This reviewer provides a comprehensive overview of disorders of the pancreas, tailored for nursing students preparing for their medical-surgical nursing finals. It covers essential concepts, clinical manifestations, diagnostic procedures, and nursing management strategies.
Chronic disorder of impaired DM can lead to chronic health problem
carbohydrates, protein and lipid and early death as a result of
metabolism caused by a deficiency of complication that occur in a large and
insulin. small blood vessels in the tissues and
regulate the blood glucose levels organs
hyperglycemia (no control of blood
sugar) decreased insulin
MACROVASCULAR COMPLICATIONS
INCLUDES:
2 TYPES OF DIABETES MELLITUS 1. Coronary artery disease
1. Type 1 Diabetes Mellitus (IDDM) - Narrowing/blockage of coronary
- Nearly absolute deficiency of insulin arteries
(primarily of BETA CELLS - The blood vessels that supply
destruction) oxygenated blood to the heart
- If insulin is not given , fats are muscle due to narrowing and
metabolized for energy resulting in blockage can lead to ischemia
KETONEMIA (acidosis)(excessive (inadequate blood supply to the
use of fats) diabetic ketoacidosis heart muscle)
progression of type 1 DM 2. Cardiomyopathy
- “insulin dependent” - Cardio heart
2. Type II Diabetes Mellitus - Myo muscle
- Relative lack of insulin or resistance - Pathy death
to the action of insulin - Weakening of the heart muscle
- If insulin is sufficient it can only 3. Hypertension
stabilized fat and protein but not 4. – pulmonary artery
carbohydrates metabolism 5. Cerebrovascular disease
3. Metabolic syndrome - Stroke
- AKA “syndrome x” - ICP
- Individual has coexisting risk factor - MRI/CT Scan diagnostic
for developing type 2 diabetes procedure to identify emboli –
mellitus thrombus – hemorrhage
- Coexisting disease 6. Peripheral vascular disease
- Necrosis development of
gangrene (distal part, most
RISK FACTORS common in lower extremities)
- PAOD (peripheral arterial occlusive
Abdominal obesity disease) diagnosis for gangrene
Hyperglycemia - AVPS (arteriovenous duplex scan)
Hypertension if not controlled DM Use to see the extent of the
High triglycerides level occlusive in the affected part
Lowered HDL (high density lipoprotein) each part is last up to 2 to 4
- Lipid Profile hrs.
LDL, HDL & Triglycerides from groin to the ankle if lower
Contributing factors that extremities.
progress to DM Decreased HDL
, No special preparation needed focuses on the total grams of CHO
but need consent eaten per meal
Ask the doctor if bilateral of - Keto diet – meat centered
single leg only. carbohydrate
d. Diet must be incorporated into
MICROVASCULAR COMPLICATION individual client needs; lifestyle,
INCLUDES: cultural and socio-economic patterns
RETINOPATHY
NEPHROPATHY DIABETES MELLITUS – EXERCISE
NEUROPATHY
Lowers blood sugar level, encourage
weigh loss, reduces cardiovascular
Infection is also concern because of risk, improves circulation and muscle
reduced wound healing ability tone.
(especially in distal part) Instruct the client in diet adjustments
when exercising.
Male erectile dysfunctions (prob. In if the client requires extra food during
blood) can also occur as a result of the exercise to prevent hypoglycemia, it
disease need not to be deducted from the
regular meal plan.
If the blood glucose level is higher than
DIABETES MELLITUS ASSESSMENT 250mg/dL (14.2 mmol/L) and urinary
ketones (IDDM) are present, the client
Polyuria (excessive urine), polydipsia is instructed not to exercise until the
(excessive thirst), polyphagia blood glucose level is closer to normal
(excessive hunger/appetite) most and urinary ketones are absent.
common in IDDM The client should try to exercise at the
Polyneuropathy – not only in one same time each day and should
extremities are numb, all parts are exercise when glucose from the meal
numb is peaking, not when insulin or
Hyperglycemia glucose-lowering medications are
Weight loss (common in IDDM, rare in peaking.
NIDDM) Instruct the client to monitor blood
Blurred vision glucose level before, during and after
Slow wound healing exercising.
Vaginal infections (because of
polyuria) UTI candidiasis (yeast
infection) DIABETES MELLITUS - ORAL
Weakness and paresthesia HYPOGLYCEMIC MEDICATIONS (OHA)
Signs of inadequate circulation of the
feet Dapat hindi nag iinject ng insulin sa
ineexcercise na part ng katawan kasi
pag ininject ang insulin dun it will
DM DIET increase the insulin absorption
Oral Hypoglycemic Agents are
a. A client diet should take into account
prescribed for clients with Diabetes
weight (obesity – major risk factor),
Type 2 when diet and weight control
medications (steroid - increases
therapy have failed to maintain
glucose level), activity levels, and
satisfactory blood glucose level.
other health problems
Weigh control therapy
b. Day-to-day consistency in timing and
amount of food intake helps to control - Exercise and diet will follow
the blood glucose levels. Laboratory
c. Carbohydrate counting may be a
simpler approach for some clients, it
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