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Nursing priorities for patients with diabetes
- -these priorities are aimed at helping pts achieve and maintain lifestyle changes that prevent long-term complications
- - keeping blood glucose levels and cholesterol levels as close to normal as possible
what is the main feature for all types of diabetes?
chronic hyperglycemia (high blood glucose level)
what is the underlying problem with diabetes?
a lack of insulin and the severity of the insulin deficiency
-hormone made in the beta cells of the islets of Langerhans in the pancreas
-this hormone allows body cells to use and store carbs, fats and protein
- OVERALL, keeps blood glucose levels from becoming too high and helps keep blood lipid levels in normal range
-hormone made in the alpha cells of the pancreas
-a major "counterregulatory" hormone that has actions opposite of insulin -- causes release of glucose from cell storage sites whenever blood glucose levels are low
the first major orgn to be reached by insulin in the blood
what does insulin do in the liver?
-promotes production and storage of glycogen (glycogenesis) as it inhibits glycogen breakdown into glucose (glycogenolysis)
what does insulin do in the muscle?
- promotes protein and glycogen synthesis
what does insulin do in fat cells?
-promotes triglyceride storage
stored glucose (stored in liver and muscles)
the main fuel for the CNS
a lack of insulin causes what?
hyperglycemia (glucose build up)
what are the classic symptoms (3 P's) of diabetes?
polyuria, polydipsia, polyphagia
-abnormal breakdown products of fatty acids, they collect in blood when insulin is not available
-conversion of fatty acids to this provides a backup energy source
ketone bodies, "ketones"
what are the 5 things that result when dehydration occurs with diabetes?
hemoconcentration, hypovolemia, hyperviscosity, hypoperfusion, and hypoxia
How does Kussmaul respiration occur due to an absence of insulin?
the excess acids are caused by a lack of isulin increase H+ and CO2 levels in blood which causes metabolic acidosis. this triggers respiratory centers of brain to increase rate and depth of respiration in an attempt to excrete more CO2. producing Kussmail respiration
what are 3 glucose-related acute complications can occur in patients with diabetes?
- 1. Diabetic ketoacidosis (DKA) caused by a lack of insulin and ketosis
- 2. Hyperglycemic-hyperosmolar state (HHS) caused by insulin deficiency and profound dehydration
- 3. Hypoglycemia from too much insulin or too little glucose
- -all 3 require emergency treatment and can be fatal if treatment is delayed or incorrect
Which acute complication deals with the bad type, Type 1?
Diabetic ketoacidosis (DKA) caused by a lack of insulin and ketosis
Which acute complication deals with the bad type, Type 2?
Hyperglycemic-hyperosmolar state (HHS) caused by insulin deficiency and profound dehydration
chronic omplications of diabetes results from what?
- -poor tissue circulation and cell death
- -Macrovascular and Microvascular complications
What are the 2 macrovascular complications?
cardiovascular and cerebrovascular
What are the 3 microvascular complications?
nephropathy, retinopathy, and neuropathy