Diabetes NURS 300 Exam # 3 Questions And Answers Rated A+

Acute Complications: Hypoglycemia - -low blood glucose -occurs when too much insulin in proportion to glucose in the body -blood glucose levels less than 70mg/dl -common manifestations: confusion, irritability, diaphoresis, tremors, hunger, weakness, visual disturbances, can mimic alcohol intoxication -untreated can progress to loss of consciousness, seizures, comas, and death -CAUSES: too much insulin, mismatch in timing of insulin, food intake and peak action of insulin or oral hypoglycemic agents that increase endogenous insulin secretion, increase in exercise, too little food intake -at the first sign: CHECK BLOOD GLUCOSE: if <70 begin treatment if>70 investigare further for cause of signs/symptoms Acute Complications: Hypoglycemia - -treatment: 15:15 rule :15g of simple carb, recheck in 15 minutes -if alert enough to swallow: 15 of a simple carbohydrate: avoud foods with fat: decrease absorption of sugar -do not overtreat -recheck blood sugar 15 minutes after treatment -repeat untul blood sugar >70 mg/dl -patient should eat regularly scheduled meal/snack to prevent rebound hypoglycemia -check again 45 minutes CHRONIC COMPLICATIONS: -stroke -hypertension -islet cell loss -neuropathy -gangreneAlcohol - -high in calories with no nutritive value -detrimental effects on liver -can mask signs and symptoms of hypoglycemia Altered Mechanisms in Type 1 and Type 2 Diabetes - TYPE ONE DIABETES: genetically susceptible individuals develop islet cell autoantibodies months to years before diagnosis of type 1 diabetes: progressive autoimmune destruction of B cells (80-90% reduction: leads to hyperglycemia and diagnosis of type 1 diabetes) TYPE TWO DIABETES: insulin resistance caused by inherited defect in insulin receptor is a universal finding in patients with type 2 diabetes: precedes development of impaired glucose tolerance and type 2 diabetes by as much as 3 to 4 decades: insulin resistance stimulates a compensatory increased insulin production by B cells in the pancreas, excessive hepatic glucose production causes increased hyperglycemia in the fasting and postprandial store: adipokines from adipose tissue have a role in altered glucose and fat metabolism Angiopathy - -damage to blood vessels secondary to chronic hyperglycemia -MACROVASCULAR: diseases of the large-medium sized blood vessels: cerebrovascular, cardiovascular, peripheral vascular -MICROVASCULAR: thickening of vessels membranes in the capillaries and arterioles: retinopathy: eyes, nephropathy: kidneys, dermopathy: skin Collaborative Care - -goals of diabetes management: decrease symptoms, promote well-being, prevent acute complications, delay onset and progression of long term complications -patient teaching: self-monitoring of blood glucose, nutritional therapy, drug therapy: insulin (rapid acting, short acting, intermediate, long acting and combination) and oral agents, exercise Counterregulatory Hormones - -increase blood glucose levels by stimulating glucose production and output by the liver and by decreasing the movement of glucose into the cells -oppose effects of insulin -INCREASE blood glucose levels -provide a regulated release of glucose for energy -help maintain normal blood glucose levels-insulin and counterregulatory hormones keep each other in check and balance -EXAMPLES: glucagon, epinephrine (when patients are sick the body needs to release epinephrine to increase blood glucose), growth hormone, cortisol (stress hormone: long term stress can keep blood glucose levels high) Diabetes - -chronic multisystem disease related to ABNORMAL insulin production and impaired utilization (body is not utilizing insulin): can be BOTH -long term complications of diabetes make it a devastating disease -diabetes is the leading cause of: adult blindness (diabetic retinotopy: DR), end-stage renal disease, nontraumatic lower limb amputations -major contributing factor: heart disease, stroke ***PANCREAS MAKES INSULIN***