adults exam II Diabetes

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kbryant86
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260742
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adults exam II Diabetes
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2014-02-27 16:42:09
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adults exam II
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  1. what is diabetes?
    group of chronic disorders of the endocrine pancreas

    • inappropriate hyperglycemia
    • relative (II) or absolute (I) insulin deficiency
    • cellular resistance to insulin
  2. 3 endocrine pancreatic hormones
    • glucagon
    • insulin
    • somatostatin
  3. glucagon
    • inc blood sugar levels
    • produced by ALPHA cells
    •  - glycogenolysis
    •  - gluconeogenesis
  4. where is insulin produced?
    Beta cells
  5. Somatostatins
    • regulate b/w insulin and glucagon
    • roduced by Delta cells
  6. what occurs to regulate blood sugar when it is low?
    • @ 60-70 bld sugar, glucagon is released -->
    • liver breaks down glycogen -->
    • inc bld sgar
  7. Type I
    • No insulin production
    • ***Can develop ketosis
    • autoimmune against Beta cells
  8. 3 P's of hyperglycemia
    • polyuria
    • polydipsia
    • polyphagia
  9. Sx of hyperglycemia
    • serum hyperosmolar= vessels are hypertonic
    •  - osmostic dieresis (polyuria)
    •  - dehydration (polyispea) 
    •   ---> will ALWAYS get these

    • Decrease in energy (polyphagia)
    •  - weight loss
    •  - malaise and fatigue
    •   ---> NOT always present
  10. type II is non-ketotic
    type II is non-ketotic
  11. risk factors of II
    • family Hx
    • obesity
    • sitting on your ass
    • race
    • female
    • cardiovasc disease
  12. 3 tests used to diagnosis diabetes
    Symptoms of DM + casual plasma glucose > 200 mg/dL

    Fasting Plasma gucose > 126 mg/dL

    Two hour plasma glucose > 200 mg/ml during an oral glusoce tolerance test

    NEED 2/3 POSITIVES TO Dx
  13. Pre-diabetes
    • impaired fasting glucose
    • impaired glucose tolerance
    • fasting BG= 100-126

    Tx w/ weight loss and phys activity
  14. Dm managment tests:
    fasting glucose
    post-prandial
    hgb A1c
    FBG < 110

    post-prandial <140

    hgb A1c <6.5%
  15. Thiazolidiones / Biguanides
    sensitize body to insulin and/or reduce hepatic glucose production
  16. Sulouylureas
    stimulate the pancreas to make more insulin
  17. fast acting insulin
    • Humalog / Lispro
    • given w/n 15 minutes of meal
  18. short acting insulin
    • Humulin-R
    • only IV insulin
    • clear solution
  19. intermediate acting
    • NPH
    • cloudy
  20. Long acting insulin
    • Lantus
    • clear
    • NEVER mix and no IV
  21. varient bld glucose levels make good candidate for insulin pump
  22. diabetic diet
    inc carbs

    dec fats and proteins
  23. exercise increases muscle uptake of glucose
  24. Sx of Hypoglycemia
    • shaking
    • sweating
    • anxious
    • dizzy
    • hunger
    • tachycardia
    • vision change
    • fatigue
    • HA
    • irritable
  25. Tx of hypoglycemia
    15 by 15 rule
  26. DKA only developes in which type?
    type 1

    absolute insulin deficiency leds to ketosis
  27. DKA lab values:
    bld glucose
    plasma pH
    plasma Bicarb

    what happens to Na, Cl, and potassium
    bld > 250

    pH <7.3

    bicarb < 15

    • dec Na and Cl
    • inc K
  28. manifestations of DKA
    • kussmaul resers= tachypnic pattern w/ longer expiration than inhalation phase
    • fruity breath
    • nausea
    • lethargy
  29. sign on dehydration of e/lyte loss
    • warm, dry skin, poor turgor
    • tachycardia and HypoTN are the 2 key signs of dehydration
  30. Tx of DKA
    • Humulin-R drip
    • replace fluids and watch K levels

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