148 Hypoglycemia Flashcards

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1
Q

What are the INDICATIONS for the HYPOGLYCEMIA medical directive?

A

Suspected hypoglycemia

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2
Q

What are the CONTRAINDICATIONS for DEXTROSE in the HYPOGLYCEMIA Medical Directive?

A

Allergy

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3
Q

What are the CONDITIONS for DEXTROSE in the HYPOGLYCEMIA Medical Directive?

A

Altered
Hypoglycemia

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4
Q

What is the DOSE for DEXTROSE in the HYPOGLYCEMIA Medical Directive? D10W

A

0.2g (2ml)/kg

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5
Q

What is the DOSE for DEXTROSE in the HYPOGLYCEMIA Medical Directive? D50W

A

0.5mg (1ml)/kg

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6
Q

What is the MAX DOSE for DEXTROSE in the HYPOGLYCEMIA Medical Directive? D10W under 2

A

5g (50ml)

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7
Q

What is the MAX DOSE for DEXTROSE in the HYPOGLYCEMIA Medical Directive? D10 W over 2

A

25g (250ml)

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8
Q

What is the MAX DOSE for DEXTROSE in the HYPOGLYCEMIA Medical Directive? D50W under 2

A

N/A

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9
Q

What is the MAX DOSE for DEXTROSE in the HYPOGLYCEMIA Medical Directive? D50 W over 2

A

25g (50ml)

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10
Q

What AGE must the patient be to receive the increased single dose of D10W?

A

2

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11
Q

What AGE must the patient be to receive D50W?

A

2

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12
Q

What is the dosing INTERVAL for DEXTROSE in the HYPOGLYCEMIA Medical Directive?

A

10 minutes

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13
Q

How MANY doses can you give for DEXTROSE in the HYPOGLYCEMIA Medical Directive?

A

2

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14
Q

What is the ROUTE of administration for DEXTROSE in the HYPOGLYCEMIA Medical Directive?

A

IV only

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15
Q

What are the CONTRAINDICATIONS for GLUCAGON in the HYPOGLYCEMIA Medical Directive?

A

Allergy to glucagon
Pheochromocytoma

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16
Q

What are the CONDITIONS for GLUCAGON in the HYPOGLYCEMIA Medical Directive?

A

Altered
Hypoglycemia

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17
Q

What is the DOSE for GLUCAGON in the HYPOGLYCEMIA Medical Directive? Under 25kg IM

A

0.5mg

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18
Q

What is the DOSE for GLUCAGON in the HYPOGLYCEMIA Medical Directive? Over 25kg IM

A

1mg

19
Q

What is the DOSE for GLUCAGON in the HYPOGLYCEMIA Medical Directive? Over 4 IN

A

3mg

20
Q

What AGE must the patient be to receive GLUCAGON IN?

A

4 years old

21
Q

What is the dosing INTERVAL for GLUCAGON in the HYPOGLYCEMIA Medical Directive?

A

20 minutes

22
Q

How MANY doses can you give for GLUCAGON in the HYPOGLYCEMIA Medical Directive?

A

2

23
Q

What is the ROUTE of administration for GLUCAGON in the HYPOGLYCEMIA Medical Directive?

A

IM/IN

24
Q

What does glucagon do to the pancreas

A

The alpha cells produce more hormones

25
Q

What are pancreatic hormones involved in sugar regulation?

A

alpha: Glucagon
beta: Insulin
delta: Somatostatin

26
Q

What does Glucagon do to the liver?

A

Creates glucose through glycogenolysis

27
Q

What does somatostatin do?

A

Gluconeogenesis

28
Q

What effects does glucagon have on the heart

A

Increased inotropy and chronotrophy

29
Q

Why is glucagon good for a beta blocker overdose?

A

Triggers catecholemine release

30
Q

Why is glucagon good for esophageal obstructions?

A

Relaxes smooth muscles

31
Q

What are the off-market uses for glucagon?

A

Beta blocker overdose reversing agent
Smooth muscle relaxer in esophageal obstructions

32
Q

What conditions decrease glycogen stores?

A

Alcoholism
Starvation
Malnutrition
Renal insufficiency
Chronic hypoglycemia

33
Q

Why is dextrose preferred in depleted glycogen stores?

A

When glucagon is given the liver breaks down glycogen with glycogenolysis. If there are no glycogen stores, it is unable to be turned into glucose.

34
Q

What are some side effects of Dextrose

A

Phlebitis: hypertonic solution if given too fast
Increase ICP: in head injury patients
Wernicke’s Encephalphy: in Thiamine depleted patients (alcohol/ malnourished)

35
Q

What is the 15-15 rule?

A

15 grams of simple carbs
Check 15 minutes later
15 grams more if needed

36
Q

How high should the 15-15 rule increase CBG?

A

2.1mmol in 20 minutes

37
Q

What is an example of 15 grams in water

A

3 sugar packets

38
Q

What is an example of 15 grams in

A

150ml soft drink

39
Q

What is an example of 15 grams in honey

A

15ml

40
Q

What is the cause of DKA

A

Not enough insulin

41
Q

What happens in DKA?

A

Cells shift with fatty acids instead of glucose which creates ketones

Ketones are acidic

42
Q

What are symptoms of DKA?

A

Kussmaul’s breathing
Bounding pulse

43
Q

What should be considered after treatment of hypoglycemia?

A

Treat and release directive