Nurs300 Exam 3 Questions With 100%
Verified Answers.
Diabetes definition - answer✔Chronic multisystem disease related to
- Abnormal insulin production
- Impaired insulin utilization
- Or both
Long term effects of diabetes - answer✔Diabetes is the leading cause of:
- Adult blindness
- End-stage renal disease
- Nontraumatic lower limb amputations
Major contributing factor
- Heart disease
- Stroke
Types of diabetes - answer✔Type 1
Type 2
Gestational
Prediabetes
Normal insulin metabolism - answer✔- Produced by the b cells
- Islets of Langerhans of the pancreas
- Released continuously into bloodstream in small increments with larger amounts released after
food intake
- Stabilizes glucose range to 70 to 120 mg/dl
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Insulin - answer✔- Promotes glucose transport from bloodstream across cell membrane to
cytoplasm of cell
- Decreases glucose in the bloodstream
Insulin after meals - answer✔- increases after a meal
- Stimulates storage of glucose as glycogen in liver and muscle
- Inhibits gluconeogenesis - the process of synthesizing glucose in the body from non-
carbohydrate sources
- Enhances fat deposition
↑ Protein synthesis
Counterregulatory hormones - answer✔- Increase blood glucose levels by stimulating glucose
production & output by the liver, & by decreasing the movement of glucose into the cells.
- Oppose effects of insulin
- Increase blood glucose levels
- Provide a regulated release of glucose for energy
- Help maintain normal blood glucose levels
Examples of counterregulatory hormones - answer✔glucagon, epinephrine, growth hormone,
cortisol
Type 1 diabetes age - answer✔- Formerly known as "juvenile onset" or "insulin dependent"
diabetes
- Most often occurs in people under 30 years of age
- Peak onset between ages 11 and 13
- 5-10% of all diabetics
- Now occurring in younger children
Etiology and Pathophysiology of type 1 diabetes - answer✔- End result of long-standing process
- Immune- mediated disease
- Body's own T cells attack & destroy pancreatic beta (β)- cells, which are the source of insulin.
- Auto antibodies to the islet cells cause a reduction of 80% to 90% of normal b cell function
before hyperglycemia manifestations occur
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Causes:
- Genetic predisposition
- Related to human leukocyte antigens (HLAs)
- Exposure to a virus
- Idiopathic diabetes - not related to autoimmunity but strongly inherited
Onset of type 1 diabetes - answer✔- Long preclinical period
- Antibodies for βcell destruction present for months to years before symptoms occur
- Manifestations develop when pancreas can no longer produce insulin
- Rapid onset of symptoms
- Present at ER with ketoacidosis
- History of recent, sudden, weight loss
- will require exogenous insulin to sustain life
Classic symptoms of type 1 diabetes - answer✔Polydipsia - excessive thirst
Polyuria - production of abnormally large amounts of urine
Polyphagia - Increased appetite
Nonspecific symptoms of type 1 diabetes - answer✔Fatigue
Recurrent infections
Recurrent vaginal yeast infections
Prolonged wound healing
Visual changes
Recent sudden weight loss
Type 2 diabetes - answer✔• Most prevalent type of diabetes - over 90% of patients with diabetes
• Usually occurs in people over 35 years of age
• 80% to 90% of patients are overweight
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• Prevalence increases with age
• Genetic basis
• Greater in some ethnic populations
- African Americans, Asian Americans, Hispanic
Americans, and Native Americans
- Native Americans and Alaskan
Natives: Highest rate of diabetes in the world
Etiology and Pathophysiology of type 2 diabetes - answer✔• Pancreas continues to produce
some endogenous (self-made) insulin
• Insulin produced is either insufficient or poorly utilized by tissues or both
• Obesity (abdominal/visceral)
- Most powerful risk factor
• Genetic mutations
- Lead to insulin resistance
- Increased risk for obesity
Major metabolic abnormalities of type 2 diabetes - answer✔1. Insulin resistance
2. Pancreas ↓ ability to produce insulin
3. Inappropriate glucose production from liver
4. Alteration in production of hormones and adipose tissue (adipokines)
Insulin resistance (major metabolic abnormality) - answer✔- Body tissues do not respond to
insulin
- Insulin receptors either unresponsive or insufficient in number
- Results in hyperglycemia
Pancreas ↓ ability to produce insulin (major metabolic abnormality) - answer✔-β cells fatigued
from compensating