighs, upper arms, and buttocks.
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Insulin Lipodystrophy
Insulin Lipodystrophy
Lumps or pits at insulin injection sites.
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Insulin Resistance
Insulin Resistance
Body doesn't respond to insulin effectively.
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Hypoglycemia
Hypoglycemia
Low blood sugar.
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Morning Hyperglycemia
Morning Hyperglycemia
High blood sugar in the morning.
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Kussmaul Respiration
Kussmaul Respiration
Deep, rapid breathing.
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Hypoglycemia Causes
Hypoglycemia Causes
Too much insulin, too little food, or excessive exercise.
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Hypoglycemia Treatment
Hypoglycemia Treatment
Fast-acting carbohydrates, monitor blood glucose levels, and glucagon or D50W in severe cases.
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Nursing Interventions for Insulin Therapy
Nursing Interventions for Insulin Therapy
Rotate injection sites, monitor glucose, teach hypoglycemia recognition, and correct administration.
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Nursing Interventions for Hypoglycemia
Nursing Interventions for Hypoglycemia
Administer quick carbs, monitor blood sugar, use glucagon or IV dextrose if comatose, and provide a meal.
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Types of Diabetes Mellitus (DM)
- Four types of DM exist: Type 1 (Insulin-Dependent), Type 2 (Non-Insulin-Dependent), Gestational, and Borderline Diabetes.
Non-Modifiable Risk Factors for Type 1 DM
- Genetic susceptibility
- Autoimmune factors
- Family history of Type 1 DM
- Age (often develops in childhood or adolescence)
Modifiable Risk Factors for Type 2 DM
- Lack of physical activity
- Poor diet
- Excessive weight
- Sedentary lifestyle
Clinical Manifestations of DM
- Polyuria (excessive urination)
- Polydipsia (excessive thirst)
- Polyphagia (excessive hunger)
- Weight loss
- Extreme fatigue
- Blurred vision
- Poor wound healing
- Recurrent infections
Insulin Onset of Action
- NPH insulin: 1 to 2 hours
- Humulin R insulin: 30 minutes
Insulin Injection Sites
- Abdomen
- Thigh
- Upper arm
- Buttocks
Insulin Therapy Complications
- Local or systemic allergic reactions
- Insulin lipodystrophy (lipoatrophy or lipohypertrophy)
- Insulin resistance
- Morning hyperglycemia (e.g., dawn phenomenon, Somogyi effect)
Nursing Interventions for Insulin Therapy
- Rotate injection sites to prevent lipodystrophy.
- Monitor blood glucose levels regularly.
- Educate the patient about recognizing signs of hypoglycemia.
- Ensure the patient understands the correct administration technique.
Deep, Rapid Breathing
- Kussmaul respiration
Causes of Hypoglycemia
- Too much insulin or oral agents
- Too little food
- Excessive physical activity
Diabetic Ketoacidosis (DKA) Clinical Manifestations
- Hyperglycemia
- Dehydration
- Acidosis
- Kussmaul respirations (deep, rapid breathing)
Nursing Interventions for DKA
- Monitor fluid and electrolyte status.
- Administer intravenous fluids and insulin as per protocol.
- Monitor vital signs and blood glucose levels frequently.
- Assess urine output to ensure adequate renal function.
Macrovascular Complications of DM
- Coronary artery disease
- Cerebrovascular disease
- Peripheral arterial disease
Preventive Measures for Macrovascular Diseases
- Control of blood glucose levels
- Diet and exercise to manage obesity and hypertension
- Use of medications to manage hypertension and hyperlipidemia
- Smoking cessation
Microvascular Complications of DM
- Diabetic retinopathy
- Diabetic nephropathy
- Diabetic neuropathy
Hypoglycemia vs. DKA vs. HHNS Comparison
- Onset, heart rate, blood pressure, respiration, breath odor, mental status, insulin level, and blood glucose level during these different conditions are detailed.
Discharge Plan for DM Patient
- Diet
- Exercise
- Monitoring blood glucose levels
- Education
- Follow-Up appointments
- Medications
Nursing Care Plan for DM Patient
- Risk for fluid volume deficit related to polyuria and dehydration.
- Imbalanced nutrition related to imbalance of insulin, food, and physical activity.
- Potential for self-care deficit related to physical impairments or social factors.
Interventions for Nursing Diagnoses
- Interventions (specific actions for each nursing diagnosis listed.) are provided in the text.
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