NURS 160, Unit 7 :

ENDOCRINE CONDITIONS: DIABETES MELLITUS

STUDENT RESOURCES

LEARNING OBJECTIVES

Upon completion of this chapter, you will be introduced to Diabetes and be knowledgeable in the following:

Etiology
o Incidence and prevalence in Canada
o Common risk factors
Pathopyhsiology
Clinical Manifestations
o Common signs and symptoms
o Hypoglycaemia
o Hyperglycemia
Diagnostic tests
o Common diagnostic tests, tools, and findings (normal and abnormal)
o Glucometer
o Fasting Blood Glucose (FBG)
o Glycosylated hemoglobin (HgA1c)
o Glucose tolerance test (GGT)
o Nursing responsibilities pre- and post-diagnostic tests
Treatments
o Lifestyle and diet modifications
o Drug therapy
o Blood glucose monitoring
Nursing Process
o Nursing assessments and plans of care

o Nursing interventions and care

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o Nursing role in monitoring clients

o Glucose monitoring

o Client education

- Nutrition and healthy lifestyle choices

- Foot and skin care
- Community resources

READINGS & PREPARATION

1. Lewis et al. , chapter 50, Nursing Assessment: Endocrine System ( BRIEFLY SKIM)
2. Lewis et al., chapter 52, Nursing Management: Diabetes Mellitus ( A MUST READ***)
3. Slides on EVOLVE under Unit 7
i. Endocrine: Diabetes Mellitus

SUMMARY

Diabetes is a major contributor to morbidity and mortality, and describe its relationship to cardiovascular disease, visual
impairment, renal disease, and lower extremity amputations.
You will encounter many clients with diabetes in a variety of clinical situations that require recognition of acute and chronic
manifestations of the disease and promotion of self-management of diabetes. It is important to allow adequate time and learning
experiences related to this material to promote a thorough understanding of diabetes.
Diabetes is a disorder of glucose metabolism related to absent, insufficient, or poor utilization of insulin, rather than the common
lay attitude of diabetes being a disease of too much glucose or sugar.
You should review the normal secretion and activity of insulin to establish a basis for understanding type 1 and type 2 diabetes. Fig.
50-1 illustrates normal endogenous insulin secretion, and Fig. 50-2 illustrates the mechanisms of type 1 and type 2 diabetes.

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Compare and contrast the characteristics of type 1 and type 2 diabetes thoroughly in terms of etiology, pathophysiology, and onset
of disease. Differentiate the types of diabetes and categories of glucose intolerance, identifying the diagnostic criteria for each.
Start completing the table as you read the textbook chapter.

MEDICAL Diabetes
DIAGNOSIS
DEFINITION What is Diabetes?

How does Type 1 Diabetes differ from Type 2 Diabetes?

Type 1:

Type 2:

What is pre-diabetes?

ETIOLOGY AND What happens at the cellular level with diabetes?

PATHOPHYSIOLOGY

What is normal function of insulin and how is it altered with diabetes?

INCIDENCE & What is the magnitude of diabetes in Canada?

PREVALENCE

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RISK FACTOR(S) Who is at most risk for diabetes?

CLINICAL What is Hypoglycemia? What is Hyperglycemia?

MANIFESTATIONS

What are the 3

Ps?

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DIAGNOSTIC How is diabetes diagnosed?

STUDIES

What are the three most common diagnostic studies? Describe each.
1.

2.

3.

NURSING What subjective & objective data would you want to collect from a diabetic patient?
ASSESSMENT

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COLLABORATIVE How is diabetes managed?

CARE 1. Lifestyle (diet, exercise)

2. Monitoring blood glucose levels

3. Oral hypoglycemic

4. Insulin

Which interdisciplinary team members are involved?

COMPLICATIONS Acute Complications Long-term Complications

Hypoglycemia Macrovascular

Microvascular

Hyperglycemia

Diabetic retinopathy

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DKA***(very important)
Nephropathy

Neuropathy

Chronic Infections

CLASSROOM ACTIVITIES

Case study

TEST YOUR KNOWLEDGE

Adapted and derived items 2010, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.