Diabetets Flashcards
What is Diabetes Insipidus (DI)
Excessive urination caused by inadequate amounts of antidiuretic hormone in the body or failure of the kidney to respond to hormone
Causes of DI
Usually results from hypothalamic injury (brain trauma or neurosurgery) or from the effects of certain drugs
Other causes - sickle cell anemia, hypothyroidism, adrenal insufficiency, inherited disorder of antidiuretic hormone production and sarcoidosis
Signs, symptoms, and treatment of DI
Characterized by polyuria and thirst
If left untreated, dehydration may result in fever, vomiting, and convulsions
Fluid replacement is essential
If DI is the side effect of drug therapy, the drug should be withheld
Failure of the hypothalamus to secrete antidiuretic hormone is treated with synthetic vasopressin
What is Diabetes Mellitus (DM)
Disease marked by alternating episodes of hypoglycemia and hyperglycemia
Varying amounts of glucose can result from - defects in insulin secretion (pancreas not making insulin), defects in the action of insulin pancreas has produced the correct amount of insulin but cells are resistant to the action of insulin (hyperglycemia), defects in both secretion and action of insulin
DM type 1
Insulin dependent or juvenile - onset DM
Autoimmune disease that tend to occur in young, lean individuals before the age of 25 who produce little or no insulin
Family history appears to be of a minor importance, autoimmune, genetic and environmental factors are involved in this type
rely on insulin for survival
DM type 2
Non-insulin dependent diabetes or adult onset DM
Can still produce insulin but do so inadequately for their body’s needs
Occurs most commonly in obese individuals over the age of 40 with marked family tendency
Usually responds to changes in diet/lifestyle and oral hypoglycemic meds
Classifications of diabetic crisis
Diabetic coma - too little insulin (hyperglycemia)
Insulin reaction - too much insulin (hypoglycemia)
What is hyperglycemia
Elevated levels of blood glucose
Insufficient insulin prevents the use of glucose by the muscles causing the glucose level in the blood to rise
What is diabetic Ketoacidosis (DKA)
When excess ketone bodies appear in the blood this happens b/c when the muscles can’t use glucose the body will break down fat for muscular contraction and the byproducts of fatty acid metabolism form ketone bodies
Body compensates for this by hyperventilating and the loss of minerals and water in the urine, glucose can also spill over into the urine
most common with type 1
hyperosmolar Hyperglycemic nonketotic syndrome (HHNK)
Severe condition that can occur when patients with neglected type 2 DM become dehydrated and hyperglycemic
LOC may vary from initial confusion to coma
Treatment includes administration to rapidly expand intravascular volume thus increasing circulation and urine output
Signs/symptoms of mild-severe hyperglycemia
Terribly thirsty Frequent and copious urination Breath that smells fruity or sweet Decreased appetite Weakness Confusion or coma
What is hypoglycemia and how to treat it
Decreased levels of blood glucose
If diabetic pt has taken insulin but no food this may occur
Treatment for alert/cooperative pt is the rapid delivery of a source of easily absorbed sugar (juice, pop, prepackaged dose of glucose)
If pt is unconscious then a parental injection of 0.5-1.0 mg of glucagon can be given, IV infusion of dextrose solution could be necessary if they don’t respond to glucagon
needs to be reported to a physician/allow pt to rest until sugar takes effect
Signs/symptoms of mild - severe hypoglycemia
Sudden onset of weakness Sweating, tremors (quivering) Hunger Cold, clammy skin, diaphoresis Headache Tachycardia Impaired vision Personality change, agitated or nervous Loss of consciousness
Gestational Diabetes
Temporarily occurs during pregnancy
Significant hormone changes can lead to blood sugar elevation in genetically predisposed individuals
Usually resolves once baby is born
