complex care final Flashcards
what would you see for lab vaues in DKA
acidosis, low K, low NA, low MAG, high glucose, low skin turgor,
high respers and HR
high creat/BUN
confused, lethargic, hungry
large urine output
DKA management
fluids and insulin, potassium level monitoring
causes of HHS (Hyperglycemic Syndrome)
-type 2 diabetes
-add more to this slide
how are the s/s different in HHS
glucose >600
no ketones or fruity breath
no acidosis (just enought insulin to prevent this)
-high serum osmolarity
SIADH
overproduction of ADH
-decreased urine output, fluid retention
-thirst, dyspnea on exertion
-hyponatremia (muscle cramps, seizures, coma, death)
-increased urine specific gravity (urine that is produced is very concentrated)
how to treat siadh
treat the underlying disease
-never replete Na too fast as it can cause swelling
-fluid restrition
-hypertonic solution , salt tablits
-maybe give furosemide
what happens diabetes insipidus
polyuria, nocturia, polydipsia,, hyperNA,
If a pt does respond to DDAVP
then is is a Central cause of DI (brain, pituitary)
management of DI
desmopressin/DDAVP
drink to thirst!
fluids
labs serum and urine
if they dont respond to DDAVP
then it is a nephrogenic cause of DI
by day 3 of alcohol withdrawal, what can you get
delirium tremens
what are delirium tremens
disturbed attention, hallucinations, autonomic hyper
what is the first thing that you would do for someone in alcohol withdrawal
1) assessment
2) fluids
3) meds (benzos) – diazampam, mirazapam
if benzos dont work….
barbituates (phenolbarbitual), ketamine , sedatives
what did we talk about in class on fri aug 18th
we dont need to memorize the score, but we do need to be able to interpret the score
