NURS 3730 Persistent Illness- Test #1 Questions With
Complete Solutions
What should people who exercise for extended periods while on
insulin therapy?
Test their BG before, during, and after their exercise.
If exercising to reduce weight, what must be done to control
insulin?
Must be adjusted.
What are the risks with exercising with diabetes?
Post exercise hypoglycemias so they may need a snack at the
end of the session and before bed.
When is an exercise stress test recommended?
People older than 30 who have two or more risk factors.
What is the CDA exercise recommendation?
Individuals with diabetes at least 150 mins per week of a
moderate intensity aerobic activity. And resistance training 3
times weekly.
****Know the insulin duration of actions.
What is the insulin pump and how often is the needle changed?
Every 3 days, allows for tight glucose control. At meals, patient
programs the pump to deliver a bolus of insulin appropriate to
the amount of carbohydrate ingested and to bring down high
pre-meal BG is needed.
,What is the major side effect of oral anti diabetic agents?
Hypoglycemia.
When would patients on oral anti diabetic agents need insulin?
Temporarily for hyperglycemias due to surgery, infection, and
trauma.
What is diabetic retinopathy? What exam will these patients
require?
Earliest and most treatable stages often produce no changes in
vision and they must have annual dilated eye exams for type I.
What is the treatment for diabetic retinopathy?
- laser photocoagulation: laser destroys ischemic area of retina
and leaking blood vessels preventing future vision loss
- vitrectomy: aspiration of blood, membrane, and fibres inside
the eye which treats vitreous hemorrhage and retinal detachment
of the macula.
What is diabetic nephropathy?
Damage to small blood vessels that supply the glomeruli of the
kidney leading to end stage renal disease. must undergo yearly
screening.
What are the factors to prevent/delay diabetic nephropathy?
- tight glucose control
- prevent UTIs
- avoid nephrotoxic substances
- BP management: use of ACE inhibitors even when not
hypertensive
,What is diabetic neuropathy?
Nerve damage dur to metabolic issues from diabetes. There is a
huge change in sensory function so they can have foot injuries
without the client having pain and atrophy of the small muscles
of the hands/feet.
What is the treatment for diabetic neuropathy?
- BG control
- analgesics
- tricyclic antidepressants
- selective serotonin and norepineephrins inhibitors
- anti seizure drugs
- antiarrhytmic drugs
- TENS
What is autonomic neuropathy?
Can impact all body systems like gastroparesis (delayed gastric
emptying) so can produce anorexia, nausea, vomiting, and
always feeling full. Cardiovascular abnormalities like postural
hypotension, resting tachycardia, painless MI. Also
hypoglycaemia unawareness, sexual function (ED), and
neurogenic bladder.
What infection can lead a HCP to think infection?
Recurrent and persistence infections like Candida albicans and
frequent boils (furuncles)
Why do diabetic patients going through puberty require an
increase in insulin?
, It can decrease sensitivity to insulin
Know the pediatric considerations for diabetes
When does end stage kidney disease occur?
When GFR is less than 15 ml/min
What are the complications of reduced GFR?
- anemia
- increase BP
- calcium absorption decrease
- high lipids, fluid volume overload
- hyperkalemia
- hyperparathyroidism
- hyperphosphatemia
- metabolic acidosis
- malnutrition late)
What are the urinary manifestations of chronic kidney disease?
- polyuria: from kidneys not being able to concentrate urine,
mostly at night, SG 1.010
- oliguria
- anuria: urine output less than 40 mL per 24 hours
What are the metabolic disturbances of chronic kidney disease?
- waste production accumulation: BUN, creatine increases
- alerted carb metabolism: impaired glucose use, diabetics who
are uremic may require less insulin than before onset of CKD,
insulin depends on kidneys for excretion
Complete Solutions
What should people who exercise for extended periods while on
insulin therapy?
Test their BG before, during, and after their exercise.
If exercising to reduce weight, what must be done to control
insulin?
Must be adjusted.
What are the risks with exercising with diabetes?
Post exercise hypoglycemias so they may need a snack at the
end of the session and before bed.
When is an exercise stress test recommended?
People older than 30 who have two or more risk factors.
What is the CDA exercise recommendation?
Individuals with diabetes at least 150 mins per week of a
moderate intensity aerobic activity. And resistance training 3
times weekly.
****Know the insulin duration of actions.
What is the insulin pump and how often is the needle changed?
Every 3 days, allows for tight glucose control. At meals, patient
programs the pump to deliver a bolus of insulin appropriate to
the amount of carbohydrate ingested and to bring down high
pre-meal BG is needed.
,What is the major side effect of oral anti diabetic agents?
Hypoglycemia.
When would patients on oral anti diabetic agents need insulin?
Temporarily for hyperglycemias due to surgery, infection, and
trauma.
What is diabetic retinopathy? What exam will these patients
require?
Earliest and most treatable stages often produce no changes in
vision and they must have annual dilated eye exams for type I.
What is the treatment for diabetic retinopathy?
- laser photocoagulation: laser destroys ischemic area of retina
and leaking blood vessels preventing future vision loss
- vitrectomy: aspiration of blood, membrane, and fibres inside
the eye which treats vitreous hemorrhage and retinal detachment
of the macula.
What is diabetic nephropathy?
Damage to small blood vessels that supply the glomeruli of the
kidney leading to end stage renal disease. must undergo yearly
screening.
What are the factors to prevent/delay diabetic nephropathy?
- tight glucose control
- prevent UTIs
- avoid nephrotoxic substances
- BP management: use of ACE inhibitors even when not
hypertensive
,What is diabetic neuropathy?
Nerve damage dur to metabolic issues from diabetes. There is a
huge change in sensory function so they can have foot injuries
without the client having pain and atrophy of the small muscles
of the hands/feet.
What is the treatment for diabetic neuropathy?
- BG control
- analgesics
- tricyclic antidepressants
- selective serotonin and norepineephrins inhibitors
- anti seizure drugs
- antiarrhytmic drugs
- TENS
What is autonomic neuropathy?
Can impact all body systems like gastroparesis (delayed gastric
emptying) so can produce anorexia, nausea, vomiting, and
always feeling full. Cardiovascular abnormalities like postural
hypotension, resting tachycardia, painless MI. Also
hypoglycaemia unawareness, sexual function (ED), and
neurogenic bladder.
What infection can lead a HCP to think infection?
Recurrent and persistence infections like Candida albicans and
frequent boils (furuncles)
Why do diabetic patients going through puberty require an
increase in insulin?
, It can decrease sensitivity to insulin
Know the pediatric considerations for diabetes
When does end stage kidney disease occur?
When GFR is less than 15 ml/min
What are the complications of reduced GFR?
- anemia
- increase BP
- calcium absorption decrease
- high lipids, fluid volume overload
- hyperkalemia
- hyperparathyroidism
- hyperphosphatemia
- metabolic acidosis
- malnutrition late)
What are the urinary manifestations of chronic kidney disease?
- polyuria: from kidneys not being able to concentrate urine,
mostly at night, SG 1.010
- oliguria
- anuria: urine output less than 40 mL per 24 hours
What are the metabolic disturbances of chronic kidney disease?
- waste production accumulation: BUN, creatine increases
- alerted carb metabolism: impaired glucose use, diabetics who
are uremic may require less insulin than before onset of CKD,
insulin depends on kidneys for excretion
