NR 325 Exam 1 2023
Endocrine System Function –
CORRRECT ANSWERS Produce hormones and secrete them directly into the
bloodstream
Insulin –
CORRRECT ANSWERS Regulator of metabolism and storage of ingested
carbohydrates, fats, and proteins (anabolic or storage hormone).
Facilitates glucose transport across cell membranes
Counterregulatory Hormones –
CORRRECT ANSWERS Oppose the effects of insulin, and increase blood
glucose levels. They provide a regulated release of glucose for energy, and help
maintain normal blood glucose levels.
Ex: glucagon, epinephrine, growth hormone, cortisol
Glucagon –
CORRRECT ANSWERS Normally produced by pancreatic alpha cells when blood
sugar is low to raise blood glucose levels. In diabetes II, glucagon is still
produced, but because there is so much insulin, our pancreas doesn't respond
normally.
Diabetes Mellitus –
CORRRECT ANSWERS A chronic, multi-system disease related to abnormal
insulin production, impaired insulin utilization, or both. There is no cure, but
diabetic complications can be delayed or prevented with good management.
African Americans, Hispanic/Latino Americans, and Native Americans have a
higher incidence of diabetes.
Diabetes Complications –
CORRRECT ANSWERS Diabetes is the leading cause of adult blindness, end-
stage renal failure, and non-traumatic lower limb amputations. It is also a major
contributing factor to heart disease and stroke.
Gerontologic Considerations with Diabetes –
CORRRECT ANSWERS Diabetes prevalence increases with age related to
reduced B-cell function, decreased insulin sensitivity (!!), and altered carb
metabolism. Undiagnosed and untreated diabetes is more common in older
adults, partly due to the normal physiologic changes of aging resembling that of
DM.
Diabetes is present in at least 25% of people over age 65.
Diabetes Type I Epidemiology –
, CORRRECT ANSWERS Formerly known as "juvenile onset" or "insulin
dependent" diabetes.
Most often occurs in people under 40 years old, and accounts for 5-10% of all people
with diabetes.
Has a sudden onset.
It is an autoimmune disease, in which B-cells responsible for insulin production are
destroyed. A genetic predisposition and exposure to a virus are factors that may
contribute to the development of DM I. Autoantibody are produced and destroy B-cells.
Manifestations occur after the pancreas is unable to produced insulin, and symptoms
are rapid. Usually patients present to ER with DKA.
Diabetes Type I Classic Symptoms –
CORRRECT ANSWERS Polyuria
Polydipsia
Polyphagia
Weight loss
Prediabetes –
CORRRECT ANSWERS Known as impaired glucose tolerance (IGT) or impaired
fasting glucose (IFG).
Prediabetes Labs –
CORRRECT ANSWERS IFG: fasting glucose levels 100-126 mg/dl
IGT: 2 hour plasma glucose 140-199 mg/dl
A1C: in the range of 5.7-6.4%
A1C Lab –
CORRRECT ANSWERS It is a test that determines how well your glucose was
stabilized within the last three months.
If you have a high A1C, that means you have had high glucose levels in the last 3
months
Diabetes Type II Etiology –
CORRRECT ANSWERS Probably has a genetic basis.
A genetic mutation leading to insulin resistance, and as the disease progresses,
less insulin production. There is also an increased risk for obesity.
Obesity is the most powerful risk factor, especially obesity with an increased waist
circumference.
Type II DM is now being seen in children due to epidemic of childhood obesity.
Type II accounts for 90% of diabetics.
Pancreas continues to produce insulin, but the body can't use the insulin.
Diabetes Type II Risk Factors –
CORRRECT ANSWERS Obesity
Aging
Sedentary lifestyle
, Family history of Type II DM
Urbanization
Certain ethnicities (AA, NA, Latino)
Diabetes Type II Clinical Manifestations - CORRRECT ANSWERS Nonspecific
symptoms, may have classic symptoms of type I
Fatigue
Recurrent infections
Recurrent vaginal yeast or monilia infections
Prolonged wound healing
Visual changes
The onset of symptoms is gradual.
Diagnosing Diabetes: Fasting Plasma Glucose Level - CORRRECT ANSWERS >126
mg/dl
Fasting is no caloric intake for at least 8 hours. The FPG test needs to be confirmed by
repeating testing on another day.
Diagnosing Diabetes: Random Plasma Glucose Measurement - CORRRECT
ANSWERS >200 mg/dl plus symptoms
Diagnosing Diabetes: Two-Hour OGTT Level - CORRRECT ANSWERS >200 mg/dl
using a glucose load of 75g.
You have the patient drink a syrup drink and evaluate how well the body tolerates large
doses of sugar.
Diagnosing Diabetes: Hemoglobin A1C Test - CORRRECT ANSWERS Useful in
determining glycemic levels over time. May be used in diagnosis or to monitor success
of treatment. It shows the amount of glucose attached to hgb molecules over RBC life
span (3 months). <6.5-7%
Goal of Diabetes Management - CORRRECT ANSWERS Decrease symptoms
Promote well-being
Prevent acute complications
Delay onset and progression of long-term complications
Exogenous Insulin - CORRRECT ANSWERS Insulin from an outside source.
Required for type I DM.
Prescribed for patients with DM II who can't control blood glucose by other methods.
Insulins differ in regard to onset, peak action, and duration.
It is given by a subcutaneous injection or IV, never orally.
Regimen that closely mimics endogenous insulin production is basal-bolus.
Basal-Bolus Insulin Therapy - CORRRECT ANSWERS Intensive insulin therapy
consisting of multiple daily injections and frequent self-monitoring of blood glucose
levels. It is insulin administration that mimics normal pancreas function.
Endocrine System Function –
CORRRECT ANSWERS Produce hormones and secrete them directly into the
bloodstream
Insulin –
CORRRECT ANSWERS Regulator of metabolism and storage of ingested
carbohydrates, fats, and proteins (anabolic or storage hormone).
Facilitates glucose transport across cell membranes
Counterregulatory Hormones –
CORRRECT ANSWERS Oppose the effects of insulin, and increase blood
glucose levels. They provide a regulated release of glucose for energy, and help
maintain normal blood glucose levels.
Ex: glucagon, epinephrine, growth hormone, cortisol
Glucagon –
CORRRECT ANSWERS Normally produced by pancreatic alpha cells when blood
sugar is low to raise blood glucose levels. In diabetes II, glucagon is still
produced, but because there is so much insulin, our pancreas doesn't respond
normally.
Diabetes Mellitus –
CORRRECT ANSWERS A chronic, multi-system disease related to abnormal
insulin production, impaired insulin utilization, or both. There is no cure, but
diabetic complications can be delayed or prevented with good management.
African Americans, Hispanic/Latino Americans, and Native Americans have a
higher incidence of diabetes.
Diabetes Complications –
CORRRECT ANSWERS Diabetes is the leading cause of adult blindness, end-
stage renal failure, and non-traumatic lower limb amputations. It is also a major
contributing factor to heart disease and stroke.
Gerontologic Considerations with Diabetes –
CORRRECT ANSWERS Diabetes prevalence increases with age related to
reduced B-cell function, decreased insulin sensitivity (!!), and altered carb
metabolism. Undiagnosed and untreated diabetes is more common in older
adults, partly due to the normal physiologic changes of aging resembling that of
DM.
Diabetes is present in at least 25% of people over age 65.
Diabetes Type I Epidemiology –
, CORRRECT ANSWERS Formerly known as "juvenile onset" or "insulin
dependent" diabetes.
Most often occurs in people under 40 years old, and accounts for 5-10% of all people
with diabetes.
Has a sudden onset.
It is an autoimmune disease, in which B-cells responsible for insulin production are
destroyed. A genetic predisposition and exposure to a virus are factors that may
contribute to the development of DM I. Autoantibody are produced and destroy B-cells.
Manifestations occur after the pancreas is unable to produced insulin, and symptoms
are rapid. Usually patients present to ER with DKA.
Diabetes Type I Classic Symptoms –
CORRRECT ANSWERS Polyuria
Polydipsia
Polyphagia
Weight loss
Prediabetes –
CORRRECT ANSWERS Known as impaired glucose tolerance (IGT) or impaired
fasting glucose (IFG).
Prediabetes Labs –
CORRRECT ANSWERS IFG: fasting glucose levels 100-126 mg/dl
IGT: 2 hour plasma glucose 140-199 mg/dl
A1C: in the range of 5.7-6.4%
A1C Lab –
CORRRECT ANSWERS It is a test that determines how well your glucose was
stabilized within the last three months.
If you have a high A1C, that means you have had high glucose levels in the last 3
months
Diabetes Type II Etiology –
CORRRECT ANSWERS Probably has a genetic basis.
A genetic mutation leading to insulin resistance, and as the disease progresses,
less insulin production. There is also an increased risk for obesity.
Obesity is the most powerful risk factor, especially obesity with an increased waist
circumference.
Type II DM is now being seen in children due to epidemic of childhood obesity.
Type II accounts for 90% of diabetics.
Pancreas continues to produce insulin, but the body can't use the insulin.
Diabetes Type II Risk Factors –
CORRRECT ANSWERS Obesity
Aging
Sedentary lifestyle
, Family history of Type II DM
Urbanization
Certain ethnicities (AA, NA, Latino)
Diabetes Type II Clinical Manifestations - CORRRECT ANSWERS Nonspecific
symptoms, may have classic symptoms of type I
Fatigue
Recurrent infections
Recurrent vaginal yeast or monilia infections
Prolonged wound healing
Visual changes
The onset of symptoms is gradual.
Diagnosing Diabetes: Fasting Plasma Glucose Level - CORRRECT ANSWERS >126
mg/dl
Fasting is no caloric intake for at least 8 hours. The FPG test needs to be confirmed by
repeating testing on another day.
Diagnosing Diabetes: Random Plasma Glucose Measurement - CORRRECT
ANSWERS >200 mg/dl plus symptoms
Diagnosing Diabetes: Two-Hour OGTT Level - CORRRECT ANSWERS >200 mg/dl
using a glucose load of 75g.
You have the patient drink a syrup drink and evaluate how well the body tolerates large
doses of sugar.
Diagnosing Diabetes: Hemoglobin A1C Test - CORRRECT ANSWERS Useful in
determining glycemic levels over time. May be used in diagnosis or to monitor success
of treatment. It shows the amount of glucose attached to hgb molecules over RBC life
span (3 months). <6.5-7%
Goal of Diabetes Management - CORRRECT ANSWERS Decrease symptoms
Promote well-being
Prevent acute complications
Delay onset and progression of long-term complications
Exogenous Insulin - CORRRECT ANSWERS Insulin from an outside source.
Required for type I DM.
Prescribed for patients with DM II who can't control blood glucose by other methods.
Insulins differ in regard to onset, peak action, and duration.
It is given by a subcutaneous injection or IV, never orally.
Regimen that closely mimics endogenous insulin production is basal-bolus.
Basal-Bolus Insulin Therapy - CORRRECT ANSWERS Intensive insulin therapy
consisting of multiple daily injections and frequent self-monitoring of blood glucose
levels. It is insulin administration that mimics normal pancreas function.
