NUR 170 Diabetes Overview
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Questions and Answers

What is the correct onset time for Short-Acting Insulin?

  • 30-60 minutes (correct)
  • 1-2 hours
  • 10-20 minutes
  • 2-4 hours

What is the typical peak time for Regular Human Insulin?

  • 4-6 hours
  • 6-8 hours
  • 1-2 hours
  • 2-4 hours (correct)

Which type of insulin is specifically indicated for IV use?

  • Short-Acting Insulin (correct)
  • Rapid-Acting Insulin
  • Long-Acting Insulin
  • Intermediate-Acting Insulin

What is the duration of action for Short-Acting Insulin?

<p>5-7 hours (D)</p> Signup and view all the answers

In what scenario is Short-Acting Insulin typically used?

<p>To treat DKA emergencies (B)</p> Signup and view all the answers

What is the primary issue in Type I diabetes?

<p>Inadequate insulin production (C)</p> Signup and view all the answers

Which factor is NOT typically associated with Type II diabetes?

<p>Auto-immune dysfunction (A)</p> Signup and view all the answers

What condition results from problems with glucose regulation?

<p>Chronic Hyperglycemia (A)</p> Signup and view all the answers

What is a common treatment method for Type I diabetes?

<p>Insulin therapy (C)</p> Signup and view all the answers

Which of the following is an example of a risk factor for Type II diabetes?

<p>Genetic predisposition (B)</p> Signup and view all the answers

How does the body respond in Type II diabetes?

<p>It produces insulin but does not use it effectively. (C)</p> Signup and view all the answers

Which of these symptoms is closely associated with diabetes?

<p>Polyuria (A)</p> Signup and view all the answers

What is a primary characteristic of chronic hyperglycemia in diabetes?

<p>Consistently high glucose levels (A)</p> Signup and view all the answers

What is the primary purpose of rapid-acting insulin?

<p>To control blood sugar levels immediately before or during a meal (B)</p> Signup and view all the answers

When should rapid-acting insulin be administered in relation to meals?

<p>Just prior to meal, during meal, or within 20 minutes after meal (B)</p> Signup and view all the answers

What are common signs of hypoglycemia?

<p>Cold, clammy skin and irritability (D)</p> Signup and view all the answers

What is the recommended action for patients undergoing foot care related to diabetes?

<p>Notify a doctor of any delayed wound healing (C)</p> Signup and view all the answers

Which of the following insulin types is classified as a bolus insulin?

<p>Human Lispro (Humalog) (C)</p> Signup and view all the answers

What occurs during the night that leads to a drop in blood sugar levels?

<p>The body's release of glucagon to handle low sugar. (D)</p> Signup and view all the answers

What is the condition called when there is a release of glucagon without sufficient insulin?

<p>Hyperglycemia. (B)</p> Signup and view all the answers

What is a recommended treatment for managing blood sugar levels in a diabetic at bedtime?

<p>Give a bedtime snack or reduce insulin. (B)</p> Signup and view all the answers

What happens if blood sugar levels remain elevated at night without proper management?

<p>Blood sugar levels continue to rise. (D)</p> Signup and view all the answers

Which of the following best describes the Somogyi effect?

<p>A rebound increase in blood sugar after hypoglycemia. (A)</p> Signup and view all the answers

What is the duration of Long-Acting Insulin such as Insulin Glargine?

<p>24 hours (B)</p> Signup and view all the answers

What is the primary characteristic of Long-Acting Insulin regarding mixing with other insulins?

<p>It cannot be mixed with any other insulin. (B)</p> Signup and view all the answers

How often should Long-Acting Insulin be administered?

<p>Once daily (A)</p> Signup and view all the answers

What is the onset time for Long-Acting Insulin like Insulin Glargine?

<p>2-4 hours (C)</p> Signup and view all the answers

What happens to the insulin if not injected into the correct area?

<p>It won't work. (A)</p> Signup and view all the answers

What is the peak behavior of Long-Acting Insulin, such as Insulin Glargine?

<p>Has a constant slow release. (C)</p> Signup and view all the answers

If Insulin Glargine is ordered for a patient, how soon must it be administered at the same time each day?

<p>Within 30 minutes (B)</p> Signup and view all the answers

What is a recommended practice regarding Long-Acting Insulin priming?

<p>It needs to be primed at bedtime. (C)</p> Signup and view all the answers

What is the primary function of glucagon released by alpha cells of the pancreas?

<p>Prevents hypoglycemia (C)</p> Signup and view all the answers

Which of the following conditions may result from poor adherence to medication in diabetic patients?

<p>Elevated postprandial glucose levels (A)</p> Signup and view all the answers

What is one of the side effects associated with Metformin?

<p>Gastrointestinal discomfort (C)</p> Signup and view all the answers

Which group is notably considered in cultural considerations for diabetes management?

<p>Native Americans (C)</p> Signup and view all the answers

In diabetes care, what is a possible complication related to social determinants of health?

<p>Reduced access to healthcare services (C)</p> Signup and view all the answers

What phenomenon occurs in the early morning due to hormonal release by the body?

<p>Dawn Phenomenon (C)</p> Signup and view all the answers

Which of the following is a characteristic symptom of hypoglycemia?

<p>Cold and clammy skin (C)</p> Signup and view all the answers

What is a common risk factor for diabetes-related complications?

<p>Macrovascular and microvascular issues (B)</p> Signup and view all the answers

What impact does a high level of education generally have on adherence to diabetes management?

<p>Improves adherence and health outcomes (B)</p> Signup and view all the answers

What is the relationship between insulin levels and the Somogyi Effect?

<p>Excessive insulin leading to hypoglycemia (B)</p> Signup and view all the answers

What nursing diagnosis may be associated with ineffective diabetes management?

<p>Knowledge deficit (B)</p> Signup and view all the answers

What is a significant barrier to diabetes care linked with income levels?

<p>Higher risk for adherence problems (C)</p> Signup and view all the answers

How does physical activity generally affect blood sugar levels in diabetes management?

<p>It lowers blood sugar levels (C)</p> Signup and view all the answers

What effect does renal dysfunction have on medication clearance in diabetes patients?

<p>Decreases medication clearance (C)</p> Signup and view all the answers

Flashcards

Rapid-Acting Insulin

A type of insulin that works quickly to lower blood sugar levels.

Type 1 Diabetes

A type of diabetes where the body doesn't produce insulin.

Type 2 Diabetes

A type of diabetes where the body doesn't use insulin effectively.

Blood Glucose Monitoring

The process of checking and recording blood sugar levels.

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Carbohydrate Counting

A method to measure the amount of carbohydrates in a food to help manage blood sugar levels.

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Diabetes Type 1

The body doesn't produce insulin.

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Diabetes Type 2

Body doesn't use insulin properly (Insulin Resistance).

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Chronic Hyperglycemia

High blood sugar, due to glucose regulation problems.

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Polyuria

Excessive urination.

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Insulin

Hormone that regulates blood sugar.

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Risk Factors (Type 2)

Factors like a family history and weight.

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Type 2 Diabetes Treatment

Focuses on lifestyle changes, possibly insulin.

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Insulin Resistance

Cells don't respond to insulin properly.

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Short-Acting Insulin

A type of insulin that works quickly to lower blood sugar.

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Regular Human Insulin

A common short-acting insulin used to treat high blood sugar, including in DKA emergencies.

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Sliding Scale Insulin

A method for adjusting insulin doses based on blood sugar levels.

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DKA emergencies

A serious condition where blood sugar is very high and the body is dehydrated.

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IV Insulin Administration

Delivery of insulin directly into a vein.

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Somogyi Effect

A phenomenon where low blood sugar during the night triggers a surge of glucagon, leading to high blood sugar in the morning.

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Glucagon's Role in Blood Sugar

Glucagon is a hormone released by the pancreas when blood sugar is low. It helps raise blood sugar by prompting the liver to release stored glucose.

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Diabetic Hyperglycemia

Diabetics may experience hyperglycemia (high blood sugar) when the body releases glucagon without sufficient insulin to counter it.

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Somogyi Effect Treatment

Treating Somogyi effect might involve adjusting insulin dosage or adding a bedtime snack to prevent overnight blood sugar dips.

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Blood Sugar Monitoring for Somogyi

Regular blood sugar monitoring, especially before bed and upon waking, can reveal the Somogyi effect by showing a pattern of low blood sugar at night followed by high blood sugar in the morning.

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Long-acting Insulin

A type of insulin that works slowly and steadily over a long period (24 hours), providing a continuous background level of insulin.

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Basal Insulin

Refers to the steady, background level of insulin needed to maintain stable blood sugar levels between meals and overnight. Long-acting insulins are often used for basal insulin therapy.

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Insulin Glargine (Lantus)

A commonly used long-acting insulin, known for its slow and steady release, providing a consistent blood sugar control over 24 hours.

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Basal/Bolus Protocol

A diabetes management strategy using a combination of long-acting (basal) and rapid-acting (bolus) insulins. Basal insulin maintains stable blood sugar, while bolus insulin is used to cover mealtime carbohydrates.

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Prime

To prepare an insulin syringe by injecting a small amount of air into the vial before drawing the insulin. This helps prevent inaccurate dosing.

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Give Once Daily

Long-acting insulins are typically administered once daily, usually at bedtime.

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Cannot Be Mixed

Long-acting insulins, like Lantus, cannot be mixed with other types of insulin. They are often used separately from rapid-acting insulins.

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Inject Insulin in Adipose Tissue

Long-acting insulin should be injected into subcutaneous fat, avoiding muscle or veins.

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Optimal Metformin Dose

A dosage of Metformin that doesn't cause hypoglycemia, even when a patient isn't eating (NPO).

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Oral Hypoglycemic Agents

Medications that help regulate blood sugar levels.

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Metformin

An oral hypoglycemic agent that primarily lowers blood glucose.

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Secretagogues

Type of oral hypoglycemic agent that stimulates the pancreas to release insulin.

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Sensitizers

Oral hypoglycemic agents that improve how the body responds to insulin.

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Hypoglycemia

Low blood sugar, a condition that needs immediate attention.

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Dawn Phenomenon

Elevated fasting blood sugar levels in the morning due to natural hormonal changes.

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Risk for Non-Compliance

A nursing diagnosis related to potential difficulties following treatment plans.

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Knowledge Deficit

A nursing diagnosis related to patients' lack of understanding of their condition.

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Altered Nutrition

A nursing diagnosis related to problems with a patient's diet and health.

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Alpha Cells

Pancreatic cells that secrete glucagon to prevent hypoglycemia.

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Beta Cells

Pancreatic cells that produce both insulin and amylin to control blood sugar levels.

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Social Determinants of Health

Factors outside of medical care that affect a person's health.

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Study Notes

Diabetes Overview

  • AIC = 5.5%
  • 3Ps: polyuria, polydipsia, polyphagia
  • NUR 170 course

Definitions

  • Chronic hyperglycemia from glucose regulation problems
  • Type 1 and Type 2 diabetes

Type 1 Diabetes

  • Body does not produce insulin
  • Possible autoimmune cause
  • Requires insulin treatment

Type 2 Diabetes

  • Body does not use insulin properly
  • Often associated with lifestyle factors
  • Potential for some insulin production

Risk Factors for Type 1

  • Family history
  • Genetics (autoimmune)
  • Geography
  • Age (less than 30 years)
  • Beta cell issues
  • Post-viral infections
  • Usually not obese
  • Abrupt onset

Risk Factors for Type 2

  • Weight
  • Family History
  • Inactivity
  • Age (peaks around 50)
  • Insulin Resistance
  • Dysfunction of beta cells
  • Obesity
  • Gradual onset
  • Associated with specific cultures (Hispanic, African American, Native American, Asian American)

Signs and Symptoms of Type 1

  • Hyperglycemia
  • Polyuria
  • Polydipsia
  • Polyphagia
  • Weight loss
  • Pronounced symptoms

Signs and Symptoms of Type 2

  • Hyperglycemia
  • Polyuria
  • Polydipsia
  • Weight gain
  • Less obvious symptoms

Therapeutic Management - Type 1

  • Insulin (must have)
  • Diet
  • Blood glucose monitoring
  • Education of client
  • Managing blood glucose to prevent complications

Therapeutic Management - Type 2

  • Diet
  • Exercise
  • Possible medication
  • Frequent blood glucose monitoring
  • Education of client

Lab and Diagnostics

  • Blood glucose (normal 70-110)
  • Hemoglobin A1c (5.5% or 6%)
  • Glucose tolerance
  • Postprandial tests
  • Urine screening for ketones

Other Issues to Assess for in Diabetes

  • Skin breakdown/infections
  • Diabetic dermopathy
  • Unhealed injection sites
  • Eyes (cataracts, retinopathy)
  • Peripheral issues (hair loss, pale skin, weak pulses, thick nails, erectile dysfunction)
  • Cardiovascular issues (angina, MI, dyspnea, edema)
  • Kidney issues (urine retention, UTI)
  • GI issues (dental caries, periodontal disease, candidiasis, yeast infections)

Nursing Interventions

  • Blood glucose monitoring
  • Diabetic sick day rules
  • Diet
  • Exercise
  • Wound care
  • Foot care
  • Nutrition education (carbohydrate counting)
  • Patient teaching (medications and disease management)

Medical Management

  • Type 1: Insulin
  • Monitor for Hypoglycemia (cold, clammy, shaky, irritable)
  • Type 2: Oral medications

Types of Insulin

  • Rapid-acting (bolus): Humalog, Novolog, Apidra - fast onset/short duration, used before meals
  • Short-acting: Regular insulin - given SQ or IV, slower onset/intermediate duration
  • Intermediate-acting: NPH - slower onset/longer duration, often given twice a day
  • Long-acting: Lantus - once daily, very long duration

Basal Insulin Therapy

  • Insulin Glargine (Lantus)
  • Cannot be mixed with other insulins
  • May be ordered twice a day, but needs to be given within 30 minutes of the same time each day

Oral Hypoglycemic Agents

  • Metformin
  • Secretagogues
  • Sensitizers
  • Monitor for hypoglycemia

Nursing Diagnosis

  • Knowledge deficit
  • Risk for non-compliance
  • Altered nutrition

Cultural Considerations

  • Cultural upbringing
  • Healthcare perspectives
  • Access to care relevant to specific cultures (African American, Hispanic, Native American, Asian, Pacific Islander)

Collaborative Problems/Potential Complications

  • Adherence
  • Adjustment
  • Macrovascular/microvascular problems
  • Renal/neuropathy complications
  • Infection
  • Amputation
  • Heart attack
  • Stroke
  • DKA (diabetic ketoacidosis)
  • Hyperglycemia awareness
  • Hyperosmolar hyperglycemic state (HHS)

Social Determinants of Health Considerations

  • Increased risk of adherence problems
  • Level of education
  • Income
  • Cultural upbringing
  • Access to care
  • Case managers for social services or health advocates

Dawn Phenomenon/Somogyi Effect

  • Dawn phenomenon: early-morning hyperglycemia due to hormonal changes and the need for more insulin or adjusting the administration time
  • Somogyi effect: overnight hypoglycemia followed by rebound hyperglycemia due to excess insulin. The body compensates with glucagon release, resulting in high blood sugar in the morning.

Pancreas - Brief Summary

  • Alpha cells secrete glucagon for preventing hypoglycemia
  • Beta cells secrete insulin and amylin for preventing hyperglycemia.

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Related Documents

Diabetes (NUR 170) PDF

Description

This quiz provides an overview of diabetes, including definitions, risk factors, and specific details about Type 1 and Type 2 diabetes. It covers symptoms, causes, and essential treatment information discussed in the NUR 170 course.

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