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38 notecards = 10 pages (4 cards per page)

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Endocrine exam 4- final one!!!(:

front 1

which cells are responsible for insulin?

back 1

beta cells

front 2

exogenous insulin

back 2

  • insulin made outside of the body
  • provided by injections

front 3

endogenous insulin

back 3

  • insulin produced inside the body
  • body produces the insulin on its own

front 4

type 1 diabetes

back 4

  • insulin dependent; IDDM; juvenile diabetes
  • typically occurs before age 30
  • autoimmune
  • body depends on exogenous insulin
  • complications- diabetic ketoacidiosis

front 5

type 2 diabetes

back 5

  • non-insulin dependent; NIDDM; adult-onset diabetes
  • typically occurs after age 30
  • complications- hypersmolar nonketotic syndrome (HHNS)

front 6

gestational diabetes

back 6

only occurs with pregnancy

front 7

etiology & pathophysiology of diabetes mellitus

back 7

  • genetic factors
  • metabolic factors
  • mircoiologic factors

front 8

metabolic syndrome

back 8

  • hypertension
  • hyperglycemia
  • excess abdominal fat
  • elevated cholesterol and triglycerides

front 9

diabetes mellitus S/S

back 9

  • elevated blood glucose levels
  • fatigue/weakness
  • weight loss (type 1) or weight gain (type2)
  • prone to infection
  • delayed healing
  • vascular issues
  • polyuria
  • polyphagia

front 10

diagnosis for diabetes

back 10

  • screening (A&P)
  • hemoglobin a1c
  • fasting serum glucose
  • 2 hour 75-G oral glucose tolerance test (GTT)

front 11

hemoglobin a1c

-measurement (in percentage) of blood sugar over a 3 month/ 120 day period

back 11

  • normal - less than 5.7
  • pre diabetic- 5.7%-6.4%
  • diabetes- 6.5% and above

front 12

normal glucose range

back 12

70-100

front 13

diabetic ketoacidosis (DKA)

back 13

caused by incomplete metabolism of fats from absent or insufficient supply of insulin

  • body will break down proteins and fats for energy when there is not enough insulin
  • the byproducts of fat metabolism are ketones
  • ketones accumulate in the body creating an acidotic state

front 14

causes of DKA

back 14

  • infection
  • poor compliance
  • insulin pump failure

front 15

ketonuria

back 15

body will attempt to rid the body of acidosis by urinating ketones out

front 16

kussmauls respirations &fruity breath

back 16

body will increase respiratory rate in an attempt to release ketone bodies from the lungs

front 17

polyuria

back 17

kidneys exercise excess glucose and ketones as well as large qualities if water and electrolytes

front 18

DKA ketones are acidic and begin to accumulate in the blood and produce signs and symptoms

back 18

  • ketonuria
  • kussmauls respirations and fruity breath
  • polyuria
  • polydipsia
  • nausea/vomiting

front 19

DKA treatment and management

back 19

  • establish IV site, preferably two sites
  • IV fluids
  • NS,LR
  • IV insulin drip (regular insulin only)
  • continuous cardiac monitoring
  • treat nausea/vomiting
  • closely monitor blood glucose levels and BMP

front 20

factors associated with the development of DM type 2

back 20

  • older age
  • obesity
  • family history of DM2
  • history of gestational diabetes
  • physical inactivity
  • metabolic syndrome
  • HTTN
  • abdominal fat
  • elevated cholesterol and triglycerides

front 21

signs and symptoms of type 2 diabetes

back 21

  • excess weight gain
  • fatigue
  • polydipsia, polyuria, polyphagia
  • blurred vision
  • itching
  • tingling/numbness in feet

front 22

(HHNS) hyperglycemic hyperosmolar nonketotic syndrome

aka: hyperglycemia hyperosmolar state

back 22

occurs in clients with type 2 diabetes with high blood glucose levels due to illness, infection, stress

-glucose levels greater than 600 mg/dl are typical but can reach over 1000 mg/dl

front 23

(HHNS) hyperglycemic hyperosmolar nonkektoic syndrome treatment and management

back 23

  • focused on IV fluids replacement and correction of electrolyte imbalances
  • monitor lung sounds
  • monitor for edema
  • continuous cardiac monitoring
  • accurate I&O
  • treat underlying cause

front 24

gestational diabetes can occur due to what?

back 24

stress of pregnancy

- may be treated with diet, oral medications, or insulin (based on patient )

front 25

there is a chance the mother can be diagnosed with type 2 diabetes In the years following delivery, as can the baby.

(t/f)

back 25

true

front 26

short term complications of diabetes

back 26

  • hypoglycemia
  • hyperglycemia
  • somogyl effect (rebound hyperglycemia)
  • dawn phenomenon

front 27

hypoglycemia

back 27

decreases in blood sugar

  • <70 considered hypoglycemia
  • clients/ family members to be educated on S/S of hypoglycemia and how to treat it

front 28

causes of hypoglycemia

back 28

  • often a response to too much insulin or too much exercise in relation to the amount of food eaten
  • overdose of insulin
  • skipped or delayed meals
  • strenuous exercise
  • tumors of pancreas
  • alcohol abuse

front 29

hypoglycemia s/s

back 29

  • shaky
  • tremors
  • tachycardia
  • diaphoresis
  • weakness
  • confusion
  • nervousnesss
  • cool,clamy skin
  • headache

front 30

hyopglycemia management

back 30

  • modify eating patterns
  • smaller, more frequent meals
  • avoid simple sugars
  • diet high in proteins and low in carbohydrates
  • carbs should eb complex
  • carry snacks

front 31

hyperglycemia

back 31

elevation of blood sugar levels

front 32

causes of hyperglycemia

back 32

  • failure to take insulin
  • illness or infection
  • overeating
  • too many carbohydrates or simple carbs
  • severe stress
  • surgery, trauma, emotional

front 33

s/s of hyperglycemia

back 33

  • polydipsia
  • polyuria
  • polyphagia
  • dry mucous membranes
  • weakness

front 34

treatment for hyperglycemia

back 34

  • IV fluids
  • corrections of electrolyte imbalances
  • insulin (sub-q and iv)

front 35

Dawn phenomenon

back 35

elevated blood glucose levels in the morning

-caused by a release of growth hormone, glucagon, and epinephrine during the night

front 36

some long term diabetic complications

back 36

  • cardiovascular disease
  • peripheral vascular disease
  • nephropathy
  • retinopathy
  • diabetic neuropathy

front 37

retinopathy

back 37

changes in retina vessels lead to hemorrhage and retinal detachment

-visual impairment and blindness can occur

front 38

nephropathy

back 38

develops from changes in renal blood circulation