Endocrine and Electrolytes Flashcards
6 symptoms to always remember with hyperglycemia and dka or HHS?
3 ps, abdominal pain, N/V, neuro problems
6 symptoms to remember specific to DKA?
ab pain, kussmaul repsirations, hypotension, fruity odor breath, neuro symptoms, tachycardia
Neurologic symptoms (seizures, focal weakness, lethargy, coma, death) – more prevalent in?
HHS
big picture difference between DKA and HHS?
DKA is in younger patients, type 1 diabetes and rapidly over a 24 hour period.
HHS is in older patients, type 2, and several days
3 most common causes of DKA?
most common cause of HHS?
infection, insulin not being regulated very well, new onset diabetes.
poorly controlled type 2 with an infection
What is the 3.5 - 5.5 rule for potassium when treating DKA?
over 5.5, start insulin infusion
3.5 - 5.5, add potassium to fluids
under 3.5, hold insulin and supplement k
What is a very serious complication of both DKA and HHS?
cerebral edema, especially in kids and young adults
When replacing fluids, what do we do when serum sodium normalizes?
switch to one half isotonic saline
What do we do when serum glucose reaches 250?
add dextrose to the fluids
The most common condition leading to hyperkalemia is?
missed dialysis in a patient with end stage renal disease (ESRD)
What are the 3 big picture mechanisms leading to hyperkalemia?
renal issues, release from intracellular space like rahbdo or trauma, and not being able to get into the cells.
two symptoms/problems I am always thinking with hyperkalmia?
muscle weakness and cardiac
5 things to give in the management of hyperkalmia?
calcium, beta agonists, insulin, glucose and dialysis or diuretics
What is the role of calcium in hyperkalemia?
stabilize the cardiac membrane, it does not lower the potassium
with hypoglycemia, what are the two broad groups of symptoms?
altered autonomic function, usually increased so adrenergic and cholinergic
cognitive function decreased, ha, dizzy, AMS, seixure, coma etc.
