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NU-214 Test 2 (Diabetes/Cardiac) Review Questions and Correct Answers

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  • NUR 214
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  • NUR 214

Diabetes mellitus (DM) -A disease in which the body's ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood and urine. - A chronic multi system disease related to abnormal insulin production, i...

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  • September 18, 2024
  • 57
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NUR 214
  • NUR 214
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NU-214 Test 2 (Diabetes/Cardiac) Review
Questions and Correct Answers
Diabetes mellitus (DM) ✅-A disease in which the body's ability to produce or respond
to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates
and elevated levels of glucose in the blood and urine.
- A chronic multi system disease related to abnormal insulin production, impaired insulin
utilization, or both.

How does insulin work? ✅insulin lowers blood glucose by facilitating uptake and the
use of glucose by muscle and fat cells; decrease the release of glucose from the liver.

- Insulin is the "key" that unlocks the cell in order for glucose to flow into the cell and be
processed.

See diagram on slide 7

Homeostasis of blood glucose: ✅*Low blood glucose*:
- alpha cells release glucagon.
- Glycogenolysis in the liver; glucose released into the blood.
- leads to normal blood glucose

*High blood glucose*:
- beta cells release insulin.
- peripheral tissue cells take glucose from blood.
- leads to normal blood glucose

Pathophysiology of hyperglycemia ✅Pancreas:
- impaired insulin secretion.

Liver:
- increase basal hepatic glucose production.

Muscle:
- decreased insulin stimulate the glucose uptake.

GI:
- gastrointestinal absorption of glucose.

*all cause hyperglycemia*

Type I Diabetes Mellitus facts ✅- About 5% of all diabetes cases.

- generally affects people under the age of 40.

,- autoimmune destruction of the pancreatic beta cells.

- Genetic predisposition

- Insulin dependent.

Risk factors for type 1 DM ✅- cause is unknown.
- no known way it can be prevented.

Autoimmune:
- The disease is triggered when your body's immune system does not function properly
and attacks itself by mistake.

Genetic:
- The disease is triggered by the genes you inherited at birth.

Environmental:
- The disease is triggered by something in the environment (like a virus).

Type 1 DM ✅• No endogenous insulin- no insulin is produced by the pancreas at all.
Except when they are first developing type one diabetes, the pancreas may produce a
very small amount but soon stops.

- need exogenous insulin for life.

- *Ketosis prone- your body starts to break down fat and not carbs. Body will produce
ketones.*

• Acute complication of hyperglycemia.
- diabetic ketoacidosis (DKA)

Signs and symptoms of type 1 DM ✅3 P's:
- Poyluria- Increased urination.
- Polydipsia- Increased thirst.
- Polyphagia- Increased hunger.

As well as: Weight loss, fatigue, increase frequency of infections, will be rapid onset, will
be insulin-dependent, familial tendency, and peak incidence from 10 to 15 years.

Why would these signs occur?
- The blood sugar stay in the blood stream and cannot be used by the body or it's cells.

Early symptoms of type 1 DM ✅- polyuria
- polydipsia
- feeling weak or tired

,- yeast infection
- increased appetite
- dry mouth or throat
- unexplained weight loss

Type 2 DM facts ✅- 90-95% of all diabetes cases.
- 80% are obese at diagnosis.
- 75% are diagnosed after complications have developed.
- No islet cell antibodies

- Insulin resistance- the body does produce insulin, but it is not enough.

Risk factors:
- family history
- BMI > 23
- lead an inactive lifestyle
- high blood pressure
- have abnormal blood cholesterol/lipid levels
- history of gestational diabetes
- > 40 yo
- have impaired glucose tolerance or impaired fasting glucose.

Assessment of risk factors for type 2 DM ✅Non-modifiable:
- history of gestational diabetes
- race/ethnicity
- age of over 45 years
- family history

Modifiable:
- physical inactivity
- high body fat and body weight
- high blood pressure
- high cholesterol

7 common symptoms of type 2 DM ✅- slow healing wounds
- constant hunger
- frequent urination
- blurred vision
- fungal infection, itching of skin and genitals
- unexplained weight loss
- numbness of hands and feet

Signs/symptoms/ predispositions to type 2 DM ✅- sedentary lifestyle
- familial tendency
- average age 50 years
- history of increased BP

, - fatigue, decreased energy
- obese
- recurrent infections
- polyuria
- polydipsia
- feeling tired, drowsy, or weak
- irregular periods
- increased hunger
- dark areas of skin folds
- weight loss
- yeast or bladder infections
- FBS >125

Treatment of type 2 DM ✅- oral hypoglycemic drugs.
- May need insulin on a short or long term basis for control.
- Ketosis-resistant- NOT prone to ketosis because their body still makes some insulin.
So some insulin is still able to pass into the cells.

• Acute complications of hyperglycemia
- hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)

Contributors to type 2 DM hyperglycemia ✅- Pancreatic B cells decreased insulin
production.
- liver- insulin resistance, increased glucose production.
- muscle- insulin resistance.
- nervous system- dysfunctional neurotransmitters.
- kidney- increased reabsorption of glucose.
- Pancreatic A cells- increased production of glucagon.
- Adipose tissue- enhanced lipolysis
- Small intestine- deficiency of incretin effect

Diagnosis of type 2 diabetes ✅Diabetes:
- A1C- 6.5% or above
- FBS 126 or above
- Glucose tolerance of 200 or above

Prediabetes:
A1C- 5.7-6.4%
FBS- 100-125
Glucose tolerance- 140

Normal:
A1C- 5.7 or below
FBS- 99 or below
Glucose tolerance- 140 or below

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