Flashcards in Chapter 20 - Acute Diabetic Emergencies Deck (34):
disease that frequently causes changes in the Pts mental status resulting from alterations in the BGL.
Diabetes mellitus (DM)
carbs are a primary energy source for the cells. three major sources of carbohydrates:
sucrose (table sugar)
lactose (milk and dairy)
starches (potatoes and bread)
the two hormones primarily responsible for controlling levels of blood glucose are ______ and ______, both of which are secreted by the pancreas.
insulin and glucagon
____ is secreted when the BGL is elevated.
insulin has three main functions:
increase movement of glucose out of the blood and into the cells
causes the liver to take up the glucose out of the blood and convert it into glycogen, the stored form of glucose
decreases the BGL by the actions listed in 1 and 2: facilitating the movement of glucose into the cells and the liver
_____ is secreted by the pancreas when the blood glucose level is low and will work to increase the BGL.
three major functions of glucagon are:
converts glycogen stored in the liver back into glucose and releases it into the blood.
it converts other, noncarbohydrate substances into glucose in the liver
increases and maintains the BGL by the actions listed in 1 and 2: converting glycogen and other substances into glucose
________ is released by the adrenal glands when the BGL decreases to a dangerously low level. stops the secretion of insulin and promotes the release of stored glucose from the liver as well as the conversion of other substances into glucose.
glycogen stores in the liver can last for up to________.
after that fats and proteins will begin to be used by the body at a high rate for energy
the BGL of a nondiabetic pt following a meal will typically rise to ________
after a 8- to 12-hr fast, a nondiabetic pt's BGL will typically read _______
typically defined as a BGL of 60mg/dL or less with signs or symptoms or a BGL of less than 50mg/dL with or without s/s
the primary sign of hypoglycemia is an _______
altered mental status
_______ can be defined as a persistent BGL greater than 120mg/dL
diabetes mellitus (DM) is a condition in which there is disturbance in the metabolism of carbohydrates, fats, and proteins. the primary problem in this condition is either one of two things:
1 ) a lack of insulin being secreted by the pancreas
2 ) the inability of the cell receptors to recognize the insulin and allow the glucose to enter at a normal rate
the three P's
polydipsia (frequent thirst)
polyuria (frequent urination)
type 1 diabetes
insulin-dependent diabetes mellitus (IDDM)\
pancreas does not secrete any insulin
type 2 diabetes
non-insulin-dependent diabetes mellitus (NIDDM)
regulate diet and exercise and take oral drugs to help the pancreas secrete more insulin or to make the insulin that is secreted more effective
usually middle aged or older
hypoglycemia in type 1 (IDDM) pt who takes his insulin, but with excessive results (BGL decreases too much), for one of the following reasons:
pt takes insulin but does not eat
pt takes insulin, eats, but drastically increases activity
pt takes too much insulin - either takes too much or forgets and takes an extra dose
signs and symptoms caused by epinephrine release
pale, cool, clammy skin
signs and symptom caused by brain cell dysfunction
strokelike symptoms including hemiparesis
Oral glucose may only be administered if the patient meets all of the following three criteria:
1 ) has an altered mental status
2 ) has a history of diabetes controlled by medication or a blood glucose reading less than 60 mg/dL
3 ) has the ability to swallow
A condition typically found in type 1 diabetics where the blood glucose level is excessively elevated and insulin level is extremely low to absent, which causes glucose to be excreted in the urine, dehydrating the patient, and causing the body to metabolize fat for energy, producing ketones and creating an acidic environment
Diabetic ketoacidosis (DKA)
Factors causing hyperglycemia in the diabetic ketoacidosis patient
Infection that has upset insulin/glucose balance
Patient takes inadequate dose of insulin
Patient is taking medications such as thiazide, Dilantin, or steroids
Patient suffered some type of stress – surgery, trauma, pregnancy, or heart attack
Patient had over eaten or increased carb or sugar intake
A pattern of deep and rapid breathing that is commonly seen in the patient with DKA. It is an attempt by the body to blow off carbon dioxide to reduce the acid load of the body. Produces a fruity odor.
A condition typically found in type two diabetic's where the blood glucose level rises excessively, causing loss of large amounts of fluid from glucose spilling into the urine, leading to severe dehydration
Hyperglycemic hyperosmolar nonketotic syndrome
Glucose draws large amounts of water with it into the urine, which is called a _________ effect.
Emergency care for diabetic ketoacidosis:
Establish/maintain patent airway
SpO2 > 94% no O2
Emergency medical care for HHNS:
Est./maintain a patent airway
SpO2 > 94% no O2
Medications often taken by diabetics:
Insulin (humulin, novolin, iletin, semilente)
insulin (humulin, novolin, iletin, semilente