MED SURG 1 FINAL EXAM 2022| VERIFIED SOLUTION

MED SURG 1 FINAL EXAM 2022 common clinical manifestation of TYPE 1 diabetes -Polyuria (frequent urination) -Polydipsia (excessive thirst) -Polyphagia (excessive hunger) -Weight loss (breaking down fats and proteins to get energy it needs) -Fatigue/Weakness -Blurred Vision (swelling behind eyes) common clinical manifestations of TYPE 2 diabetes -Nonspecific symptoms: May have classic symptoms of type 1 -Fatigue -Recurrent infection -Recurrent vaginal yeast or monilia infection -Prolonged wound healing -Visual changes Type 1 diabetes: etiology -occurs in people younger than 40 -long preclinical period -Antibodies present for months to years before symptoms occur -Manifestations develop when PANCREAS CAN NO LONGER PRODUCE INSULIN Type 1 diabetes: treatment will require exogenous insulin for life Type 2 diabetes: etiology -Pancreas is still producing some endogenous insulin -Insulin produced is insufficient or is poorly utilized by tissues (resistant) Type 2 diabetes: Four major metabolic abnormalities 1. Insulin resistance 2. Pancreas ↓ ability to produce insulin 3. Inappropriate glucose production from liver 4. Alteration in production of hormones and adipokines (cell signaling proteins that are released by adipose tissue) Diagnostic DM fasting glucose levels are... 100 to 125 mg/dL Diagnostic DM random or casual plasma glucose measurement levels are... 140 and 199 mg/dL purpose of the glycosylated hemoglobin A1C -useful in determining glycemic levels over time -Shows the amount of glucose attached to hemoglobin molecules over RBC life span -Approximately 120 days -Shows how controlled a diabetic is. SHOULD BE LESS THAN 6.5% clinical manifestations hypoglycemia: Confusion Sleepiness Dizziness/lightheadedness Irritability/anxiety Diaphoresis/Perspiration ***Tremors/Shakiness Hunger Weakness Visual disturbance Difficulty speaking Tachycardia Diabetic ketoacidosis -caused by profound deficiency in insulin -pH is low -Metabolic -Ketones excreted in urine -K+ is lower -Extremely high blood sugar -Pt. loses bicarb -Could go into coma if not treated and die -Stressful event triggers it. -Can be treated if recognized early on Diabetic ketoacidosis clinical manifestations: -Lethargy/weakness -Dehydration -Tachycardia -Orthostatic hypotension -Kussmaul respirations: Rapid deep breathing, Attempt to reverse metabolic acidosis, SWEET FRUITY ODOR DKA diagnostic findings: Hyperglycemia: BG 250mg/dL Acidosis: pH 7.30 HCO3 15 Ketosis Electrolyte abnormalities controlling blood glucose levels in relation to microvascular disease: -Result from thickening of vessel membranes in capillaries and arterioles *In response to chronic hyperglycemia -Areas most noticeably affected *Eyes (retinopathy) *Kidneys (nephropathy) *Skin (dermopathy) controlling blood glucose levels in relation to macrovascular disease -Diseases of large and medium-sized blood vessels -Tight glucose control may delay atherosclerotic process. -Risk factors *Obesity *Smoking *Hypertension *High fat intake *Sedentary lifestyle insulin pump -Continuous subcutaneous infusion -Battery-operated device -Connected via plastic tubing to a catheter inserted into subcutaneous tissue in abdominal wall -Potential for tight glucose control onset, peak, and duration times for lispro Rapid acting Onset: 10-15 min Peak: 60-90 min Duration: 4-5 hrs onset, peak and duration times for regular