NON-DKA, hypoglycemia Flashcards

1
Q

metabolic complications

A

-DM is same thing as having HF same risks?? she said this
-Acute
-DKA
-HHNK
-Hypoglycemia

-Chronic
-Macrovascular- Cardiovascular disease; cerebrovascular disease
-Microvascular:
-Retinopathy
-Nephropathy
-Neuropathy

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2
Q

HHNK (hyperglycemia, hyperosmolar nonketotic syndrome)

A

-MC occurs in older adults with type 2 diabetes
-always look for precipitating factors

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3
Q

factors associated with HHNK

A

-Drugs
-Procedures
-Chronic illness
-Acute illness
-K is not as urgent bc insulin is present

-4 major clinical features
-Severe hyperglycemia
-No or slight ketosis
-Profound dehydration
-Hyperosmolality
-Complications: MI, Stroke, PE, Mesenteric vein thrombosis, DIC
-No acidosis
-The severe dehydration and low output state may predispose the patient to complications such as MI, stroke, PE, mesenteric vein thrombosis, and disseminated intravascular coagulation

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4
Q

treatment

A

-similar to DKA
-Volume replacement
-Insulin
-Find underlying cause

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5
Q

hypoglycemia

A

-AKA insulin reaction or hypoglycemia reaction

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6
Q

hypoglycemia risk factors

A

-Overdose of insulin/hypoglycemic medication
-Omitting a meal
-Overexertion
-Nausea and vomiting
-Alcohol intake

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7
Q

symptoms of hypoglycemia

A

-ADRENERGIC:
-Shakiness
-Irritability
-Nervousness
-Tachycardia
-Tremor
-Hunger
-Diaphoresis
-Pallor
-Paresthesias

-NEUROGLYCOPENIC:
-Headache
-Mental illness
-Inability to concentrate
-Slurred speech
-Blurred vision
-Confusion
-Irrational behavior
-Lethargy
-LOC, coma, seizure

-diff dx- hypothyroid, stroke

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8
Q

hypoglycemia interventions

A

-Mild- carbohydrate 10-15 gram*

-Moderate:
-20-30 gram of carbohydrates*
-Glucagon, 1 mg IM - if unconscious

-Severe:
-50% dextrose 25 g IV
-Glucagon 1 mg IM or IV

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9
Q

hypoglycemia other complications: somogyi phenomenon

A

-tendency of the body to react to extremely low blood sugar (hypoglycemia) by overcompensating, resulting in high blood sugar
-hormones can change at night and affect sugar
-Somogyi effect, also known as the “rebound” effect
-adjust nighttime insulin

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10
Q

hypoglycemia other complications: dawn phenomenon

A

-Hormones (growth hormone, cortisol, and catecholamines) release large amounts of glucose: released in the early morning hours: may partially block the effect of insulin,—-hyperglycemia ensues
-adjust nighttime insulin

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11
Q

diabetic client and surgery

A

Preoperative care- stop PO and start injection insulin

Intraoperative care

Postoperative care

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12
Q

sick days and diabetes

A

-Individualized plan
-Monitoring:
-glucose levels
-ketones
-insulin
-nutrition
-fluids

-Know when to call the Clinician

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