Nursing Care of Patients with Diabetes Mellitus Nursing 1118

Diabetes MellitusPathophysiology Diabetes

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Statistics of Diabetes Mellitus?
-Prevalence- Approximately 1.3 million new cases of DM are diagnosed each year in the United States. Estimated 18.2 million people have the disease. 13 million have been diagnosed and an estimated 5.2 million are undiagnosed.-Chronic Disease - requires continuing medical supervision and client self-care education.
What are the Endrocrine Hormones involved in Diabetes?
-Alpha Cells-Beta Cells -Basal -Prandial
Describe Type I (IDDM) ?
-Onset at early age-Hyperglycemia & Ketosis-Destruction of beta cells -Genetic predisposition -Environmental factor -
Describe Type I Diabetes Pathophysiology?
-Lack of insulin (pathophysiology) -Serum hyperglycermia -Serum hyperosmolality
What are classic signs of Type 1 DM?
-Polyuria - excessive urine output-Polydipsia - displays excessive thirst-Polyphagia - eating excess
What is the pathophysiology of Type 2 diabetes?
Pathophysiology-Insulin resistance/insulin deficiency-Increased Hepatic glucose production-Decreased insulin level-Decreased Incretin level
What are the signs and symptoms of Type 2 diabetes?
Signs and Symptoms: -Polyuria - excessive urine output -Polydipsia - displays of excessive thirst -No polyphagia or weight loss -Blurred vision -Fatigue -Paresthesias -Skin infections
What are some indicators of DM in the Elderly?
-Orthostatic hypotension-Periodontal disease-Infections-Stroke-Gastroparesis (hypotony)-Impotence -Neuropathy-Confusion
What are the other types of Diabetes?
-Injury/ disease of the pancreas-Gestational diabetes-Secondary diabetes -Steroid-induced diabetes
What are the diagnostic screening tests?
-Normal fasting blood glucose 70-100mg/dL -Symptoms + random blood glucose > 200 mg/dL -Fasting blood sugar > 126 mg/dL -Two-hour blood glucose > 200 mg/dL (during Oral Glucose Tolerance Test (OGTT)
What is pre-diabetes?
Blood sugars are higher than normal and will become Type 2 diabetes in 10 years or less.
What is the Lab/Diagnostic Tests for HgBA1C (normal 4-7%)
Average glucose mg/dL HgbA1C (%)-360 14-330 13-300 12-270 11-240 10-210 9-180 8-150 7-120 6-90 5
What are some tests for Monitoring of DM?
-Bedside monitoring - RMG-Urine glucose & ketones-Creatinine & BUN-Albuminuria-24 hour creatinine clearance-Serum cholesterol & triglycerides-Serum electrolytes -
What is Pharmacology of Rapid acting Insulin?
Insulin-Control of Hyperglycemia Patient who need insulin-Sources of insulin-Insulin preparations-Rapid acting: Insulin: Lispro (Humalog), Insulin Aspart (Novolog), Insulin gluisine (Apidra)-Onset _________,Peak_________Duration_________--
What is the Pharmacology of Short acting Regular Insulin?
Novolin-R, Humulin-R-Onset _________,Peak_________,Duration________