Diabetes and Final exam, NU 331 exam 2-4 | Study Guide
Insulin Basics: where is it made - in pancreas
Insulin basics: lvls throughout the day - low steady secretion of insulin overnight
- fasting between meals w/ spikes of insulin @ mealtime
Type 1: Patho - autoimmune process
- destruction of pancreas (insulin secreting cells)
- common w/ CF
- very slow process
Hyperglycemia: classic symptoms - polyuria
- polydipsia
- polyphagia
- weight loss
Hyperglycemia: other symptoms - behavior changes
- H/A and vision changes
- Infections and slow healing
DKA: symptoms - dehydration
- kussmaul breathing
- fruity breath
- stomach ache (N/V)
- lethargy->coma->death
DKA: BS/KEtone - increased
, DKA: ABG's -Decreased pH
-Decreased bicarb
- decreased PC02
- mild pH: 7.25-7.35
- serious: 7.15-7.25
- critic: < 7.15
DKA: electrolytes -Decreased K (exchange for H+ ions)
- increase K+ levls (watch for falling levels)
DKA: Urine - inc glucose
- increase ketones = acetone
- do not need sterile process
DKA: dehydration - inc: hematocrit, BUN, osmolality
DKA: complications - hypovolemic shock
- cerebral edema
- arrhythmias
DKA: treatment - rehydrate w/ NS
- Insulin (regular via IV)
- adjust IV
- switch to SQ insulin and oral diet ASAP
DKA: monitor - glucose, pH, electrolytes
- cardia monitor for K+ levels
- VS, neuro, Resp/CV, GI
Type 1: Labs - Random BS > 200 mg/dl
- history of S/Sx
- Hgb A1C ? 6.5%
- Fasting BS > 126 mg/dl (repeat to confirm)
- oral glucose tolerance test (not often used)
Type 1: Hgb A1C goals - better to be on high side than the low side
- these are often changing
- normal: 4-6%
- acceptable: 6.5%-8%
- high: 9%
Type 1: BS goals - Toddler/preschool:
1. Before meals: 80-200 mg/dl
2. Bedtime: 150
ii. School-age
1. Before meals: 70-180 mg/dl
2. Bedtime: >130
iii. Teens:
1. Before meals: 70-150 mg/dl
2. Bedtime: >130
Insulin Basics: where is it made - in pancreas
Insulin basics: lvls throughout the day - low steady secretion of insulin overnight
- fasting between meals w/ spikes of insulin @ mealtime
Type 1: Patho - autoimmune process
- destruction of pancreas (insulin secreting cells)
- common w/ CF
- very slow process
Hyperglycemia: classic symptoms - polyuria
- polydipsia
- polyphagia
- weight loss
Hyperglycemia: other symptoms - behavior changes
- H/A and vision changes
- Infections and slow healing
DKA: symptoms - dehydration
- kussmaul breathing
- fruity breath
- stomach ache (N/V)
- lethargy->coma->death
DKA: BS/KEtone - increased
, DKA: ABG's -Decreased pH
-Decreased bicarb
- decreased PC02
- mild pH: 7.25-7.35
- serious: 7.15-7.25
- critic: < 7.15
DKA: electrolytes -Decreased K (exchange for H+ ions)
- increase K+ levls (watch for falling levels)
DKA: Urine - inc glucose
- increase ketones = acetone
- do not need sterile process
DKA: dehydration - inc: hematocrit, BUN, osmolality
DKA: complications - hypovolemic shock
- cerebral edema
- arrhythmias
DKA: treatment - rehydrate w/ NS
- Insulin (regular via IV)
- adjust IV
- switch to SQ insulin and oral diet ASAP
DKA: monitor - glucose, pH, electrolytes
- cardia monitor for K+ levels
- VS, neuro, Resp/CV, GI
Type 1: Labs - Random BS > 200 mg/dl
- history of S/Sx
- Hgb A1C ? 6.5%
- Fasting BS > 126 mg/dl (repeat to confirm)
- oral glucose tolerance test (not often used)
Type 1: Hgb A1C goals - better to be on high side than the low side
- these are often changing
- normal: 4-6%
- acceptable: 6.5%-8%
- high: 9%
Type 1: BS goals - Toddler/preschool:
1. Before meals: 80-200 mg/dl
2. Bedtime: 150
ii. School-age
1. Before meals: 70-180 mg/dl
2. Bedtime: >130
iii. Teens:
1. Before meals: 70-150 mg/dl
2. Bedtime: >130
