Whittney Shared "DM" - 12 Picmonics

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DM

Hypokalemia
Assessment
< 3.5 mEq/L
Muscle Weakness
Arrhythmia
U Wave
Ileus
Hyporeflexia
Interventions
IV K+ Infusion at 5-10 mEq/hr
Give Orally with Food
Nursing Considerations
Monitor Respiratory Status
3 mins
Type 1 Diabetes
Commonly develops in childhood
Insulin
HLA DR3 and DR4 polymorphism on chromosome 6
Late manifestation of symptoms
T -cell mediated pancreatic beta-cell injury
Autoantibody to insulin, GAD and ICA512
Type 1 diabetes triad
Diabetes Interventions
Early Diagnosis
Insulin
Oral Hypoglycemics
Glucose Monitoring
Routine Exercise
Diabetic Diet
Monitor for Complications
Insulin Therapy
Diabetic Ketoacidosis (DKA)
2 mins
Dawn Phenomenon
Cause/Mechanism
Increased Hormone Production
Assessment
Hyperglycemia Upon Awakening
Interventions
Long-Acting Evening Insulin
Change Administration Times
Insulin Pump
Considerations
Closely Monitor Glucose Levels
Between 2-6AM
Limit Carbohydrates Before Bedtime
2 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
2 mins
Diabetes Education
Self-Monitoring (Blood Glucose)
SubQ Injection Technique
Lifestyle Changes
Symptoms of Hyperglycemia and Hypoglycemia
Sick Day Care
Foot Care
Exercise Therapy
Medication
1 min
Diabetes Insipidus Assessment
Polyuria
Nocturia
Low Specific Gravity (USG)
Polydipsia
Dehydration
Hypotension
Tachycardia
Confusion
2 mins
Metabolic Syndrome
Assessment
Dyslipidemia
Central Obesity
Insulin Resistance
Hypertension
Increased C-Reactive Protein (CRP)
Increased Fibrinogen
Considerations
Increased Risk Cardiovascular Disease
1 min
Diabetes Insipidus
Excess urinary loss of water
Deficiency/insensitivity to vasopressin
Hypernatremia
Low urinary sodium excretion
Treat with desmopressin
Patient should drink to thirst
Chronic Complication of Diabetes
Advanced glycation end products
Increased VEGF, TFG-beta and smooth muscle
AGEs crosslink ECM proteins
Albumin
Activation of protein kinase C
Oxidative stress
Cataract
Fructose-6-phosphate
Procoagulant effect
Diabetic Nephropathy
Visual impairment
Diabetic neuropathy
Enhanced susceptibility to infections
Anti-Diabetic Drugs
Sulphonylureas
Glyburide and Glipizide (2nd Generation Sulfonylureas)
Glibendamide
Glimepiride
Meglitinides
Repaglinide and Nateglinide (Meglitinides)
Biguanides
Metformin
a-Glucosidase inhibitors
Pioglitazone (Thiazolidinediones)
Glucagon
Delta cells release Somatostatin
Glucagon-like peptide-1
Sitagliptin (Januvia) and Saxagliptin (Onglyza) (DPP-4 Inhibitors)
Hyperglycemic Hyperosmolar State
Insufficient insulin
Dehydration
Mostly Type 2 Diabetes
Mortality highest in elderly
Insidious development
Neurologic defects
Hypotension
Hypernatremia
Treat with water, potassium

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