Diabetes (NUR 170) PDF

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RE EXCELLENCE PURE CALLING PURE NURSING PURE CALLING PURE NURSING PURE DEDICATION PURE EXCELLEN PURE COMMITMENT PURE COMPASSION Ac = 5. 5% PURE NUR 3p's PURE DEDICA Diabetes · polyuria poly PURE EXCELLENCE PURE CO poly PURE DEDICATION NUR 170 PURE NURSING PURE CALLIN PURE NURSING PURE DEDICATION PURE EXCELLEN PURE COMMITMENT PURE COMPASSION PURE COM E DEDICATION PURE NURSING PURE DEDICATION Definitions Chronic Hyperglycemia resulting from problems with glucose regulations Type 1 Type 2 Diabetes Type I Type II the body does not produce (Insulin Resistance)the body insulin. does not use insulin - coutd be : properly. Auto-immune makes some insulin Treatment : Loading… Insulin ·eatm  know Risk Factors Type II Type I won't Weight eat right 100seught - T need Family History , > - Blood Family history Insulin. Genetics Auto-immune Glucose Inactivity drops Geography Peaks around age 50 Less than 30 years of age Usually insulin resistant and Issue with beta cells which but can have some produce insulin dysfunctional beta cells Post viral infection A Obesity Usually not obese Insidious onset Slow Abrupt onset - Certain cultures – Hispanic, African Americans, Native American, Asian American, and Pacific Islanders Has history of gestational  diabetes cold & clammy Signs / Symptoms Same need some candy Type I Type II Hyperglycemia Hyperglycemia polyuraPodia a 3P’s , 3 P’s Weight loss Weight gain Symptoms are pronounced Loading… from Symptoms are not always as obvious d pehydrated Polyurid musthave insulin - -  ↓ Cold clammy , need some candy. Therapeutic Management Type I Type II Insulin Must Have Diet Frequent small Meals -constantly ↑ sugar Diet exercise levels. Blood sugar monitoring Possible medication Education of Client Frequent blood sugar monitoring Sulin Education of Client Giving p+ In because their Blood Glucose is. too high Lab and Diagnostics Normal 70-110 Less tha Blood glucose -. 5 % or 6 % sugaer is doing in past Hemoglobin A1C -what blood 3monts/90 days. Glucose tolerance test Postprandial Urine screening * Keetones in rive = issue in kidneys. properly - not filtering  going everywhere Because blood is Other issues that occur with Diabetes to assess for Skin Cardiac Breaks in skin, infection Angina Diabetic dermopathy MI Unhealed injection sites Respiratory Eyes Dyspnea Cataracts and/or retinal problems infection Kidneys Peripheral Edema, yeast HIV Hair loss on extremities UTI, Skin is shiny, thin, pale and cool urinary retention Pulses are weak or absent GI Nails are thick Dental caries, Erectile disorder Periodontal disease, Candidiasis  Nursing Interventions Blood glucose monitoring Sick Nutriticist- day rules still have pt check their blood glucose when for Garl Diet diabeticcourcarb Box Healthy Q4M over 240-test urive ketores nurse - : , count bed Exercise eat. Small me als 6 Drink 8-1202 tuno Patient teaching 3 7/4- - - Sugar- Foot care ↓Thic diab Sahy thid toopen Take med Shoes not not too right , natrist to cu nails. Delayed Wound healing+ poor v / N/. circulation's Notify Dr Nutrition Test 1st proven-s infection How to count carbohydrates Medical Management Pharmacological interventions Type 2 Oral Type I Insulin Monitor for Adverse Reaction glycemia cold , clarmy shaky , · , irritable Types of insulin Rapid-Acting Insulin (bolus) works rapidly Examples: Human Lispro (Humalog), Insulin Aspart (Novolog) & Insulin Glulisine (Apidra) when Onset within 5-15 minutes It starts right away given Peak in about one hour Loading… Given just prior to meal, during meal or within 20 minutes after meal. -Have Good in front of them. Types of Insulin Short-Acting Insulin – given SQ & IV Examples: Mixw/INH Regular Human Insulin(Humulin R, Novolin R) Still have food in front Onset-30-60 minutes - Peak 2-4 hours Duration 5-7 hours we Mix regular EINH = RN *Only kind of insulin to be used IV - Use for Sliding Scale it -clear · cloudy t the Scale based sugar :s 130 give Units. Can move Ef pts glucose , Used to treat DKA emergencies (will be discussed in later course). on ↑ 300 gircose S dehydrated. check (S) Give Insulin IV ! Regular RUN IV - >  Bidding scale Types of Insulin Once Daily. 9 AM. Intermediate-Acting Insulin daily at counits ex give Examples: - Breakfast 7-an NPH (Humulin N, Novolin N) Mix w/ regular Onset-1-2 hours 8 Am Lunch Gave 11-12pm at - ex : Peak 4-12 hours peak at 12 pm - Dinner Duration 18-24 hours 6-Tom in Lase lunch/dinner is late Between meal snacks may be ordered for patients to prevent hypoglycemia - come back during peak (lunch time). to check Sugar  Blood Circose scale Sliding ACMS 140-Lunits Betrees( hous of Sleep (Before Bed) Sunits standing order : Give 10 Units NPM TAM Daily + Sliding scale 3 Units ↓ 250 - Gunits Total = 13 units 300-call Draw up Bu air ist,. in - Draw up regular Watch thevideo last syringe. in put air it PUt 10 Units air in NPH (regular " Invert Vile" PV3 Units air in INH  ·. 81 ? -- Insulin per pg tell ot coun its but they Types of Insulin have to prime it at Bedtime Long-Acting Insulin – basal Give Once Daily Cannot be mixed Examples: Insulin Glargine (Lantus) the Den has How do know Onset- 2-4 hours we been Primed Peaks-relatively constant slow release at Duration 24 hours We see a drop Used with Basal/Bolus protocol the ena insulim area where we inject Rotchte · arm (adipose tissue area Or · it won't work ! Basal Insulin Therapy Insulin Glargine (Lantus) Cannot be mixed with any other insulin May be ordered twice a day, but needs to be given within 30 minutes of the same time each day. Optimum dose will not cause hypoglycemia even when NPO  of fluid sure kidneys working * print a lot make. are , Before Car scan Bun 2 · 8 Oral Hypoglycemic Agents creatinept has Metformin Type blood Secretagogues ↓ It's Sugar Ceric Sensitizers - Monitor for Hypogly Slow absorption cold , clammy- > need Sugar Metformin Uses : : Glucose Side effects : ↓ Blood min Gi discomfort Gi emptieg ↓ post eating glucose * cannot wei take , no losstheyfaile E ↑ COS 2)n-yohr hold +o betore prior gihis ex catScan: contrast post dye Nursing Diagnosis Knowledge deficit Risk for non-compliance Altered nutrition has + o change Cultural Consideration African American Hispanic Native American Asian, Pacific Islander  Collaborative Problems/Potential Complications Adherence Adjustment Macrovascular/microvascular problems are kidny Renal Destroy wornd artif Infection neurop Amputation stresson t - Heart attack Stroke DKA , Hyperglyceria cora Social Determinants of Health Considerations health Increased Risk for Adherence Problems have access or for care p+ may not Level of Education , Income Cultural upbringing (cultural perspectives related to healthcare) Access to care case managers/social Services to help S Nurses Can Help Patients p+ Recognize potential barriers Provide effective education appropriate for the person Ask the patient to describe concerns about adherence or potential barriers Pause – Consider this Pancreas – Alpha cells – secretes glucagon (prevents HYPOglycemia) Beta cells – produces insulin and amylin (prevents HYPERglycemia) - Gas and Brake working together I treat oral Type cannot /  Test Dawn Phenomenon Somogyi Effect Drug 2 Snack In the early morning hours your body starts to Usually due to taking too much insulin before release hormones to get you up and going bed or when miss the nighttime snack. (think circadian rhythm). Plus, you release the - necessary glucagon to handle the “get up and So, the blood sugar drops during the night. go”. adjust dro g mea change Body react to the low sugar by releasing Lantis Insulizofie glucagon. regive & If you are a diabetic, you don’t have enough it insulin to keep up with that release and the7. Release of glucagon without insulin leads to T person experiences hyperglycemia. hyperglycemia. S Treatment: Treatment: 350e Increase insulin or change administration time Give bedtime snack or reduce insulin at is 120/140 bedtime Sugar normal Am · sugar just keeps going up.  Bet apmtgo to 110 BG - is 350. GAmptsugar By ? what happened betwee glucose test Dr says do 223 am Somogyi