問題一覧
1
Select ADPIE in order
Assessment , Diagnosis , Planning, Intervention , Evaluation
2
Select SBAR in order
Situation , Background , Assessment , Recommenation
3
Where is glucose absorbed?
Small intestine
4
Select the correct words in order. When blood glucose increases Insulin SHOULD _____ to ____ blood glucose levels.
Increase, Decrease
5
Isulin suppresses what kind of lipoprotein? (the bad fat)
low density lipoprotien (LDL)
6
Insulin decides what sugar is used as energy and which to ____?
Store
7
Match the definition with the correct term. Low level around the clock insulin (all the time).
Basal
8
Match the definition with the correct term. Insulin described as burst, rising release.
Postprandial
9
Match the definition with the correct term. Destruction of pancreatic beta cells (the key).
Type 1 diabetes
10
Match the definition with the correct term. Insulin resistance and impaired insulin secretion.
Type 2 diabetes
11
True or False? Type 1 diabetes is genetic.
True
12
Is type 2 Diabetes hereditary?
Lifestyle and SLIGHTLY hereditary
13
Select the two other electrolyte imbalances associated with hyperglycemia.
Hyperkalemia , Hypokalemia
14
Match the definition to the correct term. High pottasium
Hyperkalemia
15
Match the definition to the correct term. Low pottasium.
Hypokalemia
16
What is seen first Hyperkalemia or Hypokalemia?
Hyperkalemia
17
True or False? Insulin can cause Hypokalemia by driving Ka+ back into cells
True
18
When pts with DM become dehydrated these are the 5 complications of the dehydration
Hypovolemia (Less h2o, higher conc. of glucose elec. imbalances), Hemoconcentration (increased glucose elec imbalance), Hypoperfusion (hypotension), Hypoxia , Acidosis (increase in lactic acid)
19
What is acidosis?
An increase in lactic acid due to livers inability to keep up
20
What is the result of fat breakdown and conversion of free fatty acids FFA?
Ketones
21
Select the correct word to fill the blank. Ketones result from break down of fat leading to an increase of _____ ___ leading to metabolic acidosis (DKA).
Lactic acid
22
What is the major complication of DKA?
Resipiratory filaure
23
Select the correct word to fill in the blank. An increase in ____ ___ causes ______ ____ overproduction and rebsorption. Eventually leading to respiratory failure.
Lactic acid, Hydorgen ion
24
Select the correct term that matches the definition. Type of breathing someone does when in DKA “blowing off” hydrogen ions
Kussmaul respirations
25
True or false? DKA is most common in type 2 diabetics
False
26
Select the B(B)OL of metBOLic syndrome (diabetes mellitus) in order
High B.P, High B.S, Abdominal Obesity , Hyperlipidemia
27
Below are symptoms of diabetes mellitus select weather they are symptoms of type 1 , type 2, or both. Abrupt onset, hunger, weight loss, increased urine output, acetone breath.
Type 1
28
Below are symptoms of diabetes mellitus select weather they are symptoms of type 1 , type 2, or both. Often NO symptoms, hunger, fatigue, blurred vision, microvascular complications.
Type 2
29
Below are symptoms of diabetes mellitus select weather they are symptoms of type 1 , type 2, or both. Thirst, slow healing infection mental status changes
Both
30
Select the 4 symptoms that need immediate attention.
Persistent vomiting and/or not tolerating intake., Persistent diarrhea and progressive weakness, Difficulty breathing, rapid and labored respirations. (what is the name of these respirations), Moderate or large ketones that do not improve after 12-24 hours of treatment.
31
What is is the HbgA1c test?
Glycosylated hemoglobin (avg of 3 mos)
32
What does a patients HbgA1C have to be for them to be considered diabetic? (Just the number not spelled out)
7
33
Select three urine tests also used when diagnosing diabetes.
Ketone bodies, Renal Funciton, Glucose
34
Select 4 symptoms of hyperglycemia
Polyuria (freq. urination), Polydipsia (thirsty), Polyphagia (hungry), Lipolyisis (fat break down= ketones= DKA)
35
What are the 4 S’s
Sepsis, Stress/ Sickness, Skip insulin, Steroids
36
What are the three macrovascular (chronic) complications of DM.
Coronary artery disease , Cerebrovascular disease , Peripheral vascular disease
37
Select the three microvascular (chronic) complications of DM.
Nephropathy , Neuropathy , Retinopathy
38
Select the goals of a diabetic diet.
Prevent excess prandial hyperglycemia , Prevent/ delay complications of diabetes mellitus , Maintain good B.P. levels , Prev. hypoglycemia , Achieve and maintain ideal body weight
39
Select the nutrition guide for diabetic patients.
Plate method 3 sections, Carb counting is relevant start at 45-60 grams/meal, 25 g of fiber daily (decreases cholesterol), Mediterranean-style diet, Try to eat moderate to GI food or balance between high and low
40
Select the numbers to fill in the blanks IN order. Exercise recommendations are to do moderate to vigorous aerobic activity for ____ mins 5 days/week totaling ____ minutes a week.
30, 150
41
How often should diabetics do strength training per week?
Twice
42
True or false? Diabetics should not go more than 2 days without exercising?
True
43
For planned exercise what is the preferred choice to prevent hypoglycemia?
Reduction in insulin dosage
44
For unplanned exercise what is the preferred choice to prevent hypoglycemia?
Additonal carbohydrates
45
When is the best time for a diabetic to exercise?
After a meal
46
When should a diabetic check their B.S. when exercising? (Select all)
Before, After
47
If a diabetic plans on exercising upon checking their B.S it is <100 what should they do?
Eat
48
Is it safe for a diabetic to exercise if ketones are present (DKA)?
Yes but only light
49
4 positive affects of weight loss on diabetic pt.
Decreased insulin resistance , Improved measures of glycemic , Reduced dyslipidemia , Reduced B.P.
50
What should a diabetic do if they plan on drinking and how many drinks may they have?
Eat, 1
51
Match the definition to the correct class of oral agents for DM. Drugs that sensitize the body to insulin and or control hepatic glucose production. Low risk of hypoglycemia.
Biguanides (metformin)
52
Match the definition to the correct oral agent for DM. Drugs that stimulate the pancreas to make more insulin. The pancreas can become tired it has a high risk for hypoglycemia and it only produces insulin no say in storage or usage.
Sulfonylueraes
53
What oral agent sensitizes the body to insulin by deacreasing hepatic glucose production and improving insulin resistance by increasing insulin mediated peripheral glucose upatake, is very effective has fasting B.S. 60-70 reduces A1C by 1-2%
Biguanides (metformin)
54
What are the side effects of Biguanides (metformin)?
Diarrhea abdominal discomfort , Lactic acidosis (alcohol) (DKA), Vitamin B12/ folic acid defficencies
55
What are the concerns of pts on metformin?
Impaired renal function , Pts receiving IV contrast
56
True or false? Metformin IS available in the hospital but only for the most severe DM pts.
False
57
Select the benefits of Biguanides (metforimin)
Cost effective , No weight gain/loss, No hypoglycemia , Lower CVD risks , Decreases Cholesteral levels , Prediabetes prevention
58
Why are pts on metformin taken off in the hospital and put on sliding scale insulin?
Risk for kidney failure and dehydrataion with IV contrast use.
59
Select the oral agent that matches the definition. Drug that increases insulin secretion by stimulating the pancreas to make more insulin, has a high risk for hypoglycemia, these should be taken in the morning no later than noon. They decrease fasting B.S to 60-70 as well as reduce A1C by 1-2%
Sulfonylureas
60
These oral DM manegment drugs have a high risk for hypoglycemia and beta blockers increase the risk for hypoglycemia as well as mask the symptoms.
Sulfonylureas
61
Insulin is made from?
Synthetic human
62
Where do we inject insulin?
Subq (abdomen supposed to be better)
63
A B.G. reading of what and above requires a call to H.O. (sliding scale)
401
64
For sliding scale insulin and the patient is PO when are the BGs checked? select all.
AC Before meals, HS hour of sleep
65
For sliding scale insulin pts NPO, on TPN, or tube feedings when are BGs checked?
At intervals q 4 hours, q 6 hours
66
What kind of insulin should never be mixed?
Long acting
67
Select 3 things we’re asking when evaluating the effectiveness of insulin?
Is it working?, Is the patient experiencing hypoglycemia or hyperglycemia? , Is it helping the patient to avoid long term complication of DM?
68
Select the kind of insulin used in pumps.
Rapid
69
True or false? Only one nurse or physician should be giving insulin via the pump?
True
70
What are three complications of insulin pumps?
Infection at site, Hypoglycemia , Hyperglycemia
71
Select the correct term to match the definition. Early morning hyperglycemia in which there is a nighttime release of hormones that increase production and uptake of glucose.
Dawn phenomenon
72
Select the correct term that matches the definition. Early morning hyperglycemia that is a counterregulatroy effect of hypoglycemia.
Somogyi effect
73
What do we do for the dawn pheneomenon? Select both answers.
Give intermediate insulin accordingly , Carb snack at night
74
What do we do for Somogyi effect?
Less insulin in evening
75
Select all(4) of the Neuroglycopenic hypoglycemia symptoms.
Headache/ confusion, Slurred speech/ behavioral changes , Coma/warm/weak, Faint/ Dizzy/ Blurred vision
76
Select the 4 Neurogenic symptoms of hypoglycemia.
Tremulous (shaking), Tachycardia , Nervous/ anxious, Diaphoresis
77
Select 4 causes of hypoglycemia.
Exercise , Alcohol, Insulin PEAK times , Nausea/ vomiting
78
Selecy the 4 most deadly hypoglycemia symptoms.
Cool, Pale “pallor” , Sweaty “diaphoretic” “clammy:, Nervous “anxious” “trembling”
79
What do beta blockers do with hypoglycemia?
mask/ block symptoms
80
Select 4 causes of DKA.
Sepsis , Sickness, Stress, Skip insulin
81
What is the 15:15 rule used for?
Treatment of hypoglycemia
82
With the 15:15 rule We are doing what? Select the answer in order.
Administer 15 grams of carbohydrate (or dextrose), Re-check in 15 minutes
83
What is the other condition not DM that we use insulin to treat?
Hyperkalemia
84
What BS reading and below are we administering D5 (dextrose)? Just the number.
49
85
True or false? If a Hyperkalemic patient receiving insulin becomes hypoglycemic we MUST give them dextrose?
True
86
True or false? With type 1 DM insulin and glucose are administered during procedures.
True
87
True or false? With type 2 DM Insulin may need to be given.
True
88
True or false? Infection or illness causes increase in hormone levels increasing glucose levels.
True
89
What is SO important with sick day management for DM?
Dehydration
90
Select the sick day management/ teaching for DM.
Continue insulin, Notify provider if BG over 240 cotinues after 2 doses of insuli, Follow meal plan, Check BG every 4hrs , Check urine ketones notify provider if elevated for over 24 hrs , Use otc wisely (sugar)
91
Why is metformin not used in the hospital?
High risk for kidney failure in dehydration and IV dye use.
92
True or false? Sulfonylureas and beta blockers mixed together can be bad because beta blockers mask the symptoms of hypoglycemia and can even block them.
True