Adult Health NR-325 Exam 1 Questions And Answers

Adult Health NR-325 Exam 1 Questions And Answers Why is polydipsia seen in diabetes? - ANSWER -because your body thinks its dehydrated from all the urination Why is polyphagia seen in diabetes? - ANSWER -polyphagia means super hungry People with diabetes are super hungry because there is no glucose being let into the cells (which is what is needed to create energy/ATP) This makes the body think that it needs more glucose What are some signs that a person is experiencing diabetic keto acidosis? - ANSWER --kussmaul respirations- rapidly blowing off excess CO2 -altered LOC (may seem intoxicated) -increased potassium (because H+ is going into the cell, forcing potassium out of the cell) - the 3 P's - sweet fruity smelling breath What would be the first thing you would do for someone who is experiencing DKA? Then what would you do? - ANSWER -First give fluids (isotonic- NS 0.9%NaCl) Then, give regular insulin by IV. *Note that Regular insulin is the ONLY insulin that can be given by IV What kind of compensation does the body do when someone is experiencing DKA? why? - ANSWER -they compensate via their respiratory system (deep, rapid respirations) because when they are experiencing DKA they are in metabolic acidosis. *This compensation occurs rapidly but, is not extremely effective and a therapeutic approach is needed to help the problem What is metformin used for? what is its MOA? - ANSWER -It is used in diabetes and it decreases hepatic glucose creation and increases insulin sensitivity What should be tried before metformin therapy? - ANSWER -lifestyle changes What makes insulin? - ANSWER -beta cells in the pancreas Stage 1 of DM Type I is AKA ____________________ How long does this stage last? - ANSWER -honeymoon period lasts 3-12 months after diagnosis It is known as the honeymoon period because only a small amount of insulin is needed because their are still beta cells creating insulin What are the 3 stages of Type I DM for? - ANSWER -They stand for beta cell decline, meaning the more beta cells that are ruined, the less insulin is being produced and then the more insulin is needed via medication. If an individuals A1C is between 5.7%-6.4% they are in what category of diabetes? - ANSWER -Pre-diabetes because this is elevated but not high enough to be labeled diabetes What does A1C measure? - ANSWER -amount of glucose on hemoglobin in the blood What range of 2 Hr GTT (2-hour glucose tolerance test) is considered pre-diabetic? - ANSWER -140-199 mg/dL because this is elevated but not high enough to be labeled diabetes What range of intermittent fasting glucose is pre-diabetic? - ANSWER -100-125 mg/dL What are the ranges for A1C, fasting blood glucose, random blood glucose and 2 Hr GTT for someone with Type II DM? - ANSWER -A1C- > 6.4 FBG- >/= 126 mg/dL random BG- > 200 mg/dL 2 Hr GTT- >/= 200 mg/dL Why is high fructose corn syrup bad? - ANSWER -it tricks the brain because our body cannot process it, which makes you crave more sugar and causes weight gain Alcohol blocks ____________________________ - ANSWER -Gluconeogenesis causing low plasma glucose levels When mixing insulins, what is the correct process? - ANSWER -Air into cloudy Air into clear Draw up clear Draw up cloudy What does basal rate of insulin mean? - ANSWER -this is the normal amount of insulin you're going to give to a specific patient before meals What is sliding scale insulin? - ANSWER -units of insulin given on top of basal insulin Ex: you're always going to be giving basal insulin but you may not always be giving sliding scale insulin (it depends on their blood glucose reading) What type of diabetic medication is an insulin stimulator? Give a couple examples - ANSWER -sulfonylureas (oral medication) Ex: glimepiride & glipizide - this medication will not work if all beta cells are destroyed what is the major side effect of sulfonylureas? - ANSWER -hypoglycemia because a lot of insulin has been produced What is the range of normal blood sugar? - ANSWER -70-100 mg/dL What is the purpose of giving basal insulin? - ANSWER -to regulate blood glucose levels on a consistent basis What are the 3 P's of Diabetes? - ANSWER -Polydipsia Polyuria Polyphagia Why is polyuria seen in diabetes? - ANSWER -because your body is trying to get rid of the extra glucose What diabetic medication class decreases liver production of glucose and increases insulin sensitivity? - ANSWER -Biguanides Ex: metformin What is a common side effect of metformin? - ANSWER -diarrhea How long must metformin be withheld before someone gets contrast dye? How long after? - ANSWER -48 hours before and 48 hours after How does the oral antidiabetic medication thiazolidinediones work? - ANSWER -it increases insulin sensitivity allowing glucose into the cells If someone has sweet urine (lots of glucose in the urine) what are they at risk for? - ANSWER -UTI and infection When should you re-check blood sugars after insulin has been administered? - ANSWER -Whenever the peak of that insulin is supposed to occur or if they didn't eat their whole meal/threw up their food to check for hypoglycemia What blood glucose level is considered hypoglycemia? - ANSWER -< 70 mg/dL What are some teaching considerations for a diabetic patient when concerning exercise? - ANSWER -- do not go more that 2 days without exercising - BG levels need to be > 100 mg/dL because exercise can cause hypoglycemia - do not exercise when your insulin is peaking -increases HDLs (good cholesterol) which decreases risk of heart disease