NURS 620 EXAM CH. 60 ACTUAL
VERIFIED STUDY QUESTIONS AND
ANSWERS
Diabetes Mellitus: Overview of the Disease and Its Treatment - ANSWER-
•Disorder of carbohydrate metabolism
•Deficiency of insulin
•Resistance to action of insulin
•Sustained hyperglycemia, polyuria, polydipsia, ketonuria, and weight loss
Insulin release in 2 different phases. First phase is stimulated by GLP1,
triggers breakdown of glycogen in levels from rising too high.
Phase 2 more controlled in the amount and speed of insulin release
determine by how the carbohydrate is digested, glycemic index of the food.
Ranks number of carbs in foods from 0-100 and how quixkly it causes blood
sugar to rise.Insukin secretion maintained until blood glucose doesn't trgiger
release
Symotoms result from deficiency of insulin or both?
Diabetes can lead to heart disease, renal failure, blindness, neuropathy,
amputation, impotence, and stroke
Texas has the highest rate in the nation for diabetes amputation
Types of Diabetes Mellitus - ANSWER-•Type 1 diabetes (T1DM)
•As a rule, type 1 diabetes develops during childhood or adolescence, and
symptom onset is relatively abrupt
•Can develop during adulthood
•Accounts for 5% of all cases of diabetes mellitus
•Primary defect is destruction of pancreatic beta cells due to autoimmune
process
•Trigger for this immune response is not entirely known, but genetic,
environmental, and infectious factors likely play a role
•Type 2 diabetes (T2DM)
,•Most prevalent form of diabetes
•Accounts for 90% to 95% of all cases of diabetes
•Affects approximately 22 million Americans
-T2DM can begin at any age, including in children, but it most commonly
begins in middle age and progresses gradually. In contrast to T1DM, T2DM
carries little risk for ketoacidosis
•Insulin resistance and impaired insulin secretion
•Hyperinsulinemia
•Insulin resistance
•Strong family association
-n fact, early in the disease, insulin levels tend to be normal or slightly
elevated, a state known as hyperinsulinemia. Although insulin is still
produced, however, its secretion is no longer tightly coupled to plasma
glucose content: release of insulin is delayed and peak output is subnormal.
More importantly, the target tissues of insulin (liver, muscle, adipose tissue)
exhibit insulin resistance: For a given blood insulin level, cells in these
tissues are less able to take up and metabolize the glucose available to
them.
Insulin resistance- body produces insulin but cannot use it effectively.
Obesity a risk factor, physical inactivity, etc. High insulin levels needed to
push insulin into the cell.
Raised levels of blood glucose can cause beta cell failure
Complications of Diabetes- Long term! - ANSWER-•Macrovascular damage
•Heart disease!
•Hypertension
•Stroke
•Hyperglycemia
•Altered lipid metabolism - hyperlipidemia
•Microvascular damage
•Retinopathy!
, •Nephropathy!: Angiotensin-converting enzyme (ACE) inhibitor or
angiotensin II receptor blocker (ARB)
•Sensory and motor neuropathy
•Gastroparesis!
•Amputation secondary to infection!
•Erectile dysfunction!
Diabetic Neuropathy - ANSWER-Nerve damage is directly related to sustained
hyperglycemia, which may cause metabolic disturbances in nerves or may
injure the capillaries that supply nutrients to the nerves. Symptoms of
diabetic neuropathy, which are usually bilateral and symmetric, include
tingling sensations in the fingers and toes (paresthesias), either increased
pain or decreased ability to feel pain, suppression of reflexes, and loss of
other sensations (especially vibratory sensation).
-diabetic neuropathy can prevent the patient from feeling discomfort and
other sensations that would signal that a serious infection is developing.
Diabetes and Pregnancy - ANSWER-•Before insulin: Virtually all babies born
to severely diabetic women died during infancy
•Factors during pregnancy
•Three factors that contribute to management of diabetic pregnancy:
•Placenta produces hormones that antagonize the actions of insulin
•Production of cortisol increases threefold
•Glucose can pass freely from the maternal to the fetal circulation (fetal
hyperinsulinemia)
•Proper glucose levels are needed in the pregnant patient and in the fetus to
prevent teratogenic effects
•Fetal death frequently occurs near term
•Earlier delivery is desirable
•Gestational diabetes
•Appears in the mother during pregnancy and subsides rapidly after delivery
•Managed in much the same manner as any other diabetic pregnancy
VERIFIED STUDY QUESTIONS AND
ANSWERS
Diabetes Mellitus: Overview of the Disease and Its Treatment - ANSWER-
•Disorder of carbohydrate metabolism
•Deficiency of insulin
•Resistance to action of insulin
•Sustained hyperglycemia, polyuria, polydipsia, ketonuria, and weight loss
Insulin release in 2 different phases. First phase is stimulated by GLP1,
triggers breakdown of glycogen in levels from rising too high.
Phase 2 more controlled in the amount and speed of insulin release
determine by how the carbohydrate is digested, glycemic index of the food.
Ranks number of carbs in foods from 0-100 and how quixkly it causes blood
sugar to rise.Insukin secretion maintained until blood glucose doesn't trgiger
release
Symotoms result from deficiency of insulin or both?
Diabetes can lead to heart disease, renal failure, blindness, neuropathy,
amputation, impotence, and stroke
Texas has the highest rate in the nation for diabetes amputation
Types of Diabetes Mellitus - ANSWER-•Type 1 diabetes (T1DM)
•As a rule, type 1 diabetes develops during childhood or adolescence, and
symptom onset is relatively abrupt
•Can develop during adulthood
•Accounts for 5% of all cases of diabetes mellitus
•Primary defect is destruction of pancreatic beta cells due to autoimmune
process
•Trigger for this immune response is not entirely known, but genetic,
environmental, and infectious factors likely play a role
•Type 2 diabetes (T2DM)
,•Most prevalent form of diabetes
•Accounts for 90% to 95% of all cases of diabetes
•Affects approximately 22 million Americans
-T2DM can begin at any age, including in children, but it most commonly
begins in middle age and progresses gradually. In contrast to T1DM, T2DM
carries little risk for ketoacidosis
•Insulin resistance and impaired insulin secretion
•Hyperinsulinemia
•Insulin resistance
•Strong family association
-n fact, early in the disease, insulin levels tend to be normal or slightly
elevated, a state known as hyperinsulinemia. Although insulin is still
produced, however, its secretion is no longer tightly coupled to plasma
glucose content: release of insulin is delayed and peak output is subnormal.
More importantly, the target tissues of insulin (liver, muscle, adipose tissue)
exhibit insulin resistance: For a given blood insulin level, cells in these
tissues are less able to take up and metabolize the glucose available to
them.
Insulin resistance- body produces insulin but cannot use it effectively.
Obesity a risk factor, physical inactivity, etc. High insulin levels needed to
push insulin into the cell.
Raised levels of blood glucose can cause beta cell failure
Complications of Diabetes- Long term! - ANSWER-•Macrovascular damage
•Heart disease!
•Hypertension
•Stroke
•Hyperglycemia
•Altered lipid metabolism - hyperlipidemia
•Microvascular damage
•Retinopathy!
, •Nephropathy!: Angiotensin-converting enzyme (ACE) inhibitor or
angiotensin II receptor blocker (ARB)
•Sensory and motor neuropathy
•Gastroparesis!
•Amputation secondary to infection!
•Erectile dysfunction!
Diabetic Neuropathy - ANSWER-Nerve damage is directly related to sustained
hyperglycemia, which may cause metabolic disturbances in nerves or may
injure the capillaries that supply nutrients to the nerves. Symptoms of
diabetic neuropathy, which are usually bilateral and symmetric, include
tingling sensations in the fingers and toes (paresthesias), either increased
pain or decreased ability to feel pain, suppression of reflexes, and loss of
other sensations (especially vibratory sensation).
-diabetic neuropathy can prevent the patient from feeling discomfort and
other sensations that would signal that a serious infection is developing.
Diabetes and Pregnancy - ANSWER-•Before insulin: Virtually all babies born
to severely diabetic women died during infancy
•Factors during pregnancy
•Three factors that contribute to management of diabetic pregnancy:
•Placenta produces hormones that antagonize the actions of insulin
•Production of cortisol increases threefold
•Glucose can pass freely from the maternal to the fetal circulation (fetal
hyperinsulinemia)
•Proper glucose levels are needed in the pregnant patient and in the fetus to
prevent teratogenic effects
•Fetal death frequently occurs near term
•Earlier delivery is desirable
•Gestational diabetes
•Appears in the mother during pregnancy and subsides rapidly after delivery
•Managed in much the same manner as any other diabetic pregnancy
