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Med surg chapter 20; nursing care of patients with diabetes mellitus

Terms in this set (22)

diabetes
a disease resulting in hyperglycemia from defects in secretion of insulin, action of insulin, or both
type 1
type of diabetes that is characterized by a total deficit of circulating insulin (10%)
type 2
type of diabetes that is characterized by insulin resistance (95%)
insulin
secreted by beta cells

hormone that is needed to convert sugar, starches and other food into energy needed for daily life
pancreas hormones (islets of langerhans)
alpha cells
beta cells
delta cells
type 1 diabetes
IDDM; juvenile

destruction of pancreatic beta cells

pancrease secretes NO insulin
alpha cells
produce glucagon to increase blood glucose levels

initiated in most people when blood glucose falls below 70 mg/dl
beta cells
secrete insulinn to decrease blood glucose

the release is regulated by what glucose levels
delta cells
produces hormone somatostatin, that inhibits glucagon and insulin
type 2 diabetes
NIDDM, adult

90% of diabetes cases

LARGE genetic component

decreased beta cell responsiveness to glucose

largest risk factor is obesity
.
ALL patients with diabetes experience hyperglycemia

the S/S of hyperglycemia are the 3 Ps: polyuria, polydipsia, polyphagia

-increase urine output
-increased thirst
-increased hunger
..
Diagnostics: casual or non fasting blood glucose, fasting blood glucose, or oral glucose tolerance test
casual or non fasting blood glucose
sample taken without regard to caloric intake
glucose > 200
fasting blood glucose
no caloric intake for 8 hours
glucose > 126
oral glucose tolerance test
high glucose drink ingested, blood draw 2 hours later
glucose > 200
glycosylated hemoglobin
blood tests that reflects the average blood glucose levels over the last 2-3 months

when blood glucose is high, glucose molecules bind to hemoglobin

normal should be under 7%
hypoglycemia
blood sugar < 60

causes: too much insulin, not enough food

S:S/ headache, hunger, sweating, tremor
diabetic ketoacidosis (DKA)
PATHO: absence of insulin, cells starving, fat breaks down, the byproduct of fat is ketones, ketones are acidic which causes metabolic acidosis, causes coma and death if left untreated
DKA
FRUITY BREATH, symptoms of hyperglycemia, and kussmauls respirations (deep and labored) are signs that blood sugar is extremely high
.
ALWAYS check ketones if BS is > 300

drink lots of fluids because odds are they are dehydrated too
hyperglycemic hyperosmolar nonketonic syndrome
condition in which blood sugar levels rise and the body tries to compensate by getting rid of the glucose in the urine

blood glucose levels about 600 (no ketones present)
...
INSPECT FEET DAILY IN DIABETIC PTS

wash and dry feet daily
wear well fitted soes
protect feet from injury
THIS SET IS OFTEN IN FOLDERS WITH...