NR 325 exam 1
- Encourage oral fluid intake of sugar free fluids to prevent dehydration
- administer insulin
- restrict exercise when glucose levels greater than 250 MG/DL
- test urine for key tones/report if outside expected range
- consult provider if manifestations progress
- encourage client to wear medical ID
-oral hypoglycemics - ANS-Hyperglycemia management
-Muscular weakness and fatigue
-Dark pigmentation of skin
-hypoglycemic
-postural hypotension
-hyponatremia, *hyperkalemia
-GI disturbances and anorexia - ANS-addison's disease s/s
-Target: kidneys
-Effect: stimulates reabsorption of sodium in the kidneys; increases blood pressure and blood
volume - ANS-Mineralcorticoids (aldosterone)
"salt-retaining hormone" which promotes the retention of Na+ by the kidneys. na+ retention
promotes water retention, which promotes a higher blood volume and pressure -
ANS-Aldosterone
<100 mg/dL - ANS-normal FPG
<140 mg/dL - ANS-OGTT normal
<270 mOsm/L - ANS-Serum osmolality in SIADH
<5.7% - ANS-hemoglobin Alc normal
<70 mg/dL - ANS-hypoglycemia
>126 mg/dL - ANS-Diabetes FPG
, >140 mg/dL - ANS-hyperglycemia
>200 mg/dL - ANS-OGTT diabetes
>6.5% - ANS-hemoglobin Alc diabetes
0.5-3 hours - ANS-rapid acting insulin peak
0.6-1.2 - ANS-Creatinine
1-4 hours - ANS-long acting insulin onset
1. diet
- protein, fats, carbs, fiver, sweeteners, fat re placers,
- DM diet: eat in moderation except protein reduced in renal patients
- plate method: 50% veggie, 25% starch, 25% protein (9 inch plate)
2. meds
- different med regimen for different needs
- only regular in IV
- bolus: rapid (0-15..must have lunch nearby)
- basal: intermediate, long (lantus) ---> concern about when it is going to drop
- combo
- diuretics alter effect of insulin bc of K loss
EDU: once open, insulin good for one week
3. exercise - goal = control glucose + rebuild receptors = reduce level of insulin needed
- ideally exercise 1 hr after meals
- always carry ketone strips and glucose tablets, wear ID bracelet
- frequency = 3 x week
- intensity - 60-80% of max HR
- time = 20-30 min aerobics w/5-10 min warm-up
- monitor sugar levels when exercising
- start with small snack, recheck sugar 15-20 min later ----- sugar > 100 is OK to exercis -
ANS-triangle of diabetes management
1. inject long-lasting insulin w/ air
2. inject regular insulin w/ air
3. draw up regular insulin
4. draw up long-lasting insulin - ANS-mixing insulin
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