Chapter 20 - Acute Diabetic Emergencies Flashcards Preview

EMT - Basic - Prehostpital Emergency Care 10th Edition > Chapter 20 - Acute Diabetic Emergencies > Flashcards

Flashcards in Chapter 20 - Acute Diabetic Emergencies Deck (34):
1

disease that frequently causes changes in the Pts mental status resulting from alterations in the BGL.

Diabetes mellitus (DM)

2

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)

3

simple sugars:

glucose
galactose
fructose

4

the two hormones primarily responsible for controlling levels of blood glucose are ______ and ______, both of which are secreted by the pancreas.

insulin and glucagon

5

____ is secreted when the BGL is elevated.

insulin

6

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

7

_____ is secreted by the pancreas when the blood glucose level is low and will work to increase the BGL.

glucagon

8

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

9

________ 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.

epinephrine

10

normal BGL

80-120mg/dL

11

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

24-48hrs

12

the BGL of a nondiabetic pt following a meal will typically rise to ________

120-140mg/dL

13

after a 8- to 12-hr fast, a nondiabetic pt's BGL will typically read _______

80-90mg/dL

14

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

hypoglycemia

15

the primary sign of hypoglycemia is an _______

altered mental status

16

_______ can be defined as a persistent BGL greater than 120mg/dL

hyperglycemia

17

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

OR

2 ) the inability of the cell receptors to recognize the insulin and allow the glucose to enter at a normal rate

18

the three P's

polydipsia (frequent thirst)
polyuria (frequent urination)
polyphagia (hungry)

19

type 1 diabetes

insulin-dependent diabetes mellitus (IDDM)\

pancreas does not secrete any insulin

typically younger

20

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

21

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

22

signs and symptoms caused by epinephrine release

diaphoresis
tremors
weakness
hunger
tachycardia
dizziness
pale, cool, clammy skin
warm sensation

23

signs and symptom caused by brain cell dysfunction

confusion
drowsiness
disorientation
unresponsiveness
seizures
strokelike symptoms including hemiparesis

24

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

25

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)

26

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

27

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.

Kussmaul respirations

28

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

29

Glucose draws large amounts of water with it into the urine, which is called a _________ effect.

Hyperosmolar

30

Emergency care for diabetic ketoacidosis:

Establish/maintain patent airway

SpO2 > 94% no O2
SpO2

31

Emergency medical care for HHNS:

Est./maintain a patent airway

SpO2 > 94% no O2
SpO2

32

Medications often taken by diabetics:

Insulin (humulin, novolin, iletin, semilente)
Actos
Diabinese, glucamide
Orinase
Micronase, DiaBeta
Tolinase
Glucotrol
Humalog
Glucophage
Glynase
Exenatide (byetta)
Lantus

33

diabetic medications:

insulin (humulin, novolin, iletin, semilente
actos
diabinese, glucamide
orinase
micronase, diabeta
tolinase
glucotrol
humalog
glucophage
glynase
exenatide (byetta)
lantus

34

diabetic/alt mental status SS:

rapid onset of alt mental after missing meal, unusual exercise or physical work

intoxicated appearance - staggering or slurred speech

tachycardia

cool, moist skin

hunger

seizure activity
uncharacteristic or bizarre behavior, combativeness

anxious or restless

bruising at insulin injection sites on the abdomen

BGL

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