Exam (elaborations)
NURS 5336-Family 3- Final Exam
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NURS 5336-Family 3- Final Exam
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NURS 5336-Family 3- Final Examcriteria for diagnosis of type 2 diabetes?
hgba1c and fpg - ANSWER Hgb A1C of 6.5 or above
FPG of 126 and above
criteria for diagnosis of pre-diabetes? - ANSWER Hgb A1C of 5.7-6.4%
FPG of 100-126
criteria for a healthy individual w/o diabetes? - ANSWER Hgb A1C of below 5.6
FPG of 99 and below
best screen for diabetic nephropathy? - ANSWER Microalbuminuria
small level of protein leaking into the urine
Anything greater than 30 is abnormal (high)
True or False. You will manage your patients more so based off of their A1c rather
than their FPG. - ANSWER True
Postprandial hyperglycemia - ANSWER - significant contributor to A1c levels, lower
end of A1c
- A1c of 7.3% - 9.2%: pp glucose accounts for 50% of this number
- Alc < 7.3%: pp glucose accounts for 70% of number
- A1c of 6.8%: look closely at reducing pp glucose
most common presentation of T2DM pt? - ANSWER overweight pt w/ insidious
onset hyperglycemia
Lab results - ANSWER - Alc if results not available within past 3 months
- Alc if not performed/available within past yr
- fasting lipids, complete panel
- spot urine albumin to creatinine ration
- serum creatinine, eGFR, LFT, CMP
Referral - ANSWER - initial diagnosis and annual dilated retinal eye exam
- family planning for women of childbearing age
- registered dietician
- DSME & DSMS for diabetes self management
- dentist
- podiatrist
- mental health profession
Vaccine recommendation - ANSWER - COVD 19
- TDAP
- flu
- HEp
- RZV
, - pneumonia
ADA guidelines - ANSWER - A1c <7.0
- FBG: 80-130 mg/dL
- peak pp < 180 mg/dL
AACE guidelines - ANSWER - A1c < 6.5
- FBG < 110
- Peak pp< 140
anti-diabetic drugs have an indication for CVD prevention? - ANSWER GLP-1
inhibitors
SGLT-2
Metformin: You will pretty much always start someone on Metformin as the first
monotherapy for someone who has a Hgb A1C of below 7.5 - ANSWER True.
You'll start them on metformin 1st (cheap and effective) and have them come back in
a few months to evaluate how they are doing on that med.
Glycemic control guidelines - ANSWER start metformin
overweight/obese/hypoglycemia risk
- GLP-1 RA or GIP/GLP-1RA or SGLT2
Access/cost
- T2D or SU/GLN
Severe hyperglycemia
- basal insulin, prandial insulin, or + GLP-1Ra
ASCVD or high risk for ASCVD
- GLP-1RA or SGLT2
HF
- SGLT2
Stroke/TIA
- GLP-1RA or pioglitazone
CKD
- SGLT2 or GLP-1RA
Med categories - ANSWER - sulfonylureas
- SGLT2 inhibitors
- GLP1 - incretin mimetics
- metformin
- DPP-4- incretin mimetic
- TZD
- insulin basil
- insulin mealtime
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