Diabetes Flashcards
Developmental concerns for DM of toddler ( 1-3 yrs)
Parents must be able to tell difference between defiance and hypoglycemia
encourage child to report if the feel funny
expect food jags
give choices regarding SBGM, injection site and food choices
developmental concerns for DM preschool (3-6)
this is not a punishment
encourage child to participate in simple tasks
teach child to report feeling low to an adult
teach child what to eat when low
developmental concerns for DM school age ( 6-12)
educate school personnel about DM
encourage age appropriate independence
ALL activities must be supervised
encourage extra curricular activities, participation in groups
11-12 yo able to perform occasional injections
developmental concerns for DM adolescent’s
if your gonna drink you gotta eat
capable of performing self care
know which foods fit into meal plan and how to adjust
more willing to perform multiple injections
RISK TAKERS (sleeping late and skipping meals)
needs continued parental involvement and support
s/s hypoglycemia
low blood sugar <60 hunger headache confusion shakiness dizziness sweating
s/s hyperglycemia
high blood sugar >180 high levels of glucose in urine frequent urination increased thirst fruity breath
treatment of hypoglycemia
Rule of 15’s
15 grams of fast acting carbs and recheck blood sugar every 15 min until normal.
when at normal eat protein
examples of 15 grams of carbs
1/2 cup fruit juice or regular soft drink 1 cup WHITE milk cake icing small bag of skittles (trick or treat) glucose tablets
tx of DKA
check FSBS and start IV fluid (NS) 10ml/kg over 1st hour to restore intravascular volume.
2nd hour start insulin drip 0.1 unit/kg/hour and change fluids to add electrolytes and change to maintenance rate
DO NOT drop glucose faster than 50-100 in 1 hour can cause cerebral edema, if dropping this fast notify HCP ASAP do not adjust anything!
When glucose reaches 250-300 change fluids to include D5 0.45% with electrolytes
you switch from insulin drip to subq depending on anion gap.
can D’C fluids after hydration and can tolerate oral fluids
you can switch to subq when child is awake and can eat and drink
how do you treat sick days?
give insulin as scheduled
check BS more frequently
monitor urine for ketones
*if not eating only give insulin based on actual glucose
how do you treat kids who play sports with DM?
extra food with increased activity
have a snack before strenuous activity and take normal insulin
decreased insulin production with strenuous activity always carry snacks incase of feeling low
what happens if DM kids drink alcohol?
can experience hypoglycemia
if you gonna drink you have to eat
what do you do if you accidently take to much insulin?
EAT! increase sugar intake hydrate rule of 15 check you BS
rapid acting insulin
onset 15 min
peak 1 hour
duration 3-4 hours
long acting insulin
onset 4-6 hours
peak 8-20 hours
duration- 24 hours
