EXAM 4 ESSAY TOPIC REVIEW

pathophysiology of diabetes type 2:

B cells within the pancreas do produce insulin, but the cells in the diabetic patients body become resistant to the insulin

-happens gradually often do to obesity

Complications of type 2 diabetes + associated treatments:

-hypoglycemia: carry fast-acting sugar (juice, crackers) or give IV D50

-hyperglycemia: oral antidiabetic drugs (metformin/glipizide) or insulin therapy

-HHS: insulin therapy + 0.9% NS for hydration

-retinopathy: routine eye exams or timolol to relive pressure

-peripheral neuropathy: daily foot checks, protective footwear, and skin checks often

-nephropathy: ACEs/ARBs, kidney labs drawn routinely (assess creatinine/BUN levels)

-stroke/MI/atherosclerosis: statins to reduce cholesterol levels, ACE's/ARB's to reduce BP

Education for type 2 diabetes patients:

-daily foot checks/no open toed shoes

-check blood sugar often/daily

-adhere to meds/insulin as prescribed

-get eye exams regularly and kidney fx labs drawn

-rotate injection site

-exercise more often

-call HCP if BG is over 300

-do not do any FAD diets

-insulin therapy: rapid acting--> right before meals, regular--> 30-60 min. before meals

-carry a fast acting sugar with you

-wear a medical alert bracelet

Assessment for type 2 diabetes:

-assess level of understanding of disease

-assess weight

-assess blood sugar levels/A1C

-assess kidney fx/eye fx

-assess skin and feet for lesions

-assess current lifestyle and diet patterns

-assess BP/HR

Diagnoses for type 2 diabetes:

1) unstable blood sugar related to insulin resistance

2) Risk for low blood sugar levels

3) Risk for infections and/or injuries

4) Knowledge deficit of disease

Planning for a type 2 diabetic patient:

-improve/stabilize blood sugar levels (remain under 150)

-promote healthy lifestyle/diet changes

-protect skin/feet

-monitor kidney/eye function

-teach s/s of hypoglycemia/hyperglycemia

-prevent HHS (prevent hyperglycemia)

Interventions for type 2 diabetes:

-blood sugar checks often

-administer antidiabetic drugs or insulin therapy

-promotion of exercise, smoking cessation, limiting alcohol, and a healthy/balanced diet

-administer antihypertensives or cholesterol medications as prescribed

-assess and monitor eyes/kidney fx/skin

Evaluation of type 2 diabetic patients:

-evaluate if blood sugar levels are controlled or uncontrolled

-evaluate level of understanding of management moving forward

-evaluate for presence of complications (blindness, HHS, wounds, etc.)

Elderly considerations for type 2 diabetic patients include:

-elderly patients are already at a higher risk for stroke/MI, so diabetic elderly patients have a high chance of stroke--> monitor closely

-may be forgetful/need medication reminders

-kidney function may be impaired: may need altered doses for meds and close monitoring of labs

-risk for falls/injury/skin breakdown (assess skin and feet more often for wounds/pressure injuries)