NR571 final DM UPDATED ACTUAL Questions and CORRECT Answers
Diabetic complications kidney failure, nontraumatic limb amputation, adult blindness, heart disease,
stroke. (DKA) and (HHS) are two life-threatening complications with diabetes are
complications
Glucose Production and Release glucose found in carbohydrates, stores in the liver released in bloodstream, for
constant source of energy are
Insulin Release in Type I Diabetes high glucose in blood, stimulate beta cells- release insulin, Insulin stops the
release of glucose, small amount stores in liver, beta cells damaged/destroyed no
insulin produced are
Systemic Insulin and Glucose in Type I Diabetes low insulin production, low insulin and high glucose in their blood are
Glucose Absorption in Type I Diabetes Insulin is needed for glucose to enter cells for energy, insulin binds to receptors
on the cell surface, initiates glucose transporters to open and glucose to flow into
the cell. low insulin prevents enough glucose from entering the cell. Glucose
remains in bloodstream not for energy, patients are fatigue, exhaustion, and
dizziness.
Glucose Absorption in Type II Diabetes= Due to insulin resistance and resulting hyperglycemia, patients with type 2
diabetes increased thirst or hunger, fatigue, blurry vision, and slow-healing
wounds.
Beta-blocker for thyroid storm Given to reduce sympathetic stimulation-Primary agents include: (Esmolol IV for
rapid titation; Bisoprolol PO)
Thionamide for thyroid storm Given to correct hyperthyroid state (High-dose methimazole or PTU)
Iodine compounds for thyroid storm Blocks release of thyroid hormones, given 1 hour after starting antithyroid therapy
(SSKI or Lugol's iodine drops)
Glucocorticoids for thyroid storm Decreases conversion of T4 to T3 (IV hydrocortisone or dexamethasone)
Meds for thyroid storm Beta-blocker, Thioamides, Iodine compounds, and Glucocorticoids are meds for
PTU the antithyroid medication of choice in pregnant pts is
glucocorticoids and iodine meds for thyroid storm, they do not need to be continued once the emergent
situation is resolved.
Hypothyroidism s/s underproduction of the hormone thyroxine (T4), body's metabolism slows down,
symptoms- fatigue, depressed mood, slow heart rate, constipation, weight gain,
and irregular menstrual periods. >women and family history is
, Somogyi effect and dawn phenomenon Elevated blood glucose levels are seen at 0700 with
metformin Monotherapy with ? is the drug of choice when initiating drug therapy in a type 2
diabetic according to all clinical practice guidelines.
lifestyle recommendations for DM Weight loss, Regular exercise, Medical nutrition therapy (nutritionist), , Adequate
sleep, ,Smoking cessation, Behavioral support groups, Diabetic educator are
consider for
DKA symptoms polyuria & polydipsia, weakness/fatigue, nausea & vomiting, Kussmaul respirations,
altered loc, fruity breath
DKA labs results hyperglycemia (usually > 300 mg/dL), ketonuria, metabolic acidosis, high anion
gap, elevated hematocrit, azotemia,
Pathology of HHS intracellular dehydration, complication of T2DM, hyperglycemia, osmotic diuresis,
and extracellular fluid depletion, due to non-compliance or "stretch" their
medication is the
HHS symptoms polyuria, weakness, changes in LOC, hypotension, tachycardia, poor skin turgor
are symptoms of
HHS lab results (> 600 mg/dL), hyperosmolality (> 320 mOsm/L), elevated HbA1C, normal pH, no
ketonuria, normal anion gap are lab
anion gap the difference between positively and negatively charged electrolytes
responsible for maintaining acid-base balance.
Serum anion gap Na+ - (Cl- + CO2-) is the calculation for
High-anion-gap metabolic acidosis ketoacidosis, lactic acidosis, severe chronic renal failure, toxic ingestion are due
to
Non-anion-gap metabolic acidosis diarrhea, nephrotic syndrome, renal tubular acidosis, renal failure, acetazolamide,
adrenal insufficiency are due to
non-anion gap metabolic acidosis exists calculate the urine anion gap by measuring urine electrolytes should do to help
narrow the differential if
DKA and HHS most common precipitating factor in both conditions is infection, CVA, MI, alcohol abuse,
pancreatitis, trauma, and noncompliance with medication.
Work up for DKA and HHS CBC (hemoglobin and WBCs), CMP (electrolytes, renal function, and calculated
anion gap), serum osmolality, ABG (pH, HCO3, pCO2, pO2), lactic acid, beta-
hydroxybutyrate (measures the most abundant ketone during DKA), U/A (ketones
and glucose), urine culture, if U/A is positive, blood cultures (septicemia), CXR
(pneumonia), lipase & amylase is the work up for
Diabetic complications kidney failure, nontraumatic limb amputation, adult blindness, heart disease,
stroke. (DKA) and (HHS) are two life-threatening complications with diabetes are
complications
Glucose Production and Release glucose found in carbohydrates, stores in the liver released in bloodstream, for
constant source of energy are
Insulin Release in Type I Diabetes high glucose in blood, stimulate beta cells- release insulin, Insulin stops the
release of glucose, small amount stores in liver, beta cells damaged/destroyed no
insulin produced are
Systemic Insulin and Glucose in Type I Diabetes low insulin production, low insulin and high glucose in their blood are
Glucose Absorption in Type I Diabetes Insulin is needed for glucose to enter cells for energy, insulin binds to receptors
on the cell surface, initiates glucose transporters to open and glucose to flow into
the cell. low insulin prevents enough glucose from entering the cell. Glucose
remains in bloodstream not for energy, patients are fatigue, exhaustion, and
dizziness.
Glucose Absorption in Type II Diabetes= Due to insulin resistance and resulting hyperglycemia, patients with type 2
diabetes increased thirst or hunger, fatigue, blurry vision, and slow-healing
wounds.
Beta-blocker for thyroid storm Given to reduce sympathetic stimulation-Primary agents include: (Esmolol IV for
rapid titation; Bisoprolol PO)
Thionamide for thyroid storm Given to correct hyperthyroid state (High-dose methimazole or PTU)
Iodine compounds for thyroid storm Blocks release of thyroid hormones, given 1 hour after starting antithyroid therapy
(SSKI or Lugol's iodine drops)
Glucocorticoids for thyroid storm Decreases conversion of T4 to T3 (IV hydrocortisone or dexamethasone)
Meds for thyroid storm Beta-blocker, Thioamides, Iodine compounds, and Glucocorticoids are meds for
PTU the antithyroid medication of choice in pregnant pts is
glucocorticoids and iodine meds for thyroid storm, they do not need to be continued once the emergent
situation is resolved.
Hypothyroidism s/s underproduction of the hormone thyroxine (T4), body's metabolism slows down,
symptoms- fatigue, depressed mood, slow heart rate, constipation, weight gain,
and irregular menstrual periods. >women and family history is
, Somogyi effect and dawn phenomenon Elevated blood glucose levels are seen at 0700 with
metformin Monotherapy with ? is the drug of choice when initiating drug therapy in a type 2
diabetic according to all clinical practice guidelines.
lifestyle recommendations for DM Weight loss, Regular exercise, Medical nutrition therapy (nutritionist), , Adequate
sleep, ,Smoking cessation, Behavioral support groups, Diabetic educator are
consider for
DKA symptoms polyuria & polydipsia, weakness/fatigue, nausea & vomiting, Kussmaul respirations,
altered loc, fruity breath
DKA labs results hyperglycemia (usually > 300 mg/dL), ketonuria, metabolic acidosis, high anion
gap, elevated hematocrit, azotemia,
Pathology of HHS intracellular dehydration, complication of T2DM, hyperglycemia, osmotic diuresis,
and extracellular fluid depletion, due to non-compliance or "stretch" their
medication is the
HHS symptoms polyuria, weakness, changes in LOC, hypotension, tachycardia, poor skin turgor
are symptoms of
HHS lab results (> 600 mg/dL), hyperosmolality (> 320 mOsm/L), elevated HbA1C, normal pH, no
ketonuria, normal anion gap are lab
anion gap the difference between positively and negatively charged electrolytes
responsible for maintaining acid-base balance.
Serum anion gap Na+ - (Cl- + CO2-) is the calculation for
High-anion-gap metabolic acidosis ketoacidosis, lactic acidosis, severe chronic renal failure, toxic ingestion are due
to
Non-anion-gap metabolic acidosis diarrhea, nephrotic syndrome, renal tubular acidosis, renal failure, acetazolamide,
adrenal insufficiency are due to
non-anion gap metabolic acidosis exists calculate the urine anion gap by measuring urine electrolytes should do to help
narrow the differential if
DKA and HHS most common precipitating factor in both conditions is infection, CVA, MI, alcohol abuse,
pancreatitis, trauma, and noncompliance with medication.
Work up for DKA and HHS CBC (hemoglobin and WBCs), CMP (electrolytes, renal function, and calculated
anion gap), serum osmolality, ABG (pH, HCO3, pCO2, pO2), lactic acid, beta-
hydroxybutyrate (measures the most abundant ketone during DKA), U/A (ketones
and glucose), urine culture, if U/A is positive, blood cultures (septicemia), CXR
(pneumonia), lipase & amylase is the work up for
