Diabetic Emergencies and Altered Mental Status Flashcards
Reticular Activating System (RAS)
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
Diabetes Mellitus
“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.
Diabetic Emergencies
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
Diabetic Ketoacidosis (DKA)
condition that occurs as the result of hyperglycemia characterized by dehydration, altered mental status and shock.
Hypoglycemia vs. Hyperglycemia
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
Seizure
sudden change in sensation, behavior, or movement. most severe form produces violent muscle contractions called convulsions
partial seizure
seizure that affects only one part or one side of the brain
generalized seizure
seizure that affects both sides of the brain
tonic- clonic seizure
generalized seizure in which the patient loses consciousness and has jerking movements of paired muscle groups
postictal phase
convulsions stop, patient may regain consciousness and enter a state of drowsiness and confusion, or may remain unconscious. headache is common
aura
sensation experienced by a seizure patient right before the seizure, which might be a smell, sound, or general feeling
Tonic phase
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.
Clonic phase
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
Causes of Seizures
Hypoxia Stroke Traumatic brain injury Toxins Hypoglycemia Brain Tumor Congenital Brain Defects Infection Metabolic Idiopathic
Seizures may be seen with…
Epilepsy
Measles, mumps, and other childhood diseases
Eclampsia (severe complication of pregnancy)
Heat Stroke
Epilepsy
Medical condition that causes Seizures
unbrella term used when a person has multiple seizures from an unknown cause
Status Epilepticus
prolonged seizure or situation when a person suffers two or more convulsive seizures without regaining full consciousness
Stroke
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)
Ischemic stroke
stroke caused by a blockage.
can occur when a clot or embolism occludes an artery
Hemorrhagic stroke
stroke caused by bleeding into the brain.
result of longstanding hypertension or an aneurysm
Signs and Symptoms of Stroke
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.
Subarachnoid Hemorrhage
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
Transient Ischemic Attack (TIA)
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.
Syncope
fainting
Causes of Dizziness and syncope
Hypovolemic Causes, Metabolic and Structural causes, Environmental/ Toxicological Causes, and Cardiovascular Causes
Hypovolemic Causes
Hypovolemia or low fluid/ blood volume, can cause dizziness or syncope when patient attempts to sit up or stand. dehydration, internal bleeding, trauma
Metabolic and Structural Causes
something is wrong with the brain or the structures near it, hypoglycemia
Environmental/ Toxicological Causes
Alcohol, drugs, Carbon Monoxide poisoning, panic attacks and anxiety attack leading to hyperventilation
Cardiovascular Causes
dysrhythmia, greater cardiac output, or low cardiac output
