week 5

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week 5
2013-03-05 21:51:22

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  1. basal insulin 1225
    • control blood glucose levels in between meals & overnight
    • 24hr background insulin
    • Insulin glargine (lantus)
    • detemir (levemir), both must not mixed or diluted with any other insulin/solution
    • released steadily & continuosly
    • no peak of action
    • once a day SQ
  2. bolus insulin 1225
    • control postmeal blood glucose levels
    • rapid acting onset 15 min
    • lispro (Humalog)
    • aspart (Novolog)
    • glusine (Apidra)
    • mimic natural insulin secretion
    • short acting onset 30-60min
  3. diabetes mellitus 1218
    chronic multisystem disease related to abnormal insulin production, insufficient insulin utilization or both
  4. diabetic ketoacidosis (DKA) 1221
    • a condition develop after the absence of insulin, type I diabetes
    • a life-threatening condition resulting in metabolic acidosis
  5. diabetic nephropathy 1249
    a microvascular complication associated with damage to the small blood vessels that supply the glomeruli of the kidney
  6. diabetic neuropathy 1249
    nerve damage that occurs because of the metabolic derangements associated with DM
  7. endogenous insulin 1221
    self-made insulin, made from the pancrease
  8. fasting blood sugar p.269 Pagana
    • fast for 8hrs, water is permitted
    • withhold insulin or oral hypoglycemics until blood is obtained
    • >= 126mg/dL
  9. hemoglobin A1C
    • monitor HbA1C in blood, used to diagnose and glucose control in diabetes pt
    • >= 6.5%
  10. hyperosmolar hyperglycemic syndrome  1244
    • life-threatening syndrome that can occur in the patient with diabetes who is able to produce enough insulin to prevent DKA but not enough to prevent severe hyperglycemia, osmotic diuresis, & extracellular fluid depletion
    • usually occurs to pt over 60 y/o type II
  11. gestational diabetes  1222
    • develops during pregnancy
    • the placenta provides the baby with nourishment. It also produces a number of hormones that interfere with the body's usual response to insulin. This condition is referred to as "insulin resistance." Most pregnant women do not suffer from gestational diabetes, because the pancreas works to produce extra quantities of insulin in order to compensate for insulin resistance. However, when a woman's pancreas cannot produce enough extra insulin, blood levels of glucose stay abnormally high, and the woman is considered to have gestational diabetes.
  12. glycemic index  1232
    the term used to describe the rise in blood glucose levels 2 hrs after a person has consumed a CHO food
  13. hypoglycemia
    abnormally low blood glucose
  14. insulin resistance
    condition in which a person's body tissues have a lowered level of response to insulin, a hormone secreted by the pancreas that helps to regulate the level of glucose (sugar) in the body. As a result, the person's body produces larger quantities of insulin to maintain normal levels of glucose in the blood.
  15. ketosis
    accumulation of excessive amounts of ketone bodies in body tissues and fluids, occurring when fatty acids are incompletely metabolized
  16. lactic acidosis
    a metabolic acidosis occurring as a result of excess lactic acid in the blood, due to conditions causing impaired cellular respiration.
  17. lipodystrophy
    abnormal fat metabolism or deposition
  18. osteodystrophy
    any generalized defect in bone development, usually associated with disturbances in calcium and phosphorus metabolism and renal insufficiency, such as in renal osteodystrophy
  19. paresthesisa
    altered sensation often described as burning, tingling, or pin pricks
  20. polydipsia
    excessive thirst
  21. polyphagia
    excessive eating
  22. polyuria
    excessive production of urine
  23. postprandial blood sugar
    a blood test in which a meal acts as a glucose challenge to the body's metabolism. It is an easily performed screening test for diabetes mellitus. A 1-hour glucose screen, using a 50-g oral glucose load, is used to detect gestational diabetes mellitus.
  24. ischemia
    • A decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels.
  25. paresthesias
    abnormal feeling: tingling, itchy, tickling, burning
  26. hyperesthesia
    so sensitive skin
  27. Acanthosis nigricans
    Dark, coarse, thickened skin
  28. Necrobiosis lipoidica diabeticorum
    •Associated with type 1

    •Red-yellow lesions 

    • •Skin becomes shiny, revealing
    • tiny blood vessels
  29. Granuloma annulare
    •Associated mainly with type 1

    •Forms partial rings of papules
  30. which insulin is used for bolus & why
    • rapid & short-acting insulin
    • onset 0-15 & 30-60 min
  31. assist control ventilation (AC)
    A method of artificial respiration in which inspiration is produced automatically after a set interval if the person has not begun to inspire earlier.
  32. continuous positive airway pressure (CPAP)
    a method of positive pressure ventilation used with patients who are breathing spontaneously, done to keep the alveoli open at the end of exhalation and thus increase oxygenation and reduce the work of breathing
  33. controlled mandatory ventilation (CMV)
    A method of artificial ventilation in which all inspirations are provided by positive pressure applied to the airway. Also called continuous positive pressure breathing, continuous positive pressure ventilation, intermittent positive pressure breathing, intermittent positive pressure ventilation.
  34. extubation
    removal of tube used in ventilation
  35. intubation
    the insertion of a tube into a body canal or hollow organ, as into the trachea.
  36. positive end expiration pressure (PEEP)
    a method of control mode ventilation in which positive pressure is maintained during expiration to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. A PEEP higher than the critical closing pressure prevents alveolar collapse and can markedly improve the arterial Po2 in patients with a lowered functional residual capacity, as in acute respiratory failure.
  37. pressure support ventilation (PSV)
    the augmentation of spontaneous breathing effort with a specific amount of positive airway pressure. The patient initiates the inspiratory flow and sets his or her own respiration rate and tidal volume. PSV can be used to decrease the work of breathing in a patient being weaned from mechanical ventilation.
  38. synchronized intermittent mandatory ventilation (SIMV)
    periodic assisted mechanical ventilation synchronized with the patient's breathing. Spontaneous breathing by the patient occurs between the assisted mechanical breaths, which occur at preset intervals. The ventilator will provide a mechanical breath if the patient fails to do so within the set interval.