Chapter 22 | Diabetic Emergencies and Altered Mental Status Flashcards
• General approaches to assessing the patient with an altered mental status • Understanding the causes, assessment, and care of diabetes and various diabetic emergencies • Understanding the causes, assessment, and care of seizure disorders • Understanding the causes, assessment, and care of stroke • Understanding the causes, assessment, and care of dizziness and syncope
Define:
DM
(abbreviation)
diabetes mellitus
Fill in the blank:
The abbreviation for diabetes is [BLANK].
The abbreviation for diabetes is DM.
Define:
RAS
(abbreviation)
reticular activating system
Define:
reticular activating system (RAS)
series of neurologic circuits in the brain that control the functions of staying awake, paying attention, and sleeping
Fill in the blank:
Normal consciousness is regulated by a series of neurologic circuits in the brain that comprise the [BLANK].
Normal consciousness is regulated by a series of neurologic circuits in the brain that comprise the reticular activating system (RAS).
True or false:
Although you may rule out immediate life threats, even a slightly altered mental status indicates serious underlying issues.
true
True or false:
If you rule out immediate life threats, a patient with a slightly altered mental status may not have any underlying issues.
false
AMS could indicate deeper problems
Define:
glucose
most basic form of sugar
body’s main source of energy
Fill in the blank:
The insulin–glucose relationship has been described as a “[BLANK]” mechanism.
The insulin–glucose relationship has been described as a “lock and key” mechanism.
Explain:
“lock and key” metaphor for insulin and glucose
insulin acts as key
(without insulin “key”) glucose cannot enter the “locked” cells
Define:
hypoglycemia
low blood sugar
Define:
hyperglycemia
high blood sugar
List:
causes of hypoglycemia in patients with diabetes
5 points
- taking too much insulin (processing sugar too fast)
- not eating (decreased sugar intake)
- over-exertion (processing sugars too fast)
- vomiting a meal (lost sugar)
- fever or shivering (increased metabolic rate)
List:
necessities to maintain consciousness
3 points (things; not processes)
- oxygen
- glucose
- water
Define:
DKA
(abbreviation)
diabetic ketoacidosis
Define:
diabetic ketoacidosis (DKA)
condition that occurs as result of severe hyperglycemia because body doesn’t have enough insulin to allow blood sugar into your cells for use as energy
Define:
SNOT
(acronym)
- stroke/seizure/sugar
- narcotics
- oxygen
- toxins/trauma/temperature
Define:
AEIOUTIPS
(“vowel tips”; acronym)
- alcohol
- epilepsy
- insulin
- overdose
- underdose
- trauma
- infection
- psychosis
- stroke
(causes of AMS)
Fill in the blank:
[BLANK] is one of the most common causes of AMS.
Hypoxia is one of the most common causes of AMS.
Fill in the blank:
For patients with AMS, you should first attempt to [BLANK] to obtain patient’s baseline mental status.
you should first attempt to interview family members and bystanders to obtain patient’s baseline mental status.
Define:
T1D
(abbreviation)
type 1 diabetes
Define:
T2D
(abbreviation)
type 2 diabetes
Explain:
difference between T1D and T2D
- T1D: underproduction of insulin by pancreas
- T2D: inability of body’s cells to use insulin properly
List:
signs of hypoglycemia
5 points (at onset)
- abnormal/agitated behavior (AMS)
- pale/clammy skin
- tachycardia
- seizures
- syncope
(very rapid onset)
List:
results of hypoglycemia
3 points (if left untreated)
- AMS
- unconsciousness
- permanent brain damage (starving brain cells)
List:
signs/symptoms of hyperglycemia
3 points
- chronic thirst or hunger
- increased urination
- nausea
List:
effects of hyperglycemia
3 points (physiology if left untreated)
- profound dehydration (hence excessive thirst)
- excessive waste products (hence extra peeing)
- DKA (extreme hyperglycemia)
Fill in the blank:
The onset of hypoglycemia is typically [RAPID/GRADUAL].
The onset of hypoglycemia is typically very rapid.
Fill in the blank:
The onset of hyperglycemia is typically [RAPID/GRADUAL].
The onset of hyperglycemia is typically gradual.
(develops over days/weeks)
List:
signs/symptoms of DKA
3 points
- profound AMS
- rapid breathing
- acetone (sweet) odor in breath
like being drunk with a sweet breath
Fill in the blank:
The severe dehydration associated with DKA can cause [BLANK].
The severe dehydration associated with DKA can cause shock.
the renal threshold for active glucose reabsorption is exceeded as blood glucose levels rise (leading to glucose loss in the urine)
renal response to dehydration by retaining fluids (in addition to glucose loss in urine) causes decrease in fluid (blood) volume
low blood volume causes hypovolemic shock (drop in blood pressure and amount of oxygen in your body)
Fill in the blank:
The blood sugar of a symptomatic diabetic patient with hypoglycemia is less than [BLANK] mg/dL.
The blood sugar of a symptomatic diabetic patient with hypoglycemia is less than 60-80 mg/dL.