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NCLEX Review & Nursing School

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(Diabetes would be a big topic in the NCLEX)

Remember that:

  • Glucagon-  Increases blood sugar.
  • Insulin- decreases the blood sugar.

Classes:

  • Type 1 and Type 2
  • Gestational

HYPERGLYCEMIA  (3 P’s)

  • Polyuria (excess urination)
  • Polydipsia (excess thirst)
  • Polyphagia (excess eating)

Complications of Diabetes:

  • DKA
    HHNC

DKA

It is also called Diabetec ketoacidosis

It is usually a complication of Type 1 Diabetes

SYMPTOMS

  • Polydipsia
  • Polyuria
  • Dehydration (flushed poor skin turgor)
  • Tachypnea
  • Kassmaul’s Breathing (acetone breath)
  • Nausea & Vomiting
  • Hypovolemia

LAB Values

Blood Glucose: 300- 800 mg/ dl

pH: less than 7.30

Ketones in Blood and Urine

Treatment:

Fluids, Insulin, Potassium

* Make sure to administer regular insulin intravenously)

HHNC

Usually a complication of Type 2 Diabetes

There is no ketoacidosis, because of some circulating insulin in the body.

SYMPTOMS:

  • Weakness
  • Fatigue
  • Flushed Skin/ Dry mucus
  • Blood Sugar: 600-3,000 mg/dl
  • Lack of ketosis

Treatments:

  • Fluids, Insulin, Pottasium
  • D51/2 NS
  • Insulin

Chronic Complications of Diabetes Mellitus

Microvascular:

  • retinopathy
  • nepropathy
  • neuropathy

Macrovascular

  • CAD
  • PVD (Diabetic feet)
  • Hyperlipidemia
  • Hypertension

Screening for Diabetes Mellitus:

  • Testing:
  • Fasting Blood Sugar
  • GTT at 2 hrs is greater than 200
  • HbA1c

Complications Insulin Treatment

HYPOGLYCEMIA

Smoygi Effect:

  • A rebound Hyperglcemia
  • Treatment: Decrease the insulin and give Evening Snack

A situation can include:

3 a.m. pt. glucose level is normal

6- 7 a.m suddenly the glucose is elevated

Treatment: Give insulin later at 10 pm

Bed time Snack

Dawn Phenomenon:

  • An early AM hyperglycemia
  • Treatment: Add 10 PM Intermediate Insulin

 

♣ TREATMENT FOR DIABETES MELLITUS

Goal: Blood Sugar 60-150 mg/dl

No Ketonuria

Types of Meds:

  1. Insulin
  2. Sulfonylureas (Used to Control Blood Glucose)

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