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NUR 239 Study Guide - Final Guide: Diabetic Neuropathy, Adipose Tissue, Diabetes Mellitus Type 2

Mennonite College of Nursing
Course Code
NUR 239
Yvette Pigman
Study Guide

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Mennonite College of Nursing at Illinois State University
NUR 239 PathoPharm 1
Book/ Chapter
# of ?’s
Porth Chapter
33 - Diabetes
Mellitus and
the Metabolic
Glucose-Regulating Hormones/794 799
1. Insulin
1) Promotes glucose uptake by target cells and allows glucose to be stored as
2) Prevents fat and glycogen breakdown
o Inhibits gluconeogenesis & increases protein synthesis
2. Glucocorticoid Hormones- How does stress effect cortisol levels?
o Increase in ATCH, which causes an increase ion cortisol secretion;
Hypoglycemia is major stimulus for cortisol release.
3. Diagnostic Criteria for metabolic syndrome?
o 3+ of the following: Intra-abd. obesity, elevated TG (triglycerides) > 150
mg/dL, low High-density lipoproteins (<50 mg women or <40 men), blood
pressure > 130/85 mm Hg, & fasting glucose >100
4. What are the risks for Type 1 DM?
- Hypoglycemia due to ability to maintain glucose levels hampered because
failure to suppress absorption of injected insulin, insulin absorption
increases, even after exercise, insulin’s lower effect continues 3 hours, liver
& skeletal muscles increase uptake of glucose for stores
5. Diabetic Management- How would multiple day injections of insulin work?
- Basal insulin requirements are met by intermediate/long-acting insulin 1-2
day by bolus or injection devices.
6. What times of the day would a patient give intermediate and rapid acting types
of insulin?
- Intermediate acting Taken in the morning but have slower onsets, takes
more hours to reach therapeutic levels so their use in Type 1 requires
supplementation with rapid/short-acting insulin. With MDIs (multiple day
injections), the base insulin requirements are met by an intermediate or long-
acting insulin administered 1-2x daily. Boluses of rapid or short acting
insulin are used before meals.
- Rapid acting given 30 minutes before meals
- Long acting May need rapid supplements
- Short acting Works within 30 minutes, lasts 5-8 hours
Acute Complications
7. DKA: hyperglycemia & dehydration (electrolyte loss) lead to this; develops
when individual has no insulin reserve (Type 1). It is the result of fatty acids
from adipose tissue.
- Treatment: Improve circulatory volume & tissue perfusion, decrease blood
glucose, and correct the acidosis & electrolyte imbalances. You do this by
administering insulin and IV fluids/electrolyte imbalances.
8. Hypoglycemia: Reaction from excess of insulin, low blood sugar
- Treatment: Immediate administration of 15g of glucose carbs; IV
dextrose/glucagon, juice. If a patient is unconscious or unable to swallow,
glucagon may be IM or 50% glucose solution may be given IV.
Chronic Complications:
9. Diabetic Neuropathies aka peripheral neuropathies: Impaired and delayed
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