NUR 242 MEDICAL–SURGICAL EXAM 4 STUDY GUIDE Unit 9 – Diabetes FALL 2025 Galen college

📘 MEDICAL–SURGICAL EXAM 4 STUDY GUIDE
Unit 9 – Diabetes
NUR 242 - Unit 9 - Diabetes_Stu…


1. DEFINITIONS
Diabetes Mellitus
Chronic hyperglycemia caused by problems with glucose regulation involving
insulin production, secretion, or utilization.
Type 1 Diabetes
 Autoimmune destruction of beta cells → no insulin production
 Typically < 30 years old
 Family history, genetics, possible post-viral trigger
 Abrupt onset
 Usually not obese
Type 2 Diabetes
 Insulin resistance + may have low insulin production
 Strong link to obesity, age > 50, inactivity
 Insidious onset
 Higher risk in Hispanic, African American, Native American, Asian,
Pacific Islander cultures
 History of gestational diabetes increases risk


2. EXPECTED BODY SYSTEM INVOLVEMENT
Priority systems affected by diabetes:
 Endocrine
 Renal
 Neuromuscular
 Visual


3. CLINICAL MANIFESTATIONS

,Type 1 Diabetes
 Hyperglycemia
 3 P’s: Polyuria, Polydipsia, Polyphagia
 Weight loss
 Pronounced, rapid symptoms
Type 2 Diabetes
 Hyperglycemia
 3 P’s
 Weight gain
 Symptoms may be subtle or missed


4. CAUSES OF HYPERGLYCEMIA
 Not enough insulin or oral meds
 Incorrect injection technique / expired insulin
 Poor diet / not following meal plan
 Inactivity
 Illness, infection, surgery
 Stress → cortisol release raises glucose
 Steroids, immunosuppressants
 Missed doses
 Emotional stress


5. HYPERGLYCEMIA – WARNING SIGNS
Late manifestations → Ketoacidosis risk
 Fruity breath
 Dry mouth
 Abdominal pain
 Nausea/vomiting
 Shortness of breath
 Confusion

,  Loss of consciousness


6. LABS & DIAGNOSTICS
 Blood glucose (pre-prandial)
 A1C
 Glucose tolerance test
 Post-prandial glucose
 Urine ketones / glucose


7. THERAPEUTIC MANAGEMENT
Type 1
 Insulin therapy
 Diet + carb counting
 Blood sugar monitoring
 Patient education
Type 2
 Diet + exercise
 Possible oral meds
 Blood sugar monitoring
 Education


8. COMPLICATIONS TO ASSESS FOR
Skin
 Poor wound healing
 Diabetic dermopathy
 Infection at injection sites
Eyes
 Cataracts
 Retinopathy
Peripheral Vascular

,  Hair loss
 Shiny, thin skin
 Weak pulses
 Thick nails
 Erectile dysfunction
Cardiac
 Angina
 MI
Respiratory
 Dyspnea
Kidneys
 UTI
 Edema
 Urinary retention
GI
 Dental caries
 Periodontal disease
 Candidiasis


9. NURSING DIAGNOSES
 Knowledge deficit
 Risk for noncompliance
 Altered nutrition


10. NURSING MANAGEMENT
 Blood glucose monitoring
 Sick-day rules
 Nutrition / carb counting
 Exercise plan
 Foot care education