NR 601 Final Test with Correct Answers

Prediabetes - impaired fasting glucose: fasting glucose is consistently elevated above normal range but below 100 and 125 mg/dl Impaired glucose tolerance: state of hyperglycemia where a 2-hour post glucose load glycemic level is 140-199 mg/dl Type 1 diabetes - characterized by severe insulin deficiency resulting from beta cell destruction producing hyperglycemia due to altered metabolism of lipids, carbs, and proteins Immune mediated DM (type 1A) - 90% of cases; autoimmune destruction of insulin producing pancreatic beta islet cells; triggering factor: infection (rubella, Coxsackie before virus, cytomegalovirus, adenovirus, mumps virus) or toxic insult with genetic predisposition Idiopathic DM (type 1B)- inherited; more common in people of Asian, African, or Hispanic origin Type 1 diabetes - risk factors - * 60% of patients are 18 years old Caucasian of European descent 1.5-2X more common *High birth weight 4,000 g; higher than expected weight gain in first year of life * Protein components of cow's milk * Intro of gluten and rice containing cereals before 3 months or after 7 months Type 1 diabetes - presentation - polyuria, polyphagia with paradoxical weight loss, polydipsia, visual changes, fatigue, weakness Signs of dehydration such as poor skin turgor, and dry mucous membranes Signs of severe ketosis (DKA): extreme fatigue, abnormal cramping, alterations and breathing pattern, and telltale sign of halitosis Hg A1C gives insight into glycemic control over what time period? - 2 to 3 months Initial goal of treatment for type 1 diabetes - plasma glucose level 80-130 mg/dl before meals, Postprandial (1-2hrs after beginning of a meal) glucose level 180 mg/dl, And a1c 7% for adults Lab values for DKA - hyperglycemia - BG 359 mg/dl Ketonemia - plasma ketone 5 mmol/L Acidosis - bicarbonate 9 meq/L Goals of glucose management in type 1 diabetes - before meals: 80-120 mg/dl Postprandial: less than 180 mg/dl Bedtime: 100-140 mg/dl Management of hypoglycemia - 1/2 cup of fruit juice 6 oz of regular soda When cup milk Glucose tabs Recheck blood sugar after 15 minutes and give additional carbs if BG less than 70 Number of kilocalories needed to maintain current weight - men col on 66 + 13.7(WT in kg) +5(by in cm) -6.8(age) Women: 65 + 9.6(at in kg) + 1.7(ht in cm) -4.7 (age) Guidelines regarding exercise to regulate glycemic re