Diabetic Emergencies and Altered Mental Status

Question 1

Reticular Activating System (RAS)

Answer 1

series of neurologic circuits in the brain that control the functions of staying awake, paying attention, and sleeping
O2 is needed to perfuse brain tissue, glucose is needed to nourish brain tissue, and water is needed to keep brain tissue hydrated

Question 2

Diabetes Mellitus

Answer 2

“sugar Diabetes” or just “diabetes”, condition brought about by decreased insulin production or the inability of the body cells to use insulin properly
Type 1 insulin dependent occurs when pancreatic cells fail to function properly and insulin is not secreted normally
Type 2 non-insulin dependent body cells fail to utilize insulin properly, pancreas may be secreting enough insulin but the body is unable to use it to move glucose out of the blood and into the cells.

Question 3

Diabetic Emergencies

Answer 3

Take too much insulin, transferring glucose into the cells to quickly and causing a rapid depletion of available sugar
Reducing sugar intake by not eating
overexercises or overexerts
vomits a meal

Question 4

Diabetic Ketoacidosis (DKA)

Answer 4

condition that occurs as the result of hyperglycemia characterized by dehydration, altered mental status and shock.

Question 5

Hypoglycemia vs. Hyperglycemia

Answer 5

Hyperglycemia usually has a slower onset
hypoglycemia tends to come on suddenly seizures may occur
hyperglycemic patients often have warm, red, dry skin.
hypoglycemic patients have cold, pale, moist, or clammy skin
Hyperglycemic patients have acetone breath
hypoglycemic patients do not

Question 6

Seizure

Answer 6

sudden change in sensation, behavior, or movement. most severe form produces violent muscle contractions called convulsions

Question 7

partial seizure

Answer 7

seizure that affects only one part or one side of the brain

Question 8

generalized seizure

Answer 8

seizure that affects both sides of the brain

Question 9

tonic- clonic seizure

Answer 9

generalized seizure in which the patient loses consciousness and has jerking movements of paired muscle groups

Question 10

postictal phase

Answer 10

convulsions stop, patient may regain consciousness and enter a state of drowsiness and confusion, or may remain unconscious. headache is common

Question 11

aura

Answer 11

sensation experienced by a seizure patient right before the seizure, which might be a smell, sound, or general feeling

Question 12

Tonic phase

Answer 12

body becomes rigid, stiffening for no more than 30 seconds. breathing may stop, patient may bit tongue, and bowel and bladder control could be lost.

Question 13

Clonic phase

Answer 13

body jerks about violently, usually for no more than 1 or 2 minutes. the patient may foam at the mouth and drool. face and lips often become cyanotic

Question 14

Causes of Seizures

Answer 14

Hypoxia
Stroke
Traumatic brain injury
Toxins
Hypoglycemia
Brain Tumor
Congenital Brain Defects 
Infection
Metabolic
Idiopathic

Question 15

Seizures may be seen with…

Answer 15

Epilepsy
Measles, mumps, and other childhood diseases
Eclampsia (severe complication of pregnancy)
Heat Stroke

Question 16

Epilepsy

Answer 16

Medical condition that causes Seizures

unbrella term used when a person has multiple seizures from an unknown cause

Question 17

Status Epilepticus

Answer 17

prolonged seizure or situation when a person suffers two or more convulsive seizures without regaining full consciousness

Question 18

Stroke

Answer 18

condition of altered function caused when an artery in the brain in blocked or ruptured, disruption the supply of oxygenated blood or causing bleeding into the brain
formally called Cerebrovascular Accident (CVA)

Question 19

Ischemic stroke

Answer 19

stroke caused by a blockage.

can occur when a clot or embolism occludes an artery

Question 20

Hemorrhagic stroke

Answer 20

stroke caused by bleeding into the brain.

result of longstanding hypertension or an aneurysm

Question 21

Signs and Symptoms of Stroke

Answer 21

Hemiparesis (one sided weakness), headache (less common), difficult to communicat with patient, loss of ability to use words or difficulty in using words (expressive aphasia), or the patient may be able to communicate well but not understand you.

Question 22

Subarachnoid Hemorrhage

Answer 22

Particular kind of bleeding from an artery under the arachnoid layer of the meninges (several layers of tissue that surrounds the brain and spinal cord)
Patient cried out in pain, clutched his head, and collapsed, this is important information for hospital staff

Question 23

Transient Ischemic Attack (TIA)

Answer 23

Mini Stroke
all normal signs of a stroke but has complete resolution of symptoms without treatment
small clots may be temporarily blocking circulation to part of the brain. when clot breaks up patients symptoms resolve.

Question 24

Syncope

Answer 24

fainting

Question 25

Causes of Dizziness and syncope

Answer 25

Hypovolemic Causes, Metabolic and Structural causes, Environmental/ Toxicological Causes, and Cardiovascular Causes

Question 26

Hypovolemic Causes

Answer 26

Hypovolemia or low fluid/ blood volume, can cause dizziness or syncope when patient attempts to sit up or stand. dehydration, internal bleeding, trauma

Question 27

Metabolic and Structural Causes

Answer 27

something is wrong with the brain or the structures near it, hypoglycemia

Question 28

Environmental/ Toxicological Causes

Answer 28

Alcohol, drugs, Carbon Monoxide poisoning, panic attacks and anxiety attack leading to hyperventilation

Question 29

Cardiovascular Causes

Answer 29

dysrhythmia, greater cardiac output, or low cardiac output