NR 325 EXAM 1 STUDY GUIDE

NR 325 EXAM 1 STUDY GUIDE Diabetes Mellitus Concept Map • Type 1- Insulin dependent (born with it) • Type 2 – Insulin Resistant (can be reversible) • Risk Factors: increased BMI, poor diet, HTN, decreased perfusion • Assessment: Polyuria, polydipsia, polyphagia, weight loss, fatigue • Complications: retinopathy, nephropathy (urine =30ml/hr, BUN, creatinine), neuropathy, CVD—stroke, Slow wound healing (skin, wbc, temp) • Nursing Diagnosis: ineffective tissue perfusion, risk for ineffective wound healing • Medications: insulin, oral meds • Labs and Diagnostic: FBS, A1C, urine, o Fasting BG: 70-110 126 o Postprandial BG (2hr) 200 o Random BG: 200 o HA1C: 6.5 – gives 8-12 week average o 2 hr plasma glucose: give pt sugar and check blood 60 min-2 hrs later to make sure it’s getting insulin and being used correctly • Nursing Interventions: monitor diet [stay away from simple carbs], exercise, specialists (eye doc), walking o When exercising make sure to check BG before, during and after, especially when starting a new regimen o Monitor skin integrity, especially feet o No lotion between toes Make sure you know the different types of Insulin • Know Onset, peak, duration • Rapid Acting: lispro, aspart, glulsine o Onset: 10-30min o Peak: 30min-3hr o Duration 3-5 hr • Short Acting: Regular Humulin R, Novolin o Onset: 30min-1hr o Peak: 2-5 hr o Duration: 5-8 hr • Intermediate: NPH Humulin R, Novalin o Onset: 1.5-4hr o Peak 4-12 hr o Duration 12-18 hr • Long Acting: glargine, determir o Onset: 0.8-4hr o Peak: no pronounced peak o Duration: 24+ hr Hypoglycemia: Cold, Clammy, changes in LOC • Good test question! Always assess situation if patient presents these signs and symptoms Dawn Phenomenon (Insulin injection complication) • Normal levels of glucose followed by an elevation of blood