study guide Washburn Flashcards
what is the dosage of dextrose?
25g of 10-50% IV
50 ml of 50% dextrose
100 ml of 25% dextrose
150 ml of 10% dextrose
what is the Peds dose of dextrose?
0.5- 1 g/kg of 10-25% dextrose IV
what is the dose of thiamine
Dose of Thiamine: 100 mg IV IO IM
what is the indication of thiamine?
coma of unknown origin
if alcohol may be involved
give thiamine prior to glucose.
Delirium tremors with thiamine prior to glucose
what does thiamine do?
Thiamin is necessary for carbohydrate metabolism. Alcoholics and malnourished patient may affect intake, absorption and utilization of glucose so thiamine is administered prior to glucose
describe type I diabetes
typically described as juvenile diabetes
body does not make insulin
what is type II diabetes
make their own insulin but it’s not used properly by the body.
Where is insulin produced?-
Pancreas
How is insulin produced?
The islets of Langerhans are made up of different types of cells that make hormones, the commonest ones are the beta cells, which produce insulin.
what is hypoglycemic unawareness?
Diabetics who have been struggling with diabetes for years. They can lose the ability to recognize symptoms of hypoglycemia such as tachycardia, pallor sweating and anxiety.
where does glucagon come from?
the pancreas.
its a response to low blood sugar.
Glucagon mobilizes glucose stored in the liver and muscle in the form of glycogen
what is the dose of glucagon?
1mg IM IN
What is Wernicke’s korsakoff syndrome?
If given dextrose before thiamine these pts can develop this brain condition
S/S: amnesia, confabulation, attention deficit, disorientation and vision impairment.
Administer thiamine to malnourished, or alcoholic patients
alcoholics or malnourished patients with depressed mental status may have deficiency of thiamine.
What is the most common med prescribed to type II diabetic?
metformin glipizide
What classification is thiamine?
Water soluble vitamin
it aids in carbohydrate metabolism for ETOH and malnourished patients.
What is DKA-
occurs mostly in pts with type I diabetes, the problem is a lack of insulin. The body is unable to use the glucose or sugar in their bloodstream but not enough insulin to use it. So now the cells still need the blood sugar but start to break down fat producing acid and chemicals (ketone bodies).
What is keto acidosis?
The patients in dka have metabolic acidosis, dehydration, and electrolyte abnormalities,the type of acidosis that this patients have is ketoacidosis
What is lactic acidosis?-
when the body is in shock- perfusion is lacking (no o2)
so the body is using anaerobic metabolism
therefore the body is in a state of lactic acidosis.
LACTATE IS THE BYPRODUCT OF ANAEROBIC METABOLISM
What is the tx for hyperglycemia (over 300mg/dL) and showing signs of hyperkalemia (12-Lead EKG shows peaked T waves)?
Administer fluids
Sodium bicarbonate: 1 mEq/kg (max of 50 mEq) bolus over 5 min - this is alkalinic *
Albuterol: 2.5 mg in 3 mL nebulized - this shifts potassium p. 74 prot
If glucose is over 300, with s/s dehydration, vomiting, abdominal pain, altered level of consciousness give: Crystalloid resuscitation: A: 20 cc/kg IV IO repeat prn P: 20 cc/kg IV IO prn
What is the ped dose of glucagon?
over 5 yo 1mg IM IN
younger than 5 yo 0.5 mg IM IN
What is hypertensive urgency?-
severe elevation of blood pressure without evidence of organ failure. P 232 guy
What is hypertensive emergency?-
high blood pressure with:
evidence of end organ damage
kidneys heart and brain.
S/S headache visual changes, altered LOC , heart failure.
What is the dose for ASA in MI attack?
162-324 mg
What is eclampsia?
very high blood pressure, visual disturbance, kidney failure liver damage SEIZURES.
What is the action of magnesium?
calcium channel blocker that blocks neuromuscular transmission.
Class: electrolyte, Antiinflammatory
What is the action of magnesium?
calcium channel blocker that blocks neuromuscular transmission.
Class: electrolyte, Antiinflammatory
What is the action of magnesium?
calcium channel blocker and blocks neuromuscular transmission.
Class: electrolyte, Antiinflammatory
What is the dose of magnesium in torsades?
2 g in 100mL NS or D5W over 10 min