Test Review exam 3
6 - Chapter 20
7 - Chapters 23 and 25
8 - Chapter 22
● Foot Care
o Must be done daily
o Can use a friend
o Can use a mirror if they don’t have friends willing to help
o Do not put lotion between the toes after foot care
o Diabetic pts are at risk for ulcer development
▪ Untreated, can lead to osteomyelitis
▪ Should have well-fitted shoes
▪ Nothing open-toed
▪ Use cotton socks
● Hyperglycemia
o When educating, we need to tell them to keep it low due to microvascular damage
o • Pt upset because they are going to have to give several diabetes shots to themselves
and are mad- how would you explain why- 1 insulin shot a day will not work-
hypoglycemia is always priority- hyperglycemia- explain micro and macro vascular
changes
o • Pt says don’t know what’s happening she just got new prescription on eye glasses and
still can’t see- suspect hyperglycemia
● Hypoglycemia
○ • Hypoglycemia- elderly pt educate if they leave home or are goin on a trip- have plan
for hypoglycemic attack- always have a snack- brain cannot survive without glucose
● Patient is 80 years old and has a prescription written for Metformin
o Call the physician
o Not recommended due to kidney damage caused by the medication
o Elderly have decreased kidney function at baseline
● Cardiovascular Disease
, o Elderly are at increased risk of this with diabetes
● Brain
o Must have glucose to function
● Must instruct them to take blood sugar multiple times a day
o Self-monitoring
o Proper sticking sites
o Proper injection sites for insulin
● If you are teaching a patient 65yr and older about diabetes
o They must be taught about hypoglycemia and hyperglycemia
o Hyperglycemia = organ and vessel damage
o Hypoglycemia = coma, death
● Insulin drip
o Regular insulin only
● Glucose in urine
o Can be a cause of incontinence
o Can lead to UTI
● Nutrition
o Eat at regular times
o “Good” carbs vs “bad” carbs
● A patient that is getting a CT with contrast and they take metformin
o Must hold Metformin for 48 hours prior to the scan
o Metformin affects kidney function
o • 70 yo woman go ct scan with contrast hold Metformin before have to be off 48 hrs
before CT procedure
● When mixing insulin
o Cloudy before clear when drawing up
o Inject air into clear then inject air into cloudy
● Know your S/S of each of Dementia, Delirium, and Depression
6 - Chapter 20
7 - Chapters 23 and 25
8 - Chapter 22
● Foot Care
o Must be done daily
o Can use a friend
o Can use a mirror if they don’t have friends willing to help
o Do not put lotion between the toes after foot care
o Diabetic pts are at risk for ulcer development
▪ Untreated, can lead to osteomyelitis
▪ Should have well-fitted shoes
▪ Nothing open-toed
▪ Use cotton socks
● Hyperglycemia
o When educating, we need to tell them to keep it low due to microvascular damage
o • Pt upset because they are going to have to give several diabetes shots to themselves
and are mad- how would you explain why- 1 insulin shot a day will not work-
hypoglycemia is always priority- hyperglycemia- explain micro and macro vascular
changes
o • Pt says don’t know what’s happening she just got new prescription on eye glasses and
still can’t see- suspect hyperglycemia
● Hypoglycemia
○ • Hypoglycemia- elderly pt educate if they leave home or are goin on a trip- have plan
for hypoglycemic attack- always have a snack- brain cannot survive without glucose
● Patient is 80 years old and has a prescription written for Metformin
o Call the physician
o Not recommended due to kidney damage caused by the medication
o Elderly have decreased kidney function at baseline
● Cardiovascular Disease
, o Elderly are at increased risk of this with diabetes
● Brain
o Must have glucose to function
● Must instruct them to take blood sugar multiple times a day
o Self-monitoring
o Proper sticking sites
o Proper injection sites for insulin
● If you are teaching a patient 65yr and older about diabetes
o They must be taught about hypoglycemia and hyperglycemia
o Hyperglycemia = organ and vessel damage
o Hypoglycemia = coma, death
● Insulin drip
o Regular insulin only
● Glucose in urine
o Can be a cause of incontinence
o Can lead to UTI
● Nutrition
o Eat at regular times
o “Good” carbs vs “bad” carbs
● A patient that is getting a CT with contrast and they take metformin
o Must hold Metformin for 48 hours prior to the scan
o Metformin affects kidney function
o • 70 yo woman go ct scan with contrast hold Metformin before have to be off 48 hrs
before CT procedure
● When mixing insulin
o Cloudy before clear when drawing up
o Inject air into clear then inject air into cloudy
● Know your S/S of each of Dementia, Delirium, and Depression
