N3661 - Exam 1 (Med Surg - D. Cleary)
Questions With Correct Answers
What type of environment does patient with hypoparathyroidism need? Why?
quiet!
due to neuromuscular excitability
↓Ca+ = ↑action potentials
Patient with Addison's disease should have what kind of snack foods?
low in K+
high in Na, carbs, protein
(turkey and cheese sandwich)
What are the 2 hormones important in maintaining blood sugar?
Where are they released from?
insulin
glucagon
released by pancreas
What cells release insulin? Where are they located?
beta cells
pancreas
What does insulin do?
facilitates transport of glucose in blood across cell membrane into the cell
What cells release glucagon? Where are they located?
alpha cells
pancreas
Starting with #1: eating carbohydrates, what are the following steps?
1. eat carbs
2. converted & absorbed via GI tract
,3. glucose travels in bloodstream to targeted cells
4. blood glucose levels are elevated, triggers beta cells in pancreas to release insulin
5. insulin transports glucose across cell membrane
6. blood glucose levels now low, insulin stops secreting and alpha cells of pancreas release
glucagon
7. glucagon stimulates release of sugar from liver stores
insulin resistance vs deficiency
resistance: can't cross cell wall
deficiency: not enough produced
type 1 vs type 2 diabetes
type 1: produces no insulin at all (dx before 30, common with autoimmune disorders)
type 2: insulin resistance
What BMI puts you at risk for type 2 DM?
>25
What are the cardinal signs of diabetes? (3)
the 3 P's
polyuria
polydipsia (excessive thirst)
polyphagia (excessive eating)
Why does diabetic experience polyuria?
result of increased concentration of glucose in urine
(sugar attracts more water, pulls from cells into urine)
Why does diabetic experience polydipsia?
due to increased output and the massive fluid shift from cells to vascular space (so much sugar
in blood)
Why do diabetics experience polyphagia?
insulin not bringing glucose into cell so cell eats proteins & fats for energy, causing starvation
mode & leads to increased appetite
Relating to reproductive system, men and women with diabetes likely experience what?
,men: erectile dysfunction
women: vaginal infections
What would the expected HA1C be for;
diabetic
prediabetic
diabetic: >6%
pre: 5.7-6%
Fasting blood sugar for;
diabetic
prediabetic
diabetic: >126
pre: 100-125
Hypoglycemia symptoms (6)
(PHIL Seeks Sugar)
sweating
pallor
irritability
hunger
lack of coordination
sleepiness
Hyperglycemia symptoms (6)
dry mouth
increased thirst
weakness
headache
blurred vision
frequent urination
What is the primary treatment of type 1 diabetes?
insulin!
(remember, not making their own or enough)
What is the onset of:
rapid acting insulin
short acting
, intermediate
long
rapid: 15 min (lispro/aspart/glulisine)
short: 30-60 min (regular)
intermediate: 2-4 hr (NPH)
long: 1 hr (glargine/detemir)
When are patients at highest risk for hypoglycemia while taking insulin?
peak level (usually when snacks are given to DM patients)
What route can insulin NOT be given?
orally
What blood sugar level is considered hypoglycemia?
<65
How long does HgA1C measure blood glucose levels?
6 - 8 week window
Times that patients are recommended to increase their accuchecks (aka BG monitoring) (3)
1. when therapy has changed/initiated
2. when ill/sick
3. hypoglycemic unaware (unable to recognize symptoms)
If diabetic patient exercises often, where should you recommend injecting insulin? Why?
abdominal
better absorption rate
Hypoglycemia is most damaging to what body system? Why?
CNS
relies solely on glucose for energy needs, if not getting glucose = cell death
What factors can precipitate hypoglycemia? (3)
1. decreased nutritional intake
2. increased metabolism d/t exercise
3. alcohol: reduces glucose levels by blunting glucose release from liver
How is hypoglycemia episode managed? (2)
Questions With Correct Answers
What type of environment does patient with hypoparathyroidism need? Why?
quiet!
due to neuromuscular excitability
↓Ca+ = ↑action potentials
Patient with Addison's disease should have what kind of snack foods?
low in K+
high in Na, carbs, protein
(turkey and cheese sandwich)
What are the 2 hormones important in maintaining blood sugar?
Where are they released from?
insulin
glucagon
released by pancreas
What cells release insulin? Where are they located?
beta cells
pancreas
What does insulin do?
facilitates transport of glucose in blood across cell membrane into the cell
What cells release glucagon? Where are they located?
alpha cells
pancreas
Starting with #1: eating carbohydrates, what are the following steps?
1. eat carbs
2. converted & absorbed via GI tract
,3. glucose travels in bloodstream to targeted cells
4. blood glucose levels are elevated, triggers beta cells in pancreas to release insulin
5. insulin transports glucose across cell membrane
6. blood glucose levels now low, insulin stops secreting and alpha cells of pancreas release
glucagon
7. glucagon stimulates release of sugar from liver stores
insulin resistance vs deficiency
resistance: can't cross cell wall
deficiency: not enough produced
type 1 vs type 2 diabetes
type 1: produces no insulin at all (dx before 30, common with autoimmune disorders)
type 2: insulin resistance
What BMI puts you at risk for type 2 DM?
>25
What are the cardinal signs of diabetes? (3)
the 3 P's
polyuria
polydipsia (excessive thirst)
polyphagia (excessive eating)
Why does diabetic experience polyuria?
result of increased concentration of glucose in urine
(sugar attracts more water, pulls from cells into urine)
Why does diabetic experience polydipsia?
due to increased output and the massive fluid shift from cells to vascular space (so much sugar
in blood)
Why do diabetics experience polyphagia?
insulin not bringing glucose into cell so cell eats proteins & fats for energy, causing starvation
mode & leads to increased appetite
Relating to reproductive system, men and women with diabetes likely experience what?
,men: erectile dysfunction
women: vaginal infections
What would the expected HA1C be for;
diabetic
prediabetic
diabetic: >6%
pre: 5.7-6%
Fasting blood sugar for;
diabetic
prediabetic
diabetic: >126
pre: 100-125
Hypoglycemia symptoms (6)
(PHIL Seeks Sugar)
sweating
pallor
irritability
hunger
lack of coordination
sleepiness
Hyperglycemia symptoms (6)
dry mouth
increased thirst
weakness
headache
blurred vision
frequent urination
What is the primary treatment of type 1 diabetes?
insulin!
(remember, not making their own or enough)
What is the onset of:
rapid acting insulin
short acting
, intermediate
long
rapid: 15 min (lispro/aspart/glulisine)
short: 30-60 min (regular)
intermediate: 2-4 hr (NPH)
long: 1 hr (glargine/detemir)
When are patients at highest risk for hypoglycemia while taking insulin?
peak level (usually when snacks are given to DM patients)
What route can insulin NOT be given?
orally
What blood sugar level is considered hypoglycemia?
<65
How long does HgA1C measure blood glucose levels?
6 - 8 week window
Times that patients are recommended to increase their accuchecks (aka BG monitoring) (3)
1. when therapy has changed/initiated
2. when ill/sick
3. hypoglycemic unaware (unable to recognize symptoms)
If diabetic patient exercises often, where should you recommend injecting insulin? Why?
abdominal
better absorption rate
Hypoglycemia is most damaging to what body system? Why?
CNS
relies solely on glucose for energy needs, if not getting glucose = cell death
What factors can precipitate hypoglycemia? (3)
1. decreased nutritional intake
2. increased metabolism d/t exercise
3. alcohol: reduces glucose levels by blunting glucose release from liver
How is hypoglycemia episode managed? (2)
