Diabetes Flashcards
1
Q
Chronic Complications of DM
A
- Caused by changes in blood vessels in tissue & organs
- Vascular changes result from:
> hyperglycemia thickens basement membranes & causes organ damage
> hyperglycemia affects cell integrity - Changes in blood vessels lead to poor tissue perfusion & cell damange & death
- 2 Types:
> macrovascular
> microvascular
2
Q
Macrovascular
A
-
Cardiovascular disease
> MI, HF -
Cerebrovascular disease
> 2-4x higher risk for stroke -
Peripheral Vascular Disease (PVD)
> PAD, leg ulcers - Risk factors of HTN, obesity, dyslipidemia, & sedentary lifestyle incr risk for these complications
- Focus should be on dcring modifiable risk factors
3
Q
Microvascular
A
- Retinopathy
- Neuropathy
- Nephropathy
4
Q
Retinopathy
A
Caused by damage to retinal vessels causing leaking & retinal hypoxia
5
Q
Neuropathy
A
- Progressive deterioration of nerves
- Loss in sensation or muscle weakness
- Caused by blood vessel changes tht cause nerve hypoxia
- Can affect all areas of body (extrems, GI, cardiac, urinary)
6
Q
Nephropathy
A
- Change in kidney tht dcrs func & causes kidney failure
- Chronic high BG causes damage to blood vessels in kidneys causing leaking & hypoxia
- Kidneys allow filtration or larger particles which damage kidneys further
7
Q
Lab Findings of DKA
serum glucose
osmolarity
serum ketones
serum pH
A
- Serum Glucose: greater than 300
- Osmolarity: variable
- Serum Ketones: postive at 1:2 dilutions
- Serum pH: less than 7.35
8
Q
Lab Findings of DKA
serum hco3
serum Na
BUN
creatinine
urine ketones
A
- Serum HCO3: less than 15
- Serum Na: low, normal, or high
- BUN: greater than 30; elevated bc of dehydration
- Creatinine: greater than 1.5; elevated bc of dehydration
- Urine Ketones: positive
9
Q
Lab Findings for HHS
serum glucose
osmolarity
serum ketones
serum pH
A
- Serum Glucose: greater than 600
- Osmolarity: greater than 320
- Serum Ketones: negative
- Serum pH: greater than 7.4
10
Q
Lab Findings HHS
serum hco3
serum na
BUN
creatinine
urine ketones
A
- Serum HCO3: greater than 20
- Serum Na: normal or low
- BUN: elevated
- Creatinine: elevated
- Urine Ketones: negative
11
Q
Diabetic Ketoacidosis
A
- Uncontrolled hyperglycemia, metabolic acidosis, incrd production of ketones
- Sudden onset
- Precipitating factors: infection, stress, inadequate insulin intake
12
Q
DKA Manifestations
A
-
Ketosis:
> Kussumaul respirations
> fruity breath
> nausea
> abdominal pain - Dehyration
- Eectrolyte loss
13
Q
DKA Monitor
A
- Airway
- LOC/mental stat
- Hydration
> VS, I&Os - Electrolyes
> assess for S/S hypokalemia: fatigue, malaise, confusion, muscle weakness, shallow resps, abdominal distention or paralytic ileus, hypotension, weak pulse
14
Q
DKA Treatment
A
- IV fluids
- Regular insulin by continuous IV infusion
- Replace potassium
> ensure output is at least 30mL/hr - IV sodium bicarbonate
> used only for severe acidosis
15
Q
Hyperglycemic-Hyperosmolar State (HHS)
A
- Hyperosmolar (incrd blood osmolarity) state caused by hyperglycemia
- Gradual onset
- Precipitating factors: dehydration, infection, poor fluid intake