Chapter 64: Care of Patients with Diabetes Mellitus

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Care of Patients with Diabetes Mellitus
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1

Diabetes Mellitus (DM)

Poor glucose regulation

2

Hyperlipidemia

High blood lipid levels

3

Hyperglycemia

High blood glucose level

4

Hypoglycemia

Low blood glucose levels

5

Glucagon

A “counterregulatory” hormone that has actions opposite those of insulin

6

Glycogenesis

The production and storage of glycogen

7

Glycogenolysis

Inhibits glycogen breakdown into glucose

8

Ketogenesis

Conversion of fats to acids

9

Gluconeogenesis

Conversion of proteins to glucose

10

Fasting State

Not eating for 8 hours

11

Lipolysis

Fat breakdown

12

Proteolysis

Protein breakdown

13

Polyuria

Frequent and excessive urinatioN

14

Diuresis

Electrolytes are excreted in the urine and water loss is severe

15

Polydipsia

Excessive thirst

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Polyphagia

Excessive eating

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Ketone Bodies or “Ketones”

Are abnormal breakdown products that collect in the blood when insulin is not available, leading to a type of metabolic acidosis

18

Hemoconcentration

Increased blood concentration

19

Hypovolemia

Decreased blood volume

20

Hypoxia

Poor tissue oxygenation

21

Kussmaul Respiration

Acetone is exhaled, giving the breath a “rotting fruit” odor

22

Hypokalemia

Low serum potassium levels

23

Hyperkalemia

High serum potassium levels

24

Diabetic Ketoacidosis (DKA)

Lack of insulin and ketosis

25

Hyperglycemic-Hyperosmolar State (HHS)

Insulin deficiency and profound dehydration

26

Hypoglycemia Complications

Too much insulin or too little glucose

27

Macrovascular)

Large blood vessels in tissues and organs

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Microvascular

Small blood vessels in tissues and organs

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Nephropathy

Kidney dysfunction

30

Neuropathy

Nerve dysfunction

31

Retinopathy

Vision problems

32

Chronic Hyperglycemia

Thickens basement membranes, which causes organ damage

33

Glucose Toxicity

Directly or indirectly affects functional cell integrity

34

Chronic Ischemia

Causes connective tissue hypoxia and microischemia

35

Albuminuria

Presence of albumin in the urine

36

Proliferative Diabetic Retinopathy

The growth of new retinal blood vessels, also known as “neovascularization"

37

Diabetic Peripheral Neuropathy (DPN)

A progressive deterioration of nerve function that results in loss of sensory perception

38

Diffuse Neuropathies

Most common, involves widespread nerve function loss and sensory perception loss, the onset is slow, affects both sides of the body, involves motor and sensory nerves, progresses slowly, is permanent, and includes autonomic nerve dysfunction.

39

Focal Neuropathies

Affects a single nerve or nerve group and usually are caused by an acute ischemic event that leads to damage or death, occur when the blood supply to a nerve or nerve group is disrupted.

40

Cardiovascular Autonomic Neuropathy (CAN)

Affects sympathetic and parasympathetic nerves to the heart and blood vessels.

41

Orthostatic Hypotension

Postural hypotension

42

Syncope

Brief loss of consciousness on standing

43

Autonomic Neuropathy

Affects the entire GI system`

44

Gastroparesis

Delay in gastric emptying

45

Microalbuminuria

Small amounts of albumin in the urine

46

Type I Diabetes Mellitus

...

47

Type II Diabetes Mellitus

...