Caring for the Client with Diabetes Mellitus

These flashcards cover key terms and concepts related to caring for clients with diabetes mellitus, including definitions, types of diabetes, complications, and management strategies.

Diabetes Mellitus

A chronic condition characterized by high levels of glucose in the blood due to insufficient insulin production or insulin resistance.

Type 1 Diabetes

An autoimmune condition where the pancreas produces little or no insulin, typically diagnosed in children and young adults.

characterized by the absence of insulin production by beta cells in the islets of langerhans

Type 2 Diabetes

A genetic disorder characterized by insulin resistance and relative insulin deficiency, more common in adults age 45-64.

HbA1c Testing 

A blood test also called glycosylated hemoglobin that measures average blood glucose levels over the past 2 to 3 months, used for diagnosing and monitoring diabetes.

assess the effectiveness of treatment and the clients compliance’

over 8% indicates lack of control of blood glucose

normal range is 4-5.7%

acceptable range for diabetics 6.5-8%, target goal of less than 7%

Hypoglycemia

A condition resulting from abnormally low blood glucose levels, with symptoms such as confusion difficulty processing information, anxious feeling, irritability, headache, hunger

Hyperglycemia

A condition characterized by high blood sugar levels, often associated with diabetes, leading to symptoms like iglycosuria, polyuria, polydipsia, and polyphasic

Diabetic Ketoacidosis (DKA)

A serious complication of diabetes type 1 that occurs when the body starts breaking down fats at an excessive rate, leading to the release of acids called ketones.

Hyperosmolar Hyperglycemic State (HHS)

A severe condition in diabetes characterized by extremely high blood sugar levels and dehydration, without significant ketone production.

blood glucose levels will be over 500 mg/dL, the pH is normal, and fluid and electrolyte imbalances will be present

signs and symptoms: hypotension, mental changes, extreme thirst, dehydration, hypokalemia, hyponatremia

Normally seen in type 2 diabetes, people who recieve drugs that elevate blood glucose, require dialysis, or TPN

Self-Monitoring of Blood Glucose (SMBG)

A method used by diabetes patients to track their blood glucose levels regularly to manage their condition.

Carbohydrate Counting

A nutritional strategy for managing diabetes by tracking carbohydrate intake to maintain stable blood glucose levels.

Nutritional Therapy

An essential part of diabetes management focused on diet modifications, particularly carbohydrate intake.

Continuous Glucose Monitoring (CGM)

A method of tracking glucose levels continuously throughout the day to provide real-time data on blood sugar fluctuations.

Microvascular Complications

Health problems related to small blood vessels, commonly associated with diabetes, such as neuropathy, retinopathy, and nephropathy.

Macrovascular Complications

Health issues related to large blood vessels, including increased risk of heart disease and stroke in individuals with diabetes.

Client Education

The process of informing and guiding patients about their diabetes management, including medications, diet, exercise, and self-care.

Sick-Day Rules

Guidelines for managing diabetes during illness, including adjustments to insulin and monitoring blood glucose more frequently.

ketosis causes include

street, infection, sleep loss

ketoacidosis

blood glucose levels of 300-1000 mg/dL

circulatory collapse

renal shutdown

death

human insulin

preffered and are replacing insulin extracts (pork and beef), must be monitored closer for low glucose levels because it is more effective

rapid acting insulin

must eat within 15 minutes of administration to prevent hypoglycemia.

can be give IV and added to TPN

lipoatrophy

break down if submit fat at injection sites with repeated injections

lipohypertrophy

buildup of subcutaneous fat at injection sites with repeated infections

rapid insulin onset (HumaLOG, NovoLOG)

onset 5-15 minutes

peak 1-2 hours

duration 3-4 hours

short acting (Humulin R, Regular)

onset 30min- 1 hr

peak 2-4 hours

duration 5-8 hours

immediate insulin (NPH, Humulin N)

onset 1.5 hours

peak 4-10 hours

duration 14 hours

:Long acting insulin

onset 1-4 hours

peak 6-9 hours

duration 24 hours

Glargine peak

no peak

oral diabetic agents

given to type 2 diabetics with a fasting blood glucose less than 200

works in one of three ways: promotes release of insulin, enhance response to insulin, slows the breakdown of complex carbohydrates

Other treatments for diabetes

pancreatitis transplantation

islet cell transplantation

bariatric surgery

dumping syndrome

an episode of extremely low glucose

sxs: tachycardia, pallor, confusion, sweating, abd pain, low BP, dizziness

nursing management of diabetes

complete medical, drug, and allergy hx

list of symptoms and duration 

when client was diagnosed and family hx

treatment regimen

last food consumed

last dose of medication

weight

monitor blood glucose AC and HS

complete head to toe looking for physical changes, FEET

injection site inspection

V/S peripheral pulses, edema, color changes, decrease visual acuity, muscle atrophy, loss of sensation

acute complications of diabetes DKA

Acute insulin deficiency or the inability to use insulin can result in this type of metabolic acidosis

Extremely elevated blood glucose

Kidneys are trying to excrete glucose

Excessive amounts of water, sodium, and potassium are excreted

Dehydration occurs

Skin is warm, dry, and flushed

Ketones accumulate in blood and urine

Acidosis occurs as ketones accumulate

Rapid-deep breathing to eliminate CO2 (Kussmaul’s respirations)

If becomes severe and prolonged the client can become comatose

Death can occur

peripheral neuropathy

motor neurpathy- motor nerves are affects, muscles weaken, joint support diminishes, bone structure affected

sensory neuropathy- sensory nerve involved that lead to paresthesia (pricking, tingling, burning, or needle like pain in feet and legs)

autonomic neuropathy- nerves that affect organ function. Stomach, bladder, ED, cardiovascular system causing orthostatic hypotension