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Med Surg 1 > Assessment and Management of Diabetes Complications (Part 3) > Flashcards

Assessment and Management of Diabetes Complications (Part 3) Flashcards

1
Q

complications of diabetes

A

hypoglycemia
diabetic ketoacidosis
HHS
long term

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2
Q

hypoglycemia numbers

A

below 70

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3
Q

severe hypoglycemia number

A

less than 40

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4
Q

clinical manifestations of hypoglycemia
- mild

A

SNS stimulation
sweating
tremor
tachycardia
palpations
nervousness
hunger

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5
Q

clinical manifestations of hypoglycemia
- moderate

A

brain deprived of glucose
CNS symptoms
inability to concentrate
headache
light headedness
confusion
memory lapse
numbness of lips and tongue

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6
Q

clinical manifestations of hypoglycemia
- severe

A

disorientation
seizure
difficulty arousing from sleep
loss of consciousness

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7
Q

can patients fix their own severe hypoglycemia

A

no
they require assistance from other people

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8
Q

who might have variable response to mild hypoglycemic

A

elderly
beta blocker
long term diabetic

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9
Q

management of hypoglycemia
- able to eat

A

check BS first
15g of carbs
repeat BS in 15 min
15 g of carb and protein

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10
Q

management of hypoglycemia
- unable to eat
- community setting

A

glucagon 1mg IM/SQ

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11
Q

management of hypoglycemia
- unable to eat
- acute care

A

25-50ml of 50% dextrose IV push
amp of D50

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12
Q

what do we need to be careful about after giving D50

A

careful assessment of IV site prior to administration and after due to dextrose

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13
Q

DKA definition

A

absence or markedly inadequate amount of insulin resulting in disorders of the metabolism of carbs, proteins, and fats

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14
Q

DKA
- clinical manifestations

A

hyperglycemia (300-800)
metabolic acidosis
severe dehydration
electrolyte losses
ketone in blood/urine
kussmual
acetone breath
3 P
altered mental status

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15
Q

DKA onset

A

rapid

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16
Q

common causes of DKA

A

missed insulin dose
illness
infection
undiagnosed/untreated diabetes

17
Q

DKA assessment findings

A

blood glucose levels 300-800
low pH, CO2, and bicarb
ketones in urine/blood
electrolyte abnormalities
elevated BUN/cr and HCT

18
Q

DKA what electrolyte is affected

A

K

19
Q

steps to treating DKA

A

rehydration first
then insulin
then electrolyte

20
Q

rehydration step of DKA treatment

A

0.9NS initially, then 0.45 few fours in, then D5W when BS is about 250-300

21
Q

who might we use .45 fluids with during first step of treating DKA

A

hypertensive
heart failure

22
Q

how many total liters should a DKA patient get

A

6-10

23
Q

steps of treating DKA insulin

A

continuous infusion of regular insulin
frequent BS monitoring
IV solution D5 when blood sugar is 250-300

24
Q

electrolyte replacement DKA

A

cautious but timely replacement of K

25
Q

why might we not treat K right away

A

because K moves out as blood sugar rises so if we fix blood sugar then K will fix itself

26
Q

HHS defintion

A

metabolic disorder of type 2 resulting from relative insulin deficiency initiated by illness that raises the demand for insulin. More common in older adults

27
Q

HHS clinical manifesations

A

slow onset
hyperglycemia (BS>600)
absence of ketones

28
Q

do HHS have metabolic acidosis

A

NO

29
Q

HHS assessment and diagnostic findings

A

BS level 600-1200
osmolality greater than 320
BUN dehydrated(elevated)

30
Q

HHS treatment

A

similar to DKA
- rehydration with IV fluids
- insulin replacement
- electrolyte replacements

31
Q

long term complications with diabetes

A

microvascular
macrovascular
neuropathic

32
Q

macrovascualr complications of diabetes

A

accelerated atherosclerotic changes
coronary artery disease
cerebrovascular disease
peripheral vascular disease

33
Q

microvascular complications of diabetes

A

diabetic retinopathy
nephropathy

34
Q

neuropathic complications of diabetes

A

perhierphal neruopathy
autonomic neuropathies
hypoglycemia unawarness
meticulous foot care

35
Q

what does autonomic neuropathy cause

A

lack of adrenergic response

36
Q

foot care of a diabetic

A

have podiatrist check feet at least once a year
file toenails
check feet daily
wash feet daily
keep skin soft
do not walk barefoot
protect feet from hot and cold

37
Q

steps to lower risk of diabetic complications

A

A1C less than 7
take care of your feet
get recommended screenings and early treatment for complications
quit smoking

Med Surg 1 (47 decks)

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