Hyperglycemia Flashcards
What are kussmaul respirations in DKA?
Body’s attempt to compensate for metabolic acidosis (low pH, low CO3) and removing CO2. Causes rapid deep breathing and a sweet fruity odour
Primary intervention for DKA?
Fluid resuscitation (IV fluids) to manage dehydration/correct electrolyte imbalances
What test will nurse use to evaluate effectiveness of diabetes type 2 treatment for a follow up visit?
Glycosylated hemoglobin level (hemoglobin A1C) tracks amount of hemoglobin on RBCs for 120 days/shows trends
What should you do when your pt with DKA has low potassium level?
Hold the insulin to prevent life threatening hypokalemia, and potassium replacement might be necessary before resuming insulin
What is hyperglycemia?
Chronic multi system disease r/t abnormal insulin produced/impaired insulin utilization. Causes high BG. Leading cause of end stage renal disease, adult blindness, and lower limb amputations. It is also a contributing factor to heart disease and strokes.
What is insulin?
Insulin is produced by B cells in the pancreas and its release into the bloodstream, especially after food intake. Insulin promotes uptake of glucose from bloodstream to cytoplasms of cells
What is hemoglobin A1C level?
Used to most to dx diabetes (>6.5%). Determines glycemic levels over time/shows amount of glucose attached to hemoglobin molecules over RBC life span (3 months).
S+S of hyperglycemia?
Polyuria, polydipsia, polyphagia, elevated BG, blurry vision, weight loss, weakness/fatigue, abdominal cramps
What is DKA?
Complication of diabetes that causes profound deficiency of insulin. Has ketosis, acidosis, hyperglycemia, and dehydration effects
What is ketones?
Acidic byproduct formed when there’s a lack of insulin and fatty acids are utilized as energy
Precipitating factors of DKA?
Illness, infection, inadequate insulin dosing, stress, undiagnosed type 1, poor self management, change in diet/insulin/exercise
S+S of DKA?
Lethargy, weakness, BG over 11.1 mmol/L, dehydration, poor skin turgor, dry mucous membranes, tachycardia, orthostatic hypotension, sunken eyes, kussmaul respirations
Fluid and electrolyte therapy?
Give IV NS or 0.9 NaCl to restore UO and raise their BP. When BG levels approach 13.8 give 5% dextrose to prevent hypoglycemia. Potassium replacement can be needed because insulin drives potassium into the cells=hypokalemia. Give insulin after fluids/electrolytes are restored
Nursing management for hyperglycemia?
Monitor pt during IV fluids, insulin therapy, and electrolyte therapy. Monitor cardiac rhythms and monitor for fluid overload signs.
Why is pt education essential?
It’s key to managing diabetes at home and having good glycemic control
