NCLEX Review & Nursing School

(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)