Diabetes 3 Flashcards
Complication of diabetes mellitus
Acute
Chronic
Acute ( short term)
Hyperglycaemia & hypoglycaemia
Diabetic ketoacidosis
Hyperosmolar hypoglycaemic syndrome (HHS)
Chronic
Micro vascular
Macro vascular
Hypoglycaemia
Blood glucose is low
Can occur day and night
Causes: too much insulin or oral hypoglycaemic , too little food
Excessive exercise, weight loss without medication
Hypoglycaemia system
Adrenergic symptoms
Automatic system
Mild hypoglycaemia
Sweating cold, clammy skin Tremor, shaking Rapid heart beat Nervousness Hunger
Moderate hypoglycaemia
Poor concentration Headache Lightheadedness Confusion Memory lapses Slurred speech Impaired coordination Double vision Drowsiness Irrational behaviour
Severe hypoglycaemia
Seizure
Difficulty rousing
Loss of consciousness
Disoriented behaviour
Hypoglycaemia
Onset is abrupt and unexpected
Symptoms vary from person to person
Vary to the speed of decrease in blood glucose and usual blood glucose range
Assess possible causes- alcohol intake without food , too much medication, too much exercise, weong timing if food and medication
Management of hypoglycaemia
Treatment must be immediately Give 15g if glucose
3 or 4 glucose tablets or 1 tube glucose gel
125 ml fruit juice
3 tsp homey or sugar
Retest bgl after 15 mins
Hypoglycaemia measures if patient cant swallow
Airway management
Glucagon injection Or 50% glucose iv solution
When conscious give food
Preventative measeure hypo
Maintaincbgl above 4 mmol/L Routine testing Consistent food intake Recognising symptoms Medic alert card carry simply food at all times
Diabetic ketoacidosis
Caused by profound insulin deficiency Mostly type 1 diabetes Characterised by: Hyperglycaemia Ketosis Acidosis Dehydration
Signs of dka
Dehydration poly uria Poly phagia Anorexia Fever Restlessness Weakness 14 mmol/l blood glucose or higher 44 mkol/l
Monitoring blood ketones
Done when bgl is persistent - more than 14-15 mmol/l
Dome with test using a meter and specific test
Normal ketone is 0.5 mmol/l
Above normal is 0.6-1.5 mmol/l( insulin to prevent dka)
Above 1.5mmol/l is acidosis
Treatment of dka
Gospitalise for fluid and electrolyte imbalance
Correct hyperglycaemia
Dehydration
Electrolyte imbalance
Acidosis
Monitor Bgl Vital signs Airway Fluid overload
Dka prevention
Sick day rules
Assess causes
Diagnosis for proper management of diabetes mellitus
Hhs
Hyperosmolar hyperglycaemic syndrome
Hyperosmolar hyperglycaemic syndrome
Lofe threatening
Occurs in type 2 diabetes >60
Hyperglycaemia and hyperosmolality occur due to laxk of effective insulin
Bgl level range 33.4-66.6mmol/l
Enough insulin circulating to prevent ketoacidosis
Persistent hyperglycaemia causes osmotic diiresis resulting in the loss of water and electrolytes
Hhs precipitating factos
Uti, pneumonia
Sepsis
Acute illness
Impaired thirst sensation and inability to replace fluids
Treatment of hhs
Immediate rehydration
Iv insulin infuy
Monitor fluid volume and electrolyte status
Nursing process : care for dka or hhs
Maintain fluid and electrolyte balance
Enhance knowledge about diabetic management
Monitor and manage potential complications:
Fluid overload, hypokalaemia, cerebral oedema
Chronic complications of diabetes
Macro vascular
Microvascular
Diabetic neuropathies
Macro vascular
Complication
Damage and death to heart tissue shown in purple
Blood clot stops the flow to an area of the brain
Plague build up in the artery blocking blood flow and oxygen to the heart
1. Coronary artery disease
2. Cerebrovascular disease
3. Peripheral vascular disease
Microvascular complication
Result from thickening of the vessel membranes in the capillaries and arterioles in response to conditions pf chronic hyperglycaemia
Diabetic retinopathy
Diabetic nephropathy
Diabetic neuropathy
