diabetic emergencies Flashcards
signs od dka
tired cobfusion passing out stomach pain pee more often high blood sugar thirsty bluured vision
what must be present to confirm dka
1) CAPILLARY BLOOD GLUCOSE >11.0 mmol/L OR KNOWN DIABETES
2) CAPILLARY BLOOD KETONES >3.0 mmol/L OR 2+ KETONURIA (on urinary ketone sticks)
3) VENOUS Ph <7.3 and/or VENOUS BICARBONATE <15 mmol/L
immediate action if presenting with dka
-ABC assessment including all routine observations including GCS,
Capillary blood glucose check and capillary ketone check
-Obtain urgent IV access and commence fluids as per trust DKA regime
-Venous bloods obtained for U&E, bicarbonate, FBC and venous blood gas, blood cultures.
-Urinalysis for ketones (if capillary ketones not available), MSU
-VTE prophylaxis unless contraindicated
criteria to admitting to ITU for severe dka
Ketone >6 pH < 7.1 HCO3 <5 / anion gap > 16 K+ < 3.5 GCS < 12 SpO2 < 92% SBP < 90, Pulse >100 / < 60
What should you continually monitor
K+
With VBG testing
What to give if K+ is low
Kcl
At what K level should you contact seniors
<3.5
When to never give Kcl
If patient is anuric
What should you monitor when administering K
Cardiac
INpection of HHS
-Patients usually appear ill and look exhausted, if they are still conscious.
There may be evidence of disorientation or confusion.
Look for signs of self neglect due to recent illness or long standing inability to self care.
Signs of dehydration may be visible on general inspection.
VITAL SIGNS
Tachycardia is common due to dehydration.
Hypotension may be present due to severe fluid depletion.
treatment of HHS
Lots of IV fluid but slowly
Insulin but low amount
LMWH for VTE prophylaxis
management of HHS
review meds
refer to speiaist nurse to stop this happening again
What is hypoglycaemia
blood glucose <4mmol
causes of hypo
missed meals
low carbs
unplanned or strenuous exercise
too much insulin
symptoms of hypo
fatigue sweating pallor headache increased HR
