Diabetic emergencies Flashcards
1
Q
what is the main function of insulin
A
- promote transport of glucose from blood into skeletal and adipose tissue (into cells)
2
Q
why is it important for glucose to move out of the blood stream and into cells
A
- main source of energy for cells
- if it stays in blood stream can have huge issues
3
Q
where does insulin come from
A
- pancreas
4
Q
how does the pancreas control blood glucose levels?
A
- with 2 hormones insulin (comes from beta cells) and glucagon (comes from alpha cells)
5
Q
what is basal levels of insulin from pancreas
A
- small levels of insulin released throughout the day
6
Q
what is type I DM
A
- breaks down pancreatic beta cells (insulin)
- is insulin dependent
- is prone to ketoacidosis when glucose levels get too high.
6
Q
bolus insulin released from pancreas
A
- when we eat food pancreas releases a big amount of insulin
7
Q
what is type II DM
A
- insulin receptors on tissues become resistant to insulin
- decreased ability for beta cells to create insulin
- glucagon is released stimulating more glucose form liver
8
Q
hypoglycemia
A
- blood sugars below 4.0
- 4.0-3.0 patients should eat carbs to increase
- less than 3.0 immediate action
9
Q
risk factors for hypoglycemia
A
- missed/delayed meals
- low carbs
- exercise
- med errors (wrong insulin dose)
- acute illness
- dementia
10
Q
what are the neurogenic autonomic symptoms of hypoglycemia
A
- tremors
- palpitations
- anxiety
- sweating
- hunger
- numbness/tingling
11
Q
neuroglycopenic symptoms
A
- dizziness
- weakness
- drowsiness
- delirium
- confusion
- seizures
- coma
-difficulty concetrating
12
Q
how to treat hypoglycemia
A
- depends on patient level of consciousness
- dietary or parenteral carbs or administer glucagon (severe cases)
13
Q
when do you give glucagon and IV 50% dextrose to a hypoglycemic patient
A
- IV 50% dextrose right away if IV is open
- if Iv cannot be put in then glucagon is the fastest choice then start IV
14
Q
what is diabetic ketoacidosis
A
- acute
- most common with type I
- body breaks down lipids for fuel
- ketones in urine
15
Q
hyperglycemia with DKA is due to:
A
- increased gluconeogenesis (produce glucose and lactic acid)
- increased glycogenolysis (forms glucose)
- decreased glucose utilization by cells
- ketosis (fat metabolism)
- metabolic acidosis
- dehydration (at risk for hypovolemic shock)
- ketonuria and electrolyte imbalances
16
Q
risk factors for DKA
A
- type I
- acute and severe illness/stress
- infection
- inadequate insulin dosages
17
Q
signs and symptoms of DKA
A
- abd pain
- breath odor
- dry mouth
- fever/flushed dry skin
- ketones in urine
- restless/confusion
- laboured breathing
- rapid/weak pulse
- hypotension
- glucose greater than 14
- thirsty/increased urine
18
Q
treat DKA
A
- infusion of isotonic saline (stabilize CO, increasing PL, an dperfusion to tissues) - add dextrose once sugars are down to 11
- 40 of KCl for correct hypokalemia
- administer insulin (regular or rapid acting
19
Q
how do we determine the dose of insulin IV to give?
A
- give low dose if serum potassium is greater or equal to 3.3 - don’t want to drop it more
