Exam 2 martrix .docx - Individuals 2 Exam 2 Disease...

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Individuals 2 Exam 2 Disease: Diabetes Mellitus 12-15Qs 1. Pathophysiology and etiology a. Type 1- juvenile onset or insulin dependent, an autoimmune destruction of the pancreatic B cells absence of insulin production b. Type 2- adult onset, non insulin dependent i. Risk factors- obesity, being older and having family history of it ii. Insulin is produced but its either insufficient or is poorly used iii. Insulin Resistance- a condition where body tissue does not respond to the action of insulin bc insulin receptors are unresponsive or insufficient in number or both 2. Nursing assessment a. Type 1- polyuria, polydipsia, and polyphagia, wt. loss, fatigue, • Ketoacidosis (complication) – most common in those with untreated DM I b. Type 2- Often non specific, may experience type 1 symptoms- polyuria, polydipsia, and polyphagia, vaginal yeast or candidal infection, prolonged wound healing, visual changes 3. Diagnostics tests a. A1C of 6.5% or higher, provides for the last 2-3 months b. Fasting plasma glucose (FPG) level greater or equal to 126 mg/dL, no calorie intake for the last 6 hours c. Two hour palsma glucose level greater than or equal to 200 mg/dL d. If pt. with classic symp of polyuria, polydipsia, and wt loss, or random plasma glucose greater than or equal to 200 mg/dL 4. Self-health management: Nutrition, activity, self-monitoring, , discharge teaching a. Nutrition i. Carbs - 130 g/day, from fruits, vegetables, whole grains and legumes, and low fat milk ii. Fiber 25-30 g/day, iii. Proteins 15-20%, high proteins are not recommended for weight loss iv. Fat <7%, trans fat should be minimal, dietary cholesterol <200 mg/day v. nonnutritive sweeteners are safe when consumed vi. 2 servings of fish per week vii. limit alcohol to 1 drink for women and 2 for man b. Exercise - at least 30 min of moderate-intense 5 days a week i. Exercise decrease insulin resistance and can lower glucose level (wt loss further decreases insulin resistance) ii. Exercise 1 hr after meal or have a 10-15 g carb snack and check their blood glucose before, and eat a snack every 30 min to prevent hypoglycemia iii. Resistance training 3x/week iv. Glucose lowering effects from exercise can last up to 48 hrs hypoglycemia can occur long after activity 5. Complications (r/t disease, diagnostic tests and treatment) a. Diabetic ketoacidosis- DKA caused by insulin insufficiency i. Mostly happens in type 1
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Individuals 2 Exam 2 ii. Characterized by hyperglycemia, ketosis, acidosis and dehydration, poor skin turgor, dry mucous membranes, tachycardia, and orthostatic hypotension. Early S&S lethargy and weakness, rapid deep breathing, nausea, vomiting, anorexia iii. The body compensates by breaking down fat for fuel iv. Ketones are acid by-products of mat metabolism that can cause serious problems, it alters pH balance metabolic acidosis v. Vomiting causes F&E losses b. Hyperosmolar Hyperglycemic syndrome- pt. is able to produce enough insulin to prevent DKA but not enough to prevent hyperglycemia, osmotic diuresis, and extracellular fluid depletion i.
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  • Spring '14
  • KelleyL.Lardy
  • Nursing

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