Diabetes

Question 1

DKA: Risk Factors

Answer 1

• Missed dose of insulin
• Illness or infection
• Undiagnosed & untreated diabetes
  (DKA may be the initial manifestation of type 1 diabetes)

Question 2

DKA: Treatment

Answer 2

• Rehydration with IV fluid
• IV continuous infusion of regular insulin
• Reverse acidosis & restore electrolyte balance

Question 3

DKA: Nursing Management (What do we monitor?)

Answer 3

• Blood glucose
• Renal function & urinary output
• ECG, V/S
• Electrolyte levels
• Lung assessments for signs of fluid overload

Question 4

HHS: Risk Factors

Answer 4

• Older adults (50-70) who have no known Hx of diabetes or who have type 2 diabetes
• Infection or acute illness (physiologic stress)
• Medications that exacerbate hyperglycemia (thiazides)
• Dialysis

Question 5

HHS: Treatment

Answer 5

• Rehydration (Fluid replacement)
• Insulin administration
• Monitor fluid volume & electrolyte status (prevent fluid overload, HF, arrhythmias)
• Manage blood glucose levels

Question 6

Diabetes Insipidus: Causes

Answer 6

1. Injury to hypothalamus or pituitary gland (head trauma, tumor, surgery)
2. Low ADH
3. Large excretion of water

Question 7

Diabetes Insipidus: S/Sx

Answer 7

• UOP: > 250 ml/hr
• Sp. Gr. 1.001- 1.005 (dilute)
• Polydipsia (intense thirst, crave cold water)

Question 8

Diabetes Insipidus: Treatment

Answer 8

• Desmopressin (DDAVP), replace ADH
• Fluid replacement
• Chlorpromazide, thiazide diuretics