Endo CIS Flashcards
Define kussmaul respiration’s?
Deep rapid respiration’s associated with acidosis
How to calculate anion gap and what is the new mnemonic for differentials for high anion gap acidosis?
GOLDMARK
Glycols, oxoproline, L lactate, D lactate, methanol, Aspirin, Renal failure, ketoacidosis.
What is the differential list for ab pain?
BAD GUT PAINS Bowel obstruction Appendicitis Diverticulitis, DKA Gastroenteritis, Gall bladder problems UTI Testicular torsion,Toxin Pneumonia, pancreatitis, peptic ulcer Abdominal aneurysm Infarction, bowel or heart, IBD Splenic rupture/infarction
Signs of DKA?
N/V Tachycardia Hypotension Fruity smell to breath Kussmaul respiration’s Ab pain Fever
3 labs for DKA?
Hyperglycemic, ketones in blood and urine, and metabolic acidosis (high potassium)
What are the 3 most common cause of hypoglycemia? Which one is first?
Meds, most common
Organ failure
Sepsis/infection
Where do we admit patients with DKA or hypoglycemia?
ICU, cardiac monitoring, one on one nurse and frequently labs
3 treatments for DKA?
Fluids
Electrolytes
Insulin
What two things to consider that are not included in CMP?
Mg and pH
How do you correct for sodium when sugar is high?
Sodium + ((glucose -100) * 0.016)
What is the initial IV fluid we give to a patient with DKA and when would we switch it?
NS
Switch it to D51/2NS in patients with an insulin drip when their glucose gets to 250 to prevent hypoglycemia
What is first priority in treating DKA?
Fix acidosis
When is it OK to stop DKA treatment protocol and what does treatment turn into at this point?
When the anion gap is closed.
Switch to long acting insulin and you can stop drip 2 hours after long acting is administered
4 symptoms of hypoglycemia?
Weak, sweating, altered mental status, and seizures
What to give for a person with low sugars who is awake and alert?
What to give decreased level of consciousness or seizure? What is the most common cause of low blood sugars?
Fast acting carb like glucose tablet or hard candy
IV D50 or IM glucagon
Medications
