DM

Question 1

DM1

Answer 1

lack of insulin

Question 2

DM2

Answer 2

insulin resistance

Question 3

DM1 Tx

Answer 3

(if you dont treat they will DIE)

• Diet (least imp)
• Insulin (most important)
• Exercise

Question 4

DM2 Tx

Answer 4

(they are DOA)

• Diet (most imp)
• Oral hypoglycemic
• Activity

Question 5

Primary Tx DM2

Answer 5

calorie restriction - divide meals into 6 feedings/day

Question 6

S/S of DM

Answer 6

polyuria (pee a lot)
polydipsia (thirsty)
polyphagia (eat a lot/swallow)

Question 7

Regular Insulin

Answer 7

clear solution, IV drip

- 1-2-4

Question 8

NPH

Answer 8

intermediate insulin

• it is cloudy
• suspension—it precipitates—can’t give IV drip
• N = not so fast, not in the bag
• 6-8-10-12

Question 9

Lispro (Humalog)

Answer 9

• give WITH the meal
• fastest
  15: 30:3

Question 10

Glargine (lantus)

Answer 10

• long-acting insulin
• no peak
• duration 12-24 hours
• only one you can give safely at bedtime

Question 11

Expiration dates

Answer 11

• opening package invalidates manufactures date

- once open, exp. date is 30 days after

Question 12

Excercise

Answer 12

• exercise potentiates insulin action

- like another shot of insulin

Question 13

Sick days

Answer 13

serum glucose goes UP
need insulin even when eating
sips of water
- two problems: hyperglycemia and dehydration

Question 14

hypoglycemia causes

Answer 14

not enough food
too much insulin
too much exercise

Question 15

s/s of hypogylcemia

Answer 15

think drunk pt in shock
- staggering gait 
- slurred speech
- cerebral impairment (labile)
- slow reaction time
- decrease social inhibition
shock
- tachycardia, tachypnea, low bp 
- cold/clammy mottled skin

Question 16

treatment of hypoglycemia

Answer 16

• give pt sugars/ juice/ soda

- sugar + starch or protein

Question 17

causes of DKA

Answer 17

• too much food
• not enough insulin
• not enough exercise
• acute viral upper respiratory infection within last 2 weeks #1 cause

Question 18

s/s of DKA

Answer 18

Dehydration
Ketones in serum, Kussmals, High K+
Acidosis, Acetone breath, Anorexia r/t NV

Question 19

Treatment of DKA

Answer 19

Regular insulin IV

IV fluid 200ml/hr

Question 20

DKA

Answer 20

high glucose in type 1

Question 21

HHNK or HHS or HHNS

Answer 21

high BS in type 2

• don’t burn ketones, no acid
• think DEHYDRATION

Question 22

1 Tx for HHNK

Answer 22

rehydration

Question 23

higher priority? dka or hhnk?

Answer 23

HHNK–> DKA easily responds to insulin