Nursing Concepts in Health and Illness III

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Questions and Answers

Which of the following symptoms is not commonly associated with type 2 diabetes?

Visual changes

Prolonged wound healing

Recurrent infections

Increased hunger (correct)

What is the main risk associated with prediabetes?

Increased risk of type 2 diabetes within 10 years (correct)

Development of gestational diabetes

Reversal of blood glucose levels

Immediate symptoms of diabetes

What is the purpose of performing an oral glucose tolerance test during pregnancy?

To assess overall nutritional status

To screen for gestational diabetes (correct)

To diagnose type 1 diabetes

To determine fetal growth rate

Which method is not used for diagnosing diabetes?

Blood pressure evaluation Signup and view all the answers

What is the main goal of diabetes management?

Achieve near-normal blood glucose levels Signup and view all the answers

Which type of insulin is specifically used to manage blood sugar levels at mealtimes?

Short-acting (bolus) insulin Signup and view all the answers

What occurs in patients with prediabetes concerning long-term damage?

Long-term damage, especially to the heart, may already be occurring Signup and view all the answers

Which statement about exogenous insulin is true?

It compensates for inadequate insulin production Signup and view all the answers

What is the primary insulin management regimen preferred for adults with Type 1 Diabetes Mellitus (T1DM)?

Basal-bolus insulin therapy Signup and view all the answers

Which of the following factors should be considered when tailoring insulin regimens for individuals with T1DM?

Diet and lifestyle Signup and view all the answers

What is the main goal for diabetes management in adults with T1DM?

Achieve balance between blood glucose levels and avoid hypoglycemia Signup and view all the answers

Which therapy may be considered if glycemic targets are not met with optimized multiple daily injections?

Continuous subcutaneous insulin infusion (CSII) Signup and view all the answers

What should all T1DM patients be counseled about regarding insulin therapy?

Risk of hypoglycemia Signup and view all the answers

Continuous glucose monitoring is recommended for which group of patients?

Those not fully compliant with glycemic targets Signup and view all the answers

What are the characteristics of insulin preparations used for T1DM?

They are classified by duration, onset, and peak of action Signup and view all the answers

Which of the following is a characteristic of continuous subcutaneous insulin infusion (CSII)?

It requires ongoing support and frequent health care professional involvement Signup and view all the answers

Which of the following is a direct effect of regular exercise in diabetes management?

Increases insulin sensitivity Signup and view all the answers

What factors influence the frequency of self-monitoring of blood glucose (SMBG)?

Type of diabetes Signup and view all the answers

Which patient might be considered for bariatric surgery as part of their diabetes management?

A patient with type 2 diabetes and a BMI greater than 35 kg/m2 Signup and view all the answers

What is a primary goal of diabetes self-management education?

To enable the patient to actively participate in their care Signup and view all the answers

What is a characteristic of diabetic ketoacidosis (DKA)?

Dehydration Signup and view all the answers

Which nursing responsibility is essential for a patient receiving insulin therapy?

Assessing the patient’s response to insulin Signup and view all the answers

What type of diabetes management might pancreas transplantation be considered for?

Type 1 diabetes with associated kidney disease Signup and view all the answers

What is a consequence of increased insulin sensitivity due to exercise?

Lower blood glucose levels Signup and view all the answers

Study Notes

You People Have No Idea - Care Scenario Notes

This document is study notes for a Nursing Concepts in Health and Illness III course at McMaster University, Fall 2021.
It covers diabetes mellitus, including type 1 and type 2, gestational diabetes, prediabetes, and diagnostic studies.
It also discusses collaborative care, drug therapy, including insulin regimens, oral agents, and noninsulin injectables, and monitoring blood glucose.
Chronic complications of diabetes, such as macrovascular and microvascular complications, are discussed, including diabetic retinopathy, nephropathy, and neuropathy.
Acute complications, such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are discussed.
Management of diabetes in children and adolescents, including education, glycemic targets, insulin therapy, and complications unique to pediatric populations.
The role of the nurse in managing diabetes, and patient/family education are also highlighted.

Diabetes Mellitus

A chronic multisystem disorder of glucose metabolism, related to insulin deficiency or impaired utilization.
Current theories link causes to genetic, autoimmune, and environmental factors.

Type 1 Diabetes Mellitus

Typically diagnosed before age 40, with 40% of cases diagnosed before 20 years old.
Characterized by the body's own T cells attacking and destroying pancreatic cells, the source of insulin.
Rapid-onset symptoms: polyuria, polydipsia, and polyphagia (caused by hyperglycemia).
Requires insulin therapy to sustain life.
Diabetic ketoacidosis (DKA) is a life-threatening complication without insulin.

Type 2 Diabetes Mellitus

Accounts for over 90% of cases.
Often associated with insufficient or poorly used insulin.
Obesity, specifically abdominal and visceral adiposity, is the most significant risk factor.
Symptoms are generally less acute than in type 1.
Common symptoms include fatigue, recurrent infections, yeast infections, slow wound healing, and visual changes.

Prediabetes

Blood glucose levels are higher than normal but not yet high enough for a diagnosis of diabetes.
Individuals with prediabetes are at high risk for developing type 2 diabetes within 10 years.
Preventive measures are crucial.

Gestational Diabetes

Develops during pregnancy, typically screened for between 24-28 weeks gestation.
Often resolves after pregnancy, but there is a higher risk of developing type 2 diabetes later in life.

Diagnostic Studies

Fasting plasma glucose test
Random plasma glucose test
2-hour oral glucose tolerance test
A1C test

Collaborative Care

Reducing symptoms and promoting well-being
Preventing acute complications of hyperglycemia.
Preventing/delaying long-term complications (macrovascular and microvascular.)

Drug Therapy: Insulin

Exogenous insulin is needed when a patient has inadequate insulin production.
Insulins are categorized as short-acting (bolus) and long-acting (basal).
Bolus insulin targets postprandial hyperglycemia; basal insulin maintains background levels throughout the day.
Several regimens are used depending on patient needs.

Oral Agents and Non-Insulin Injectable Agents

Metformin is a common oral agent used for type 2 diabetes. Works by reducing glucose production in the liver.
Sulfonylureas and Meglitinides increase insulin production from the pancreas.
a-Glucosidase inhibitors slow carbohydrate absorption.
Thiazolidinediones are effective for insulin resistance but have severe adverse effects.
Dipeptidyl peptidase IV (DPP-4) inhibitors slow the degradation of GLP-1, resulting in improved glycemic control

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Description

This quiz covers essential topics in Nursing Concepts related to diabetes mellitus, including types 1 and 2, gestational diabetes, and prediabetes. It addresses collaborative care, drug therapies, and the management of chronic and acute complications of diabetes. The role of nursing in patient education and care for children and adolescents with diabetes is also discussed.