Acute Complications Of Diabetes Flashcards

1
Q

What causes DKA

A

Profound deficiency of insulin

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2
Q

What are the DKA characteristics

A

Hyperglycemia
Ketosis
Acidosis
Dehydration

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3
Q

DKA most likely occurs in which diabetes pts

A

Type I diabetics

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4
Q

What are clinical manifestations of DKA

A

Dehydration
Poor shin turgor
Dry mucous membranes
Tachycardia
Orthostatic hypotension
Lethargy and weakness
Skin, dry, loose; eyes sunken

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5
Q

What are symptoms of DKA

A

Abd pain
Anorexia
N/v
Kussmal respirations
Sweet and fruity breath

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6
Q

What will lab values look like for a pt with DKA

A

Bg of 250 or higher
Blood ph less than 7.30
Serum bicarb less than 16
Moderate to high ketones in urine or serum

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7
Q

What is the treatment for DKA

A

Administer oxygen
Establish iv access to begin fluids (nacl 0.45% or 0.9%)
Add 5% to 10% dextrose when blood glucose level approaches 250
Continonious regular insulin drip
Potassium replacement as needed

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8
Q

Why do we need to replace potassium as needed for DKA

A

Because insulin drip will lower potassium

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9
Q

How fast is the onset for DKA

A

Rapid onset

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10
Q

HHS occurs more in what population

A

Occurs in elderly

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11
Q

Is HHS a more rapid or gradual onset

A

Gradual

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12
Q

What are the labs indicative for HHS

A

Bg over 600
Ph over 7.3
Bicarb over 30
Negative ketones

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13
Q

HHS occurs in what type of diabetes

A

Type 2 diabetes

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14
Q

What are precipitating factors to HHS

A

UTIs, pneumonia, sepsis
Acute illness
Newly diagnosed type 2 diabetes
Impaired thirst sensation and /or or inability to replace fluids

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15
Q

Is HHS a medical emergency

A

Yes

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16
Q

Does HHS have a high mortality rate

A

Yes

17
Q

What is the treatment for HHS

A

Iv fluids (na cl 0.45% or 0.9% )
Iv insulin
Monitor potassium
Correct underlying cause

18
Q

When do we know when a pt with HHS is getting better

A

Decreased urine output

19
Q

What can cause hypokalemia in a diabetic pt

A

Insulin drip

20
Q

What is the biggest concern of hypokalemia

A

Affects on the heart

21
Q

What is lipohypertrophy

A

Accumulation of sub q fat when insulin is injected at same site too frequently