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Exam (elaborations)

NR601 Final Exam Study Questions with Verified Correct Answers

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NR601 Final Exam Study Questions with Verified Correct Answers

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NR601 Final Exam Study Questions with Verified

Correct Answers

Diabetes Diagnostic criteria

- 2 fasting BS > 126
-Random BS >200 if sx of DM present
- A1C > 6.5 x2
- 2 hour plasma glucose (OGTT) >200
- Prediabetes 5.7-6.4 A1C

Initial Tx of DM

- Type 1: usually need hospitalization d/t being in crisis, endocrinology, daily basal & prandial
insulin
-Type 2: A1C <7.5: Nutritional therapy, physical activity, weight loss, monotherapy (usually
metformin).
>7.5 @ diagnosis or after 3 months: add a 2nd agent
>9.0 insulin (AACE)
>10 insulin (ADA)

DM medication side effects

- Metformin: decr B12 absorption, diarrhea, nausea, anorexia, abd discomfort, lactic acidosis
(rare), metallic taste
- Sulfonylureas (glyburide, glipizide): hypoglycemia, weight gain, GI upset, skin rashes, severe
anemia, headache
- Acarbose & Miglitol (alpha- glucosidase inhibitors): flatulence & diarrhea
-Actos & Avandia (thiazolidinones): weight gain, URI, edema, anemia, hypoglycemia, CHF,
possible liver damage, bladder tumors
- Januvia, onglyza, nesina: stevens-johnson syndrome, pancreatitis, renal failure, abd pain
- Trulicity, Tanzeum, Victoza (glucagon-like peptide-1..): pancreatitis, arthralgia
- Invokana, Farxiga, jardiance (NA-glucose transport..): renal failure, ketoacidosis, hypotension,
genital fungal infections
- Glufast, Starlix, Prandin (Meglitinides): wt gain, hypoglycemia

DM Tx goals

, - Healthy pt, long life exp.: A1C <7.5, Fasting: 90-130, Bedtime: 90-150, BP: <140/90,
- Complex/intermediate pt, interm. life exp., A1C <8.0, Fasting: 90-150, Bedtime: 100-180, BP
<140/90
- Very complex/poor health, limited life exp, A1C < 8.5, Fasting: 100-180, Bedtime: 110-200, BP
<150/90
A1C < 6.5 reduces complications

DM weight loss recommendations

- Wt loss not recommended in frail elderly d/t risk of sarcopenia, but even modest exercise is
good.
-5% weight loss recommended

DM Risk factors

-Type 1: Caucasians, environmental, autoimmune, and viral toxins, young age, congenital
rubella, CMV, Adenovirus, Coxsackie B4, and mumps, high birth weight
-Type 2: Men, native American, Alaskan, Hispanic, African American, obesity, sedentary life,
family hx, BMI > 25, > 45yo, HLD, GD, having baby > 9lbs, smoking, HTN, PCOS

Dm Complications

Retinopathy, HLD, diabetic kidney disease, HTN, Macrovascular disease, neuropathy, impotence,
blindness, CAD, stroke, slow healing wounds, GU disorder
DKA, altered behavior, seizures, coma,

Obesity comorbidities

CAD, HTN, HLD, DM, sleep apnea, asthma, varicose veins, gout, osteoarthritis, GERD,
thromboembolic disease, cancers (endometrial, breast, prostate, colon)

BMI Classifications

<18.5: underweight
18.5-24.9: Normal
25-29.9: Overweight
30-34.9: Class 1 obesity
35-39.9: Class 2 obesity
>40: Class 3 extreme obesity

Types of incontinence

-Stress: sneezing, coughing, laughing, etc. Tx: Lifestyle &behavioral interventions
-Urge: sudden need to void. Tx: Lifestyle interventions. &behavioral. Consider antimuscarinic

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