Lecture 5 Flashcards
Diabetes Mellitus
is an error in glucose metabolism
Diabetes Insipidus
is diabetes without the glucose part
- Causes polydipsia and polyuria due to low ADH and dehydration
SIADH
The syndrome of inappropriate Antidiuretic Hormome.
- the opposite of DI
- oliguria and no thirst
Urine specific Gravity
less urine -> High urine specific gravity (SIADH)
More urine -> less urine specific gravity (DI)
Fluid Volume Deficit/ Dehydration
DI, DM
FLuid volume overload/ urine retention
SIADH
DM type 1 Characteristics and tx
insulin dependent, juvenile onset, ketosis prone
- DIE Insulin (1), Exercise (2), Diet (3)
DM type 2 Characteristics and tx
Insulin Resistant, adult onset, non ketosis prone
- Diet (1), oral hypoglycemic, activity
Type 2 DM Diet
Calorie restriction is the most important thing!
- Also they need to east 6 small meals a day
Regular Insulin
Clear, IV, Drip, Rapid/intermediate
onset: 1h
Peak: 2H
Duration: 4H
Pattern: 1-2-4
R means rapid and run IV
NPH insulin
Cloudy, Non- IV, Suspension, true intermediate
onset:6h
Peak:8-10H
Duration: 12
Pattern: 6-8-10-12
N means Not so fast and not in the bag
Lispro
Short acting only give with meals
onset: 15 mins
Peak: 30 mins
Duration: 3 hours
15-30-3
Glargine
Very long acting only one that can be given at bedtime
Duration: 12-24
No peak
What invalidates a manufacturers exp date for insulin
- open the package
-once its open new exp date is 30 days after that
-A package without an exp date should be thrown out - label the package with an exp date
-Refrigeration is optional in hospital once package is open however pts must know to refrigerate their insulin at home
Exercise does what to insulin
its basically like another shot of insulin
so with more exercise they need less insulin
- pts must also have a carbohydrate rich snack with them
Sick days with Insulin
- GLucose goes up regardlessif patient eats or not
- They need to take there insulin still
- Take sips of water tp prevent dehydration
- stay active to lower glucose
Hypoglycemia
CAuses: Too much insulin(1), exercise, not enough food
Dangers: Brain Damage
Hypoglycemia S/s
Drunk in Shock
Drunk: Staggering gait, slurred speech, cerebral impairment, slow reaction time
Shock: Tachycardia, cold, clammy, hypotensive, tachypnea
Tx For hypoglycemia
If conscious: give sugar/rapidly metabolized carbs
BEst answer: one sugar + protein
Bad answer is candy and soda= 2 sugars or more are bad
If patient is unconscious with hypoglycemia
At home give IM glucagon
In Hospital: D10 or D50 IV
DKA
Hyperglycemia in TD1M with ketones
DKA causes
1 cause is acute viral upper respitratory infection for 2 weeks
- not enough
DKA s/s
D- Dehydration ( flushing overheating)
K- Ketones, Kussmauls, High K
A- Acidosis, acetone breath, anorexia
Tx for DKA
IV fluids at 200mL or faster
IV regular insulin
d5 will not create a hypoglycemic
