NR325 Exam 1 notes 2020/2021.
5Diabetes Mellitus Concept Map
Type 1- Insulin dependent (born with it)
Type 2 – Insulin Resistant (can be reversible)
Risk Factors: increased BMI, poor diet, HTN, decreased perfu
...
NR325 Exam 1 notes 2020/2021.
5Diabetes Mellitus Concept Map
Type 1- Insulin dependent (born with it)
Type 2 – Insulin Resistant (can be reversible)
Risk Factors: increased BMI, poor diet, HTN, decreased perfusion
Assessment: Polyuria, polydipsia, polyphagia, weight loss, fatigue
Complications: retinopathy, nephropathy (urine =30ml/hr, BUN, creatinine),
neuropathy, CVD—stroke, Slow wound healing (skin, wbc, temp)
Nursing Diagnosis: ineffective tissue perfusion, risk for ineffective wound
healing
Medications: insulin, oral meds
Labs and Diagnostic: FBS, A1C, urine,
o Fasting BG: 70-110 <126
o Postprandial BG (2hr) <200
o Random BG: <200
o HA1C: < 6.5 – gives 8-12 week average
o 2 hr plasma glucose: give pt sugar and check blood 60 min-2 hrs later
to make sure it’s getting insulin and being used correctly
Nursing Interventions: monitor diet [stay away from simple carbs], exercise,
specialists (eye doc), walking
o When exercising make sure to check BG before, during and after,
especially when starting a new regimen
o Monitor skin integrity, especially feet
o No lotion between toes
Make sure you know the different types of Insulin
Know Onset, peak, duration
Rapid Acting: lispro, aspart, glulsine
o Onset: 10-30min
o Peak: 30min-3hr
o Duration 3-5 hr
Short Acting: Regular Humulin R, Novolin
o Onset: 30min-1hr
o Peak: 2-5 hr
o Duration: 5-8 hr
Intermediate: NPH Humulin R, Novalin
o Onset: 1.5-4hr
o Peak 4-12 hr
o Duration 12-18 hr
Long Acting: glargine, determir
o Onset: 0.8-4hr
o Peak: no pronounced peak
o Duration: 24+ hr
Hypoglycemia: Cold, Clammy, changes in LOC
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