diabetes

Question 1

What BM level is hypoglycaemic?

Answer 1

under 3.9mmol/L

Question 2

What are the causes of hypoglycaemia?

Answer 2

excess insulin
skipped meals or low food intake
exercise
excess alcahol

Question 3

What are the S&S of hypoglycaemia?

Answer 3

hunger
irritability
confusion
headache
pale skin
decreased-consciousness
clammy and cold skin

Question 4

How can nurses provide care if their patient is hypoglycaemic but conscious?

Answer 4

1) give 15g of a readily absorbed carbohydrate
eg: 1/2 cup juice, soda
2) recheck BM in 15 minutes
3) repeat if still hypoglycaemic

Question 5

How can nurses provide care once their patients BM is >3.9mmol/L?

Answer 5

give the patient a snack with proteins and carbohydrates in it

Question 6

What should the nurse do if their patient is unconscious from hypoglycaemia?

Answer 6

administer glucagon through IM or subcut injections
repeat if still unconscious after 10 minutes

Question 7

What should nurses be aware of when administering glucagon?

Answer 7

glucagon can cause nausea and vomiting so always ensure that the patient can safely swallow before eating

Question 8

What should the nurse do once their patient regains consciousness?

Answer 8

ensure pt is fully conscious and can safely swallow
then give a snack

Question 9

What are the risk factors of DKA?

Answer 9

infections
sepsis
stress
untreated or unknown T1 diabetes

Question 10

What are the S&S of DKA?

Answer 10

Three P’s
Polydipsia (excessive thirst)
Polyphagia (extreme hunger
polyuria (excessive urination)
same as hyperglycaemia
will also experience metabolic acidosis and hyperkalaemia

Question 11

What should the patients labs be when in DKA?

Answer 11

BM >16.7mmol/L
ketones present in blood and urine

Question 12

What is a complication of hyper/hypokalaemia?

Answer 12

if K+ is too high or too low this puts pt at risk for deadly dysrhythmias

if BM >6.0mmol/L then dangerous

Question 13

What is HHS?

Answer 13

hyperglycaemic hyperosmolar state

Question 14

How does HHS present?

Answer 14

very high BM levels and severe dehydration
only in people with T2 diabetes
has a gradual onset

Question 15

What are the causes of HHS?

Answer 15

older age
inadequate food
inadequate kidney function
infections
stress

Question 16

What are the S&S of HHS?

Answer 16

same as hyperglycaemia
dehydration, hypotention, weak pulses

Question 17

What should patients labs be if HHS?

Answer 17

BM >33.3mmol/L
no ketones in blood or urine
no metabolic acidosis

Question 18

What is the nursing treatment for someone with HHS?

Answer 18

identify any underlying causes
administer IV fluids and insulin
check BM’s hourly
aim to bring BM levels <11.1mmol/L

Question 19

What should nurses monitor if DKA?

Answer 19

monitor potassium levels

Question 20

What should nurses do if pt K+ levels are high?

Answer 20

administer calcium gluconate, replace K+ if needed

Question 21

What are the chronic complications of diabetes?

Answer 21

cardiovascular diseases leading to MI
stroke
diabetic neuropathy leading to neuropathic pain
foot injuries and infections
kidney damage (nephropathy)
eye damage (retinopathy)
gastroporesis
tooth decay
gum disease
sexual dysfunction

Question 22

What is diabetic gastroporesis?

Answer 22

high blood glucose levels cause nerve damage through the digestive tract causing the muscles to slow down or stop working
the stomach stops emptying properly making food take longer to leave the stomach

Question 23

What are the “normal” BM values?

Answer 23

3.9-5.6mmol/L