Podcast
Questions and Answers
Type I DM is characterized by insulin deficiency due to destruction of ______ cells.
Type I DM is characterized by insulin deficiency due to destruction of ______ cells.
beta
In diabetic ketoacidosis, patients may experience fruity breath due to the presence of ______.
In diabetic ketoacidosis, patients may experience fruity breath due to the presence of ______.
ketones
In Type II DM, the main issue is resistance or lack of ______.
In Type II DM, the main issue is resistance or lack of ______.
insulin
Hyperglycemic Hyperosmolar Non-ketonic Syndrome (HHNS) is characterized by glucose levels exceeding ______.
Hyperglycemic Hyperosmolar Non-ketonic Syndrome (HHNS) is characterized by glucose levels exceeding ______.
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The HbA1C test provides an average of blood glucose levels over the past ______ days.
The HbA1C test provides an average of blood glucose levels over the past ______ days.
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Fluids are the most important intervention in ______ and HHNS.
Fluids are the most important intervention in ______ and HHNS.
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The Dawn Phenomenon refers to early morning ______ in patients with diabetes.
The Dawn Phenomenon refers to early morning ______ in patients with diabetes.
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The Somogyi Effect occurs when a patient experiences hypoglycemia followed by rebound ______ in the morning.
The Somogyi Effect occurs when a patient experiences hypoglycemia followed by rebound ______ in the morning.
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It is critical to be ready with ______ replacement in diabetic ketoacidosis due to rapid potassium drops.
It is critical to be ready with ______ replacement in diabetic ketoacidosis due to rapid potassium drops.
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To draw up insulin correctly, air is injected into ______ first, then into Regular insulin.
To draw up insulin correctly, air is injected into ______ first, then into Regular insulin.
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Study Notes
Diabetes
- Type I DM: Insulin deficiency due to beta cell destruction. Without insulin, fats are metabolized for energy, leading to ketoacidosis.
- Diabetic Ketoacidosis: Characterized by sudden onset, high blood glucose (>300), ketones in the urine, fruity breath, confusion, and Kussmaul respirations (rapid deep breathing). Requires immediate IV fluids (normal saline) before insulin administration to treat dehydration. Potassium replacement may be needed due to rapid loss.
- Type II DM: Insulin resistance or lack of insulin. Leads to Hyperglycemic Hyperosmolar Non-ketotic Syndrome (HHNS) – without ketones or acidosis, high blood glucose (>600), severe dehydration, altered mental status.
- HbA1c: Measures average blood glucose levels over 90-120 days. A level of 4-6 indicates blood glucose around 70-110, while 7 is ideal for diabetics.
- Insulin Types (with onset, peak, and duration): Lists different types of insulin (Rapid, Short, Intermediate, Long) and their various times until effect, maximum effect and duration, aiding in insulin administration timing.
- Dawn Phenomenon: Early morning hyperglycemia, needing adjustments for insulin or the management of blood glucose.
- Somogyi Effect: Insulin-induced hypoglycemia followed by rebound hyperglycemia around 2-3 am.
Endocrine
- Additional Notes: Emphasizes the importance of fluids in Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Non-ketotic Syndrome (HHNS), and that steroids can increase glucose levels, requiring additional insulin.
- Diabetic Neuropathy: Early sign is microalbuminuria.
- Diabetes Insipidus: A disorder involving excessive thirst and urination, dehydration and weakness. It's characterized by decreased ADH (antidiuretic hormone). Nursing interventions include monitoring I&O, electrolytes, fluids, and urine specific gravity.
- SIADH: Water retention leading to water intoxication, hyponatremia, and increased ADH. Nursing interventions focus on daily weights, diuretics, monitoring for sodium levels (<115), and maintaining a quiet environment.
- Addison's disease: characterized by dark pigmentation, weight loss, alopecia, decreased resistance to stress, GI distress, hyperkalemia, hyponatremia, and hypoglycemia. Most important assessment is blood pressure due to severe hypotension, and managing stress to avoid Addisonian crisis.
- Cushing's Syndrome: hypercortisolism resulting in moonface, buffalo hump, hirsutism, hypertension, muscle wasting, hyperglycemia, hypernatremia, and hypokalemia.
- Grave's Disease: Hyperthyroidism, characterized by weight loss, arrhythmias, fine/soft hair, heat intolerance, irritability and exophthalmos (bulging eyes).
- Myxedema: Hypothyroidism, characterized by slowed metabolism, dry skin, hair, cold intolerance, fatigue. Severe hypothyroidism is Myxedema coma.
- Post-thyroidectomy: Assess for hypocortisolism and temporary diabetes insipidus; semi-Fowler's position, neck support, trach at bedside.
- Hyper-parathyroidism: fatigue, memory loss, body aches, difficulty sleeping, joint pain (d/t increased calcium), renal calculi, with a diet focused on low calcium/high phosphorus.
- Hypo-parathyroidism: Characterized by convulsions, arrhythmias, tetany, spasms and stridor related to decreased calcium levels. Requires diet focused on high calcium/low phosphorus with Vitamin D.
Other Endocrine conditions
- Hypo-parathyroidism: Symptoms (CATS) are convulsions, arrhythmias, tetany, and spasms. Diagnosis involves checking calcium blood levels. Diet changes and vitamin D are interventions.
- Pheochromocytoma: A hormone-secreting tumor in the adrenal glands, causing hypertension, headache, tachycardia, and hyperglycemia, and requiring stress avoidance and surgical removal.
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Description
Explore the complexities of diabetes, including Type I and Type II, their pathophysiology, acute complications, and management strategies. Learn about diabetic ketoacidosis, hyperglycemic hyperosmolar non-ketotic syndrome, and the role of HbA1c in monitoring glucose levels. This quiz will test your understanding of insulin types and their effects.
