lOMoAR cPSD| 66470069
NURS.125.Final.Notes.-.Study.guide
, lOMoAR cPSD| 66470069
NURS.125.FINAL.NOTES
Diabetes.Mellitus:
• .Differentiate.between.type.1.and.type.2.diabetes..
Type.1:.destruction.of.beta.cells.in.the.pancreas,.autoimmune.disease.that.requires.patients.to.be.d
ependent.on.exogenous.insulin.for.the.rest.of.their.lives,.diagnosed.at.younger.age,.patients.are.m
ore.slender,.acute.weight.loss,.chance.of.DKA.(BG:.300-
800.mg/dL),.fasting.hyperglycemia,.decreased.insulin.production,.and.increased.glucose.producti
on
Type.2:.impaired.insulin.secretion,.the.tissues.of.the.body.become.less.sensitive.to.the.insulin.and
.become.resistant,.insulin.is.not.taken.up.by.target.cells.so.it.gets.left.in.the.body.causing.hypergly
cemia,.dependent.on.non-
insulin.agents.but.can.be.given.insulin.as.well,.diagnosed.at.an.older.age,.most.patients.are.obese.
(which.may.cause.the.tissues.to.become.less.sensitive,.therefore.causing.Type.2),.chance.of.HHS.
(hyperglycemic.hyperosmolar.syndrome).(BG:.6001200.mg/dL),.diet.and.exercise.are.the.first.ch
oice.of.treatment.before.starting.oral.glycemic.agents.(endogenous.source:.their.own.insulin.gets.
used)
• Describe.etiologic.factors.associated.with.diabetes..
Type.1:.slender.patients,.acute.weight.loss
Type.2:.overweight,.obese,.low.physical.activity
• Relate.the.clinical.manifestations.of.diabetes.to.the.associated.pathophysiologic.alterations..
3.P’s:.polyuria.(frequent.urination),.polydipsia.(thirst).due.to.excess.loss.of.fluid,.polyphagia.(hun
ger).due.to.catabolic.state.induced.by.insulin.deficiency.and.breakdown.of.fats.and.proteins..
Hypoglycemia:.(<70mg/dL),.diaphoretic.(sweaty),.confusion,.seizures,.vision.changes/blurred.vis
ion,.slurred.speech,.agitation,.irritability,.anxious,.tremors/.shakiness,.hunger,.abdominal.pain,.H
A,.weakness,.tingling/numbness.in.lips/tongue/cheek,.nausea,.sleepiness/drowsiness,.decreased.c
oordination,.palpitations
Hyperglycemia:.(>100mg/dL),.3.P’s,.confusion,.visual.changes,.HA,.weakness,.tingling/numbnes
s.in.hands.and.feet.(may.cause.unhealed.wounds),.fruity.breath.(acetone),.recurrent.infections.(ye
ast.thrives.in.high.BG),.dehydration,.dry.skin.(low.fluid.volume),.shortness.of.breath.(increased.R
R),.N/V,.drowsiness
• Identify.the.diagnostic.and.clinical.significance.of.blood.glucose.test.results..
Symptoms.of.diabetes.(3P’s,.weight.loss).plus.casual.plasma.glucose.concentration.>.or.=.than.
200.mg/dL.or.fasting.(8.hours).plasma.glucose.>.or.=.126mg/dL,.two.hour.preload.glucose.>.or.=.
200mg/dL.during.oral.glucose.tolerance.test,.A1C.<7%.(normal:.<5.7%,.pre:.5.7-6.4%,.diabetic:.
>.or.=.6.5%)
• Explain.the.dietary.modifications.used.for.management.of.people.with.diabetes.
Maintain.the.pleasure.of.eating;.include.personal.and.cultural.preferences,.promote.exercise.and.a
ctivity,.eat.at.least.three.meals.a.day..DO.NOT.skip.meals,.The.ADA.recommends.that.for.all.leve
ls.of.caloric.intake,.50%-60%.of.calories.should.be.carbohydrates,.20-
30%.from.fat,.and.the.remaining.10%-
20%.from.protein,.Avoid.large.meals,.which.often.lead.to.high.blood.glucose.
Downloaded.by.Geff.Mwaura.()
, lOMoAR cPSD| 66470069
.Describe.the.relationships.among.diet,.exercise,.and.medication.(i.e.,.insulin.or.oral.antidiabetic.age
nts).for.people.with.diabetes.
Diet,.exercise,.and.medications.aid.in.achieve.goals.such.as:.BG.levels.in.the.normal.range.or.clo
se,.lipid.and.lipoprotein.levels.in.the.normal.range.or.close,.BP.levels.in.the.normal.range.or.close
,.prevention.of.or.slow.to.rate.of.development.of.chronic.complications,.address.nutritional.needs,
.taking.into.account.cultural.and.personal.preferences
• Develop.an.education.plan.for.insulin.self-management..
Pathophysiology,.treatment.modalities.(diet,.insulin/oral,.meal.planning,.monitoring.BG,.ketones)
,.complications/signs.and.symptoms,.insulin.care.(storage,.mixing,.withdrawing),.selecting/rotati
ng.sites,.preparing.skin,.disposal
Transports.and.metabolizes.glucose.for.energy
Stimulates.storage.of.glucose.in.the.liver.and.muscle.as.glycogen
Signals.the.liver.to.stop.the.release.of.glucose
Enhances.storage.of.fat.in.adipose.tissue
Accelerates.transport.of.amino.acids.into.cells
Inhibits.the.breakdown.of.stored.glucose,.protein,.and.fat
Rapid. Prandial.(with.food),.onset.15.minutes,.peak.1-2.hours,.DOA.3-5.hours,.administer.
Acting. within.15.minutes.of.mealtime,.may.go.into.hypoglycemic.event.if.no.food.is.in.
(Insulin. front.of.pt
Lispro,..
aspart,
glulisine)
Short. Prandial,.onset.30-60.minutes,.peak.2.5.hours,.DOA.6-10.hours,.only.insulin .
Acting. through.IV,.given.within.30-60.minutes.of.mealtime
(regula r.
insulin)
Intermediat Onset.1-2.hours,.peak.4-8.hours,.DOA.10- ,.
18.hours,.suspension.is.cloudy,.roll.
e.Acting. between.hands,.often.mixed.with.regular.to.reduce.number.of.injections.a.day
(neutral. covers.needs.for.half.the.day.or.overnight
protamin e.
hegedorn.or
isophane)
Long.acting Onset.1-
2.hours,.no.peak,.DOA.24.hours,.once.or.twice.daily,.basal.insulin.due.to.
(Glargine ,. ability.to.provide.prolonged.consistent.BG.glucose.level,.used.with.rapid.or.short
detemir)
• Identify.the.role.of.oral.antidiabetic.agents.in.therapy.for.patients.with.diabetes..
Downloaded.by.Geff.Mwaura.()
, lOMoAR cPSD| 66470069
Either.they.stimulate.beta.cells.to.secrete.insulin.or.they.inhibit.production.of.glucose.by.liver.or.in
crease.the.body.tissue.sensitivity.to.insulin..Oral.antidiabetic.medications.are.used.for.patients.
with.type.2.diabetes.ONLY.and.may.be.used.in.addition.to.diet.and.exercise.for.better.
glucose.control,.major.side.effect:.hypoglycemia.so.monitor.for.complications
• Describe.management.strategies.for.a.person.with.diabetes.to.use.during.“sick.days.”
Take.insulin.or.oral.antidiabetic.agents.as.usual,.test.blood.glucose.and.urine.ketones.every.3.to.4.
hours,.Report.elevated.glucose.levels.as.specified.or.urine.ketones,.take.supplemental.doses.or.re
gular.insulin.every.3.to.4.hours,.if.needed,.if.you.take.insulin,.substitute.soft.foods.6.to.8.times.da
ily.if.unable.to.follow.usual.meal.plan,.take.liquids.every.½.to.1.hour.to.prevent.dehydration.and.t
o.provide.calories,.if.vomiting,.diarrhea,.or.fever.persists,.report.N/V.and.diarrhea.to.your.PCP,.if.
you.are.unable.to.retain.oral.fluids,.hospitalization.may.be.needed
• Describe.the.major.macro.vascular,.microvascular,.and.neuropathic.complications.of.diabetes.and
.the.self-care.behaviors.that.are.important.in.their.prevention..
Both.may.occur.without.proper.care,.macrovascular.is.more.prevalent.with.other.adults.with.type.
2.but.can.be.seen.with.type.1,.microvascular.such.as.neuropathy.is.more.prevalent.in.patients.with
.type.1.but.can.be.seen.with.type.2
Macrovascular:
Eyes,.kidneys,.extremities,.skin.integrity,.foot.complications,..
accelerated.atherosclerotic.changes,.coronary.artery.disease,.cerebrovascular.disease,.and.peripher
al.vascular.disease,.Microvascular:.diabetic.retinopathy,.and.nephropathy,.neuropathic:.peripheral
.neuropathy,.sexual.dysfunction,.diabetic.ketoacidosis.(Type.
1);.Hyperglycemic.Hyperosmolar.Syndrome.(HHS).(in.Type.2.mostly)
•. Identify.the.programs.and.community.support.groups.available.for.people.with.diabetes
Diabetic.support.group.(group.diabetes.self-
management.education.classes),.diabetic.educator,.case.manager,.Religious.support,.providers,.Pr
oyecto.Salud,.Community.clinic,.Inc
HIV/HEPATITIS:
.Describe.the.pathophysiology,.modes.of.transmission.of.human.immunodeficiency.virus.(HIV).infe
ction.and.prevention.strategies.
Pathophysiology:.Human.immunodeficiency.virus.(HIV).infection.results.from.the.HIV.virus.that
.destroys.CD4+.lymphocytes.and.impairs.cell-
mediated.immunity,.increasing.risk.of.certain.infections.and.cancers
Modes.of.transmission:.transmitted.by.bodily.fluids.(blood,.seminal.fluid,.vaginal.secretion,.amni
otic.fluids,.breast.milk),.mother.to.child,.not.through.casual.contact
Prevention:.education.on.how.to.eliminate.or.reduce.risks.associated.with.HIV/AIDS,.education.o
n.behavioral.interventions.(),.get.HIV.testing.often.and.make.it.a.part.of.medical.care,.linkage.to.t
reatment.and.care.to.allow.for.patients.to.live.longer.and.healthier.lives.
Downloaded.by.Geff.Mwaura.()
NURS.125.Final.Notes.-.Study.guide
, lOMoAR cPSD| 66470069
NURS.125.FINAL.NOTES
Diabetes.Mellitus:
• .Differentiate.between.type.1.and.type.2.diabetes..
Type.1:.destruction.of.beta.cells.in.the.pancreas,.autoimmune.disease.that.requires.patients.to.be.d
ependent.on.exogenous.insulin.for.the.rest.of.their.lives,.diagnosed.at.younger.age,.patients.are.m
ore.slender,.acute.weight.loss,.chance.of.DKA.(BG:.300-
800.mg/dL),.fasting.hyperglycemia,.decreased.insulin.production,.and.increased.glucose.producti
on
Type.2:.impaired.insulin.secretion,.the.tissues.of.the.body.become.less.sensitive.to.the.insulin.and
.become.resistant,.insulin.is.not.taken.up.by.target.cells.so.it.gets.left.in.the.body.causing.hypergly
cemia,.dependent.on.non-
insulin.agents.but.can.be.given.insulin.as.well,.diagnosed.at.an.older.age,.most.patients.are.obese.
(which.may.cause.the.tissues.to.become.less.sensitive,.therefore.causing.Type.2),.chance.of.HHS.
(hyperglycemic.hyperosmolar.syndrome).(BG:.6001200.mg/dL),.diet.and.exercise.are.the.first.ch
oice.of.treatment.before.starting.oral.glycemic.agents.(endogenous.source:.their.own.insulin.gets.
used)
• Describe.etiologic.factors.associated.with.diabetes..
Type.1:.slender.patients,.acute.weight.loss
Type.2:.overweight,.obese,.low.physical.activity
• Relate.the.clinical.manifestations.of.diabetes.to.the.associated.pathophysiologic.alterations..
3.P’s:.polyuria.(frequent.urination),.polydipsia.(thirst).due.to.excess.loss.of.fluid,.polyphagia.(hun
ger).due.to.catabolic.state.induced.by.insulin.deficiency.and.breakdown.of.fats.and.proteins..
Hypoglycemia:.(<70mg/dL),.diaphoretic.(sweaty),.confusion,.seizures,.vision.changes/blurred.vis
ion,.slurred.speech,.agitation,.irritability,.anxious,.tremors/.shakiness,.hunger,.abdominal.pain,.H
A,.weakness,.tingling/numbness.in.lips/tongue/cheek,.nausea,.sleepiness/drowsiness,.decreased.c
oordination,.palpitations
Hyperglycemia:.(>100mg/dL),.3.P’s,.confusion,.visual.changes,.HA,.weakness,.tingling/numbnes
s.in.hands.and.feet.(may.cause.unhealed.wounds),.fruity.breath.(acetone),.recurrent.infections.(ye
ast.thrives.in.high.BG),.dehydration,.dry.skin.(low.fluid.volume),.shortness.of.breath.(increased.R
R),.N/V,.drowsiness
• Identify.the.diagnostic.and.clinical.significance.of.blood.glucose.test.results..
Symptoms.of.diabetes.(3P’s,.weight.loss).plus.casual.plasma.glucose.concentration.>.or.=.than.
200.mg/dL.or.fasting.(8.hours).plasma.glucose.>.or.=.126mg/dL,.two.hour.preload.glucose.>.or.=.
200mg/dL.during.oral.glucose.tolerance.test,.A1C.<7%.(normal:.<5.7%,.pre:.5.7-6.4%,.diabetic:.
>.or.=.6.5%)
• Explain.the.dietary.modifications.used.for.management.of.people.with.diabetes.
Maintain.the.pleasure.of.eating;.include.personal.and.cultural.preferences,.promote.exercise.and.a
ctivity,.eat.at.least.three.meals.a.day..DO.NOT.skip.meals,.The.ADA.recommends.that.for.all.leve
ls.of.caloric.intake,.50%-60%.of.calories.should.be.carbohydrates,.20-
30%.from.fat,.and.the.remaining.10%-
20%.from.protein,.Avoid.large.meals,.which.often.lead.to.high.blood.glucose.
Downloaded.by.Geff.Mwaura.()
, lOMoAR cPSD| 66470069
.Describe.the.relationships.among.diet,.exercise,.and.medication.(i.e.,.insulin.or.oral.antidiabetic.age
nts).for.people.with.diabetes.
Diet,.exercise,.and.medications.aid.in.achieve.goals.such.as:.BG.levels.in.the.normal.range.or.clo
se,.lipid.and.lipoprotein.levels.in.the.normal.range.or.close,.BP.levels.in.the.normal.range.or.close
,.prevention.of.or.slow.to.rate.of.development.of.chronic.complications,.address.nutritional.needs,
.taking.into.account.cultural.and.personal.preferences
• Develop.an.education.plan.for.insulin.self-management..
Pathophysiology,.treatment.modalities.(diet,.insulin/oral,.meal.planning,.monitoring.BG,.ketones)
,.complications/signs.and.symptoms,.insulin.care.(storage,.mixing,.withdrawing),.selecting/rotati
ng.sites,.preparing.skin,.disposal
Transports.and.metabolizes.glucose.for.energy
Stimulates.storage.of.glucose.in.the.liver.and.muscle.as.glycogen
Signals.the.liver.to.stop.the.release.of.glucose
Enhances.storage.of.fat.in.adipose.tissue
Accelerates.transport.of.amino.acids.into.cells
Inhibits.the.breakdown.of.stored.glucose,.protein,.and.fat
Rapid. Prandial.(with.food),.onset.15.minutes,.peak.1-2.hours,.DOA.3-5.hours,.administer.
Acting. within.15.minutes.of.mealtime,.may.go.into.hypoglycemic.event.if.no.food.is.in.
(Insulin. front.of.pt
Lispro,..
aspart,
glulisine)
Short. Prandial,.onset.30-60.minutes,.peak.2.5.hours,.DOA.6-10.hours,.only.insulin .
Acting. through.IV,.given.within.30-60.minutes.of.mealtime
(regula r.
insulin)
Intermediat Onset.1-2.hours,.peak.4-8.hours,.DOA.10- ,.
18.hours,.suspension.is.cloudy,.roll.
e.Acting. between.hands,.often.mixed.with.regular.to.reduce.number.of.injections.a.day
(neutral. covers.needs.for.half.the.day.or.overnight
protamin e.
hegedorn.or
isophane)
Long.acting Onset.1-
2.hours,.no.peak,.DOA.24.hours,.once.or.twice.daily,.basal.insulin.due.to.
(Glargine ,. ability.to.provide.prolonged.consistent.BG.glucose.level,.used.with.rapid.or.short
detemir)
• Identify.the.role.of.oral.antidiabetic.agents.in.therapy.for.patients.with.diabetes..
Downloaded.by.Geff.Mwaura.()
, lOMoAR cPSD| 66470069
Either.they.stimulate.beta.cells.to.secrete.insulin.or.they.inhibit.production.of.glucose.by.liver.or.in
crease.the.body.tissue.sensitivity.to.insulin..Oral.antidiabetic.medications.are.used.for.patients.
with.type.2.diabetes.ONLY.and.may.be.used.in.addition.to.diet.and.exercise.for.better.
glucose.control,.major.side.effect:.hypoglycemia.so.monitor.for.complications
• Describe.management.strategies.for.a.person.with.diabetes.to.use.during.“sick.days.”
Take.insulin.or.oral.antidiabetic.agents.as.usual,.test.blood.glucose.and.urine.ketones.every.3.to.4.
hours,.Report.elevated.glucose.levels.as.specified.or.urine.ketones,.take.supplemental.doses.or.re
gular.insulin.every.3.to.4.hours,.if.needed,.if.you.take.insulin,.substitute.soft.foods.6.to.8.times.da
ily.if.unable.to.follow.usual.meal.plan,.take.liquids.every.½.to.1.hour.to.prevent.dehydration.and.t
o.provide.calories,.if.vomiting,.diarrhea,.or.fever.persists,.report.N/V.and.diarrhea.to.your.PCP,.if.
you.are.unable.to.retain.oral.fluids,.hospitalization.may.be.needed
• Describe.the.major.macro.vascular,.microvascular,.and.neuropathic.complications.of.diabetes.and
.the.self-care.behaviors.that.are.important.in.their.prevention..
Both.may.occur.without.proper.care,.macrovascular.is.more.prevalent.with.other.adults.with.type.
2.but.can.be.seen.with.type.1,.microvascular.such.as.neuropathy.is.more.prevalent.in.patients.with
.type.1.but.can.be.seen.with.type.2
Macrovascular:
Eyes,.kidneys,.extremities,.skin.integrity,.foot.complications,..
accelerated.atherosclerotic.changes,.coronary.artery.disease,.cerebrovascular.disease,.and.peripher
al.vascular.disease,.Microvascular:.diabetic.retinopathy,.and.nephropathy,.neuropathic:.peripheral
.neuropathy,.sexual.dysfunction,.diabetic.ketoacidosis.(Type.
1);.Hyperglycemic.Hyperosmolar.Syndrome.(HHS).(in.Type.2.mostly)
•. Identify.the.programs.and.community.support.groups.available.for.people.with.diabetes
Diabetic.support.group.(group.diabetes.self-
management.education.classes),.diabetic.educator,.case.manager,.Religious.support,.providers,.Pr
oyecto.Salud,.Community.clinic,.Inc
HIV/HEPATITIS:
.Describe.the.pathophysiology,.modes.of.transmission.of.human.immunodeficiency.virus.(HIV).infe
ction.and.prevention.strategies.
Pathophysiology:.Human.immunodeficiency.virus.(HIV).infection.results.from.the.HIV.virus.that
.destroys.CD4+.lymphocytes.and.impairs.cell-
mediated.immunity,.increasing.risk.of.certain.infections.and.cancers
Modes.of.transmission:.transmitted.by.bodily.fluids.(blood,.seminal.fluid,.vaginal.secretion,.amni
otic.fluids,.breast.milk),.mother.to.child,.not.through.casual.contact
Prevention:.education.on.how.to.eliminate.or.reduce.risks.associated.with.HIV/AIDS,.education.o
n.behavioral.interventions.(),.get.HIV.testing.often.and.make.it.a.part.of.medical.care,.linkage.to.t
reatment.and.care.to.allow.for.patients.to.live.longer.and.healthier.lives.
Downloaded.by.Geff.Mwaura.()
