Daiane Shared "NUR 113 Test 5 Cell Regulation" - 43 Picmonics
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NUR 113 Test 5 Cell Regulation
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
Hyperosmolar Hyperglycemic State
- Characteristics
- Insulin Present
- Increased Serum Osmolality
- Glucose >600 mg/dL
- No Significant Acidosis or Ketosis
- Clinical Features
- Severe Dehydration
- Altered Neurological Status
- Tachycardia and Hypotension
- Management
- IV Fluids
- Insulin
- Treat Underlying Disorder
3 mins
Diabetic Ketoacidosis (DKA) Signs and Symptoms
- Kussmaul respirations
- Dehydration
- Abdominal Pain
- Nausea/vomiting
- Psychosis
- Fruity breath Odor
1 min
Diabetic Ketoacidosis (DKA) Diagnosis and Labs
- Diagnosis
- Blood glucose Increased > 250 mg/dL
- Anion gap metabolic acidosis
- Decreased pH < 7.3
- Decreased serum bicarbonate < 18
- Plasma ketones
- Other Labs
- Hyperkalemia
1 min
Diabetic Ketoacidosis (DKA) Treatment
- Initial Management
- IV Normal Saline
- Regular Insulin Drip
- Subsequent Management (correction of electrolytes)
- Potassium (K+)
- Glucose
- Treat Underlying Cause
- Monitoring
- Venous pH
- Serum Bicarbonate (HCO3)
1 min
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
2 mins
Pregnant Diabetic Patient Interventions
- First Trimester
- Increase Insulin then Decrease
- Metformin
- Nutrition
- Exercise
- Second Trimester
- Increase Insulin
- More Likely to Develop Hypoglycemia than Hyperglycemia
- Third Trimester
- Double or Quadruple Insulin
- Early Delivery
- Postpartum
- Drastically Decrease Insulin
- Monitor Neonate for Hypoglycemia
3 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
Metabolic Syndrome
- Assessment
- Dyslipidemia
- Central Obesity
- Insulin Resistance
- Hypertension
- Increased C-Reactive Protein (CRP)
- Increased Fibrinogen
- Considerations
- Increased Risk Cardiovascular Disease
1 min
Hyperglycemia
- Mechanism
- Insulin Resistance
- Too Little Insulin/Medication
- Infection/Illness
- Corticosteroids
- Assessment
- Elevated Blood Glucose
- Polyphagia
- Polydipsia
- Polyuria
- Hypotension
- Fatigue/Drowsiness
1 min
Hypoglycemia Assessment
- Mechanism
- Too much insulin
- Decreased glucose
- Assessment
- < 70 mg/dL
- Change in LOC
- Lethargic
- Confusion and Irritability
- Tremors
- Diaphoresis
- Tachycardia
- Vision Changes
- Weakness
- Seizures
2 mins
Hypoglycemia Intervention
- Interventions
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Considerations
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Patient Education
- Hypoglycemia Prevention
- Encourage Self-Monitoring
3 mins
Insulin
- Rapid Acting
- Insulin Lispro (Humalog)
- Insulin Aspart (Novolog)
- Insulin Glulisine (Apidra)
- Short Acting
- Regular Insulin (Humulin R)
- Intermediate Acting
- Isophane NPH (Humulin N)
- Long Acting
- Detemir (Levemir)
- Glargine (Lantus)
2 mins
Mixing NPH and Regular Insulin for Injection
- Verify Order
- Roll NPH Insulin
- Alcohol to Multiuse Vials
- Inject Air into NPH Insulin (Cloudy)
- Inject Air into Regular Insulin (Clear)
- Withdraw Regular Insulin Units
- Withdraw NPH Units
- Verify with 2nd Nurse
- Discard if Error
3 mins
Metformin (Glucophage)
- Mechanism
- Decrease Glucose Production
- Increase Insulin Sensitivity
- Indications
- Type 2 Diabetes
- Polycystic Ovary Syndrome (PCOS)
- Side Effects
- GI Distress
- Decreased Appetite
- Lactic Acidosis
- Considerations
- IV Contrast
- Limit Alcohol Consumption
2 mins
Chlorpropamide and Tolbutamide (Orinase) (1st Generation Sulfonylureas)
- Mechanisms
- 1st Generation Sulfonylureas
- Stimulate Release of Insulin
- Indications
- Type 2 Diabetes
- Side Effects
- Hypoglycemia
- Possible Cardiovascular Toxicity
- Weight Gain
- Considerations
- Exacerbated Hypoglycemia with Beta-blockers
- Avoid During Pregnancy and Breast Feeding
- Avoid Alcohol
2 mins
Glyburide and Glipizide (2nd Generation Sulfonylureas)
- Mechanisms
- 2nd Generation Sulfonylureas
- Blocks Potassium Channels in Beta Cells
- Stimulate Release of Insulin
- Indications
- Type 2 Diabetes
- Side Effects
- Hypoglycemia
- Considerations
- More Potent
- Beta Blockers Reduce Effects
- Avoid Alcohol
- Avoid Breastfeeding
2 mins
Pioglitazone (Thiazolidinediones)
- -glitazones Suffix
- Mechanism
- Binds PPAR-Gamma
- Decreases Insulin Resistance
- Indications
- Type 2 Diabetes
- Side Effects
- Weight Gain
- Heart Failure
- Myalgia
- Hypoglycemia
- Upper Respiratory Infection
- Considerations
- Increased Risk of Bladder Cancer
- Increased Fracture Risk in Women
- Monitor Liver Enzymes
2 mins
Acarbose (Precose) and Miglitol (Glyset) (Alpha Glucosidase Inhibitors)
- Mechanisms
- Alpha Glucosidase Inhibitors
- Delays Absorption of Carbohydrates
- Indications
- Type 2 Diabetes
- Side Effects
- Flatulence
- Diarrhea
- Anemia
- Cramps
- Considerations
- Monitor LFTs
- Oral Glucose for Hypoglycemia
2 mins
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