Diabetes | Pathophysiology, Signs & Symptoms

[Music] now for patho basics as you know blood sugar naturally increases when we eat the pancreas releases insulin from the beta cells and also enzymes to help break down food for fuel so remember insulin put sugar and potassium into the cell making our hungry cells really happy now when we give insulin both sugar and potassium decrease in the blood since it's going into the cell now if we don't have food then the pancreas has a back-up plan it releases glucagon hormone to break down stored glucose aka glycogen in the liver which increases sugar in the blood glycogen is kind of like a glucose brick wall so remember glucagon means glucose gone out of the liver into the bloodstream which increases blood sugar so again when blood sugar is high like after you eat insulin is released and when blood sugar is low like when you exercise or forget to eat glucagon is released so when diabetes insulin is the problem here guys type 1 we have none since the body has killed its own pancreas it produces no insulin and people are born with it it's an autoimmune disease so type 1 you can pass on to your son since it's genetical and these patients are insulin dependent for life big key word now in type to remember few insulin receptors work since the problem is you your diet and lifestyle the high in sugars and sittings editorial lifestyle we're talking junk food like sodas white breads and sweets which eventually leads to obesity and our cells now are lazy and overused the insulin receptor sites are like an overused keyhole they basically been worn out and now just ignore the insulin this is called insulin resistance so just think in type-2 the cells are through they quit responding now the risk factors for developing diabetes guys in type 1 there are none since it's mostly genetical you can pass it on to your son and in type 2 the problem is you your diet and a little bit of genetics so we screened for metabolic syndrome which increases the risk of not only diabetes but also heart disease and stroke now this is big on exams in the NCLEX so we use the acronym bowl for metabolic syndrome so guys three or more criteria means we have metabolic syndrome so B for blood pressure meds and high BP over 130 size dalek our next B is for blood sugar medications or high blood sugar over key word your guys write this down a hundred fasting over a hundred fasting o is for obesity big keywords here guys waist size over thirty-five for females and over forty-five for males and lastly L is for lipids that are high this is not good we're talking high cholesterol panel write these numbers down two hundred one fifty and one hundred except the hdls are happy lipids that one should be over forty now guys if these numbers are off it could mean metabolic syndrome and this contributes to insulin resistance in type ii where the cells are through again like an overuse lock the cells stop responding from the overuse of insulin now I can already see questions coming up on your exam and NCLEX so I recommend writing this bowl memory trick out at least 15 times the week of your exam now to help you here's a common practice question which clients are most at risk for developing metabolic syndrome a 35 year old male with triglycerides of 140 nope guys the triglycerides are under 150 so that's okay how about option number two 48 year old female with a fasting blood glucose of 105 guys yes fasting sugars over 100 metabolic syndrome option 3 55 year old female with the waist size of 40 inches oh yes over 35 waist and a 28 year old male with a blood pressure of 135 over 85 guys yes the size Selleck pressure is over 30 lastly a 42 year old female with high HDL s of 55 guys no those are the only lipids that should be high over 140 just think the high lipids for HDL now speaking of type 2 technically not a cause but a very particular sign of insulin resistance keyword write this down brownish or dark thickening on the neck and armpits or even hyperpigmentation and skin tags this is what's called a can throw secessions now as far as diagnosing diabetes the top three must know labs for the NCLEX that you will get tested on guys write these down number one normal glucose must be 70 to 115 number two fasting glucose less than 100 and third hemoglobin a1c must be less than 6.5 those are big NCLEX key numbers there write those down now as you know the a1c test is hour-long two to three month sugar audit and it's best used to see if patients are being compliant with controlling their blood Sugar's the long-term so remember below six is controlled and fixed and over 6.5 we got a revised so review diet and exercise compliance for our type 2 problem basically the you problem and with type 1 insulin compliance always on the NCLEX now the most deadly is low sugar under 70 called hypoglycemia since it causes brain death so we say hypoglycemia diabetes but are not highly tested on the NCLEX and speaking of something that's not highly tested a little side note here the GTT or glucose tolerance test is when we give an 8 ounce drink of syrupy glucose to see if insulin is doing its job by putting the sugar into the cell if it's not then the sugar will go high but guys that's not usually tested on the NCLEX directly now signs and symptoms and causes of high sugar or hyperglycemia just think the blood is turned to mud so the body tries to get rid of all this thick syrup with the three P's first P for polyuria a lot of urine basically the body tries to urinate it out now polydipsia is a lot of drinking fluid the body tries to dilute all that sugar now third is Polly fascia which is excess hunger as cells star since insulin is not doing its job to get sugar inside the cells now a little side note this is not polyphase iya which is a psych disorder now the causes of acute high sugar can be caused from the for essence the number one key term on the NCLEX is sepsis or infection guys that's a number one cause but also stress from surgery or hospital stay and even skipping insulin doses and a big one here is steroids those own ending drugs like prednisone that is a big cost but high sugar can also be caused from hormone therapy like estrogen now we treat that high sugar with insulin to put that sugar into the cells so for your tests I know that's gonna come up yes we increase the insulin during stress like sepsis surgery and especially with steroids and guys know the patient's not on insulin forever once the S is stopped then the insulin stops and guys a big key word here if the sugar is still high after the insulin that's a critical situation always call the doctor or HCP now on the other side for hypoglycemia that low sugar below 70 guys just think low brain function which leads to rapid brain death so remember hypoglycemic we are clammy we need to give that patient some sugary candy now typical NCLEX keywords include high wash so headache irritability weakness or anxiety and even shakiness and hunger it's kind of like a Snickers commercial you're just not you when you're hungry now since hypo is so deadly that type o glide will die our very first treatment is giving sugar so on the NCLEX if the patient is awake then we a ask them to eat specifically juice soda crackers and low-fat milk not high milk or peanut butter big key word right there the fat actually slows down the sugar absorption and if they're asleep big key word here is not alert or unallowable or only arousal to painful stimuli then we s stab them with dextrose IV and always reassess sugars every 15 minutes after giving insulin now causes of hypoglycemia they usually come from exercise alcohol and even insulin peak times big NCLEX tip right there so watch out for diabetic athletes who exercise if your patients exercise then give extra glucose keywords bicyclists swimmers and even runners now alcohol is also a big no-no technically with any disease but it actually lowers sugar doesn't increase it and insulin peak times is when patients are most at risk for that low sugar so remember if there's a peak time then we give a plate of food since hypoglycemic type 1 diabetes is only responsive to painful stimuli with a blood sugar of 42 what's the first action taken by the nurse guys this is the worst case scenario here anything less than 70 is bad so hypo glide the brain will die now patient is not alert only responsive to painful stimuli so if they're not awake we can't ask them to eat technically the patient's sleep so we stab them with dextrose IV and then we reassess blood sugar in 15 minutes oh and if you chose option 4 shaking my head at you question number 2 which medication could cause hyperglycemia now guys before even look at the options you should already be saying steroids increase the sugar ending in so and like prednisone so guys so an ending steroids steroids increase the sugar now the tricky question number three the non-diabetic client is admitted for a kidney infection that has now turned septic the blood sugars have increased from 150 to 225 what is the best answer to give a family member who's asking why insulin is used so option number one the client now has type 2 diabetes no that's a wrong answer option 2 insulin is given to control hypoglycemia totally it's for hyperglycemia option three high sugar is common during infection and stress to the body and insulin will help lower the sugar until the infection resolves guys yes option three is the best option super high sugars we want to land like a plane slow and steady we don't want to crash into that hypoglycemia that low sugar with low brain function now if you chose option number four you nasty now we get many complications from this long term high sugar where the blood is turned to mud it's like dumping thick syrup into your blood vessels and guys imagine years in years of this this destroys and scars the blood vessels called atherosclerosis or apatow scar roses and leads to more infections since bacteria love sugar ultimately it destroys all the organs so the kidneys are washer machines that wash the blood guys these guys die which is called nephropathy or renal failure indicated by creatinine over 1.3 so remember NCLEX key word creatinine over 1.3 means injured kidney and also means no more PP so patients either get a transplant or go on dialysis to wash the blood and nerves die called neuropathy so patients get loss of sensation and they don't even realize when they get small cuts and injuries on their hands and feet not to mention the sugary blood so we call diabetic feet delicious treats for bacteria this leads to infections and slow wound healing and then to amputation and cutting off of those dead feet from all the infections now in the eyes the small blood vessels break called retinopathy which leads to blindness so NCLEX keator Amir guys frequent eye exams are recommended and in the heart we get hypertension from all that high tension on the heart eventually leading to heart disease and then ultimately heart attacks lastly in the brain we can have CBA's or strokes from all those narrow blood vessels that either burst or of aneurysms or get clots thanks for watching for our full video and new quiz Bank click right up here to access your free trial and please consider subscribing to our YouTube channel last but not least a big thanks to our team of experts helping us make these great videos alright guys see you next time [Music] you

Channel: Simple Nursing

Views: 35,905

Keywords: type 1 vs Type 2 diabetes, Diabetes pathophysiology, diabetic, hypoglycemia, hyperglycemia, high blood sugar, low blood sugar, polyuria, polydipsia, polyphagia, neuropathy, nephropathy, retinopathy, amputation, glycemic index, blood sugar monitoring, Registered nurse RN, RN, Osmosis, Pharmacology, NCLEX, ATI exit, HESI exit, Kaplan, student nurse, nursing student, simplenursing, simple nursing

Id: XAW6PqVGnbE

Length: 13min 42sec (822 seconds)

Published: Wed Aug 21 2019