Adv. Health Deviations Week 1 notes - Diabetes
Adv. Health Deviations Week 1 notes - Diabetes NU 433
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This 4 page Class Notes was uploaded by Allison Black on Friday January 15, 2016. The Class Notes belongs to NU 433 at Jackson State University taught by in Fall 2015. Since its upload, it has received 16 views. For similar materials see Advanced Health Deviations and Clinical Interventions in Nursing and Health Sciences at Jackson State University.
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Date Created: 01/15/16
▯ Diabetes Notes, part 1 Hypoglycemia and HHNK. ▯ ▯ 1. Define Hypoglycemia. • Low level of blood glucose. 2. Discuss causes of hypoglycemia. • Too much insulin • Too little food or delayed meals • Exercise • Vomiting • Medications • Excessive alcohol intake • Tumors 3. Inspect clinical manifestations associated with hypoglycemia. Mild hypoglycemia: Increased or sudden hunger • • Shakiness, drowsiness • Pounding heartbeat • Diaphoresis; cold, clammy skin • Headache or stomach ache Moderate hypoglycemia: • Irritability • Confusion and/or difficulty concentrating • Slurred or slow speech • Poor coordination • Altered LOC Severe hypoglycemia: • Loss of consciousness • Seizures and/or convulsions/ Clumsy or jerky movements • Death 4. Predict laboratory tests associated with diagnosis of hypoglycemia. Check blood glucose quickly. If blood glucose cannot be checked, treat anyway. 5. Prioritize nursing interventions and treatment for hypoglycemia. 1) 15 grams of a simple, fast acting sugar. Juice, crackers, sugar, etc. 2) Recheck blood glucose in 15-20 minutes. 3) Follow up with starch and protein snack. Ex. cheese and crackers. 6. Discover emergency treatments for hypoglycemia. Outpatient/away from hospital: Glucagon injection. Hospital/EMS: 5% Dextrose IV slowly (repeat as necessary). 7. Define Diabetic Ketoacidosis (DKA). • Life threatening complication of Diabetes Mellitus (DM) • Always a medical emergency • Rapid onset (over period of a few hours) • Almost always restricted to Type 1 Diabetes, however can affect Type 2 • Mortality of 1-5% 8. Outline the causes of DKA. ▯ 9. Inspect clinical manifestations associated with DKA. • Hyperglycemia • Fruity breath odor • Kussmaul’s respiration 10. Analyze laboratory findings consistent with DKA. • Severe hyperglycemia (greater than 250 mg/dl) • ABGs reveal acidosis • Ketonuria 11. Prioritize nursing interventions and a treatment plans for DKA. • Fluid replacement / Continuous IV • Insulin bolus to continuous/ Restore normal insulin regimen • Monitor Electrolytes • Potassium (Monitor and replace) • Sodium ( Monitor and adjust IV fluids as needed) • MonitorAcidosis (checkABG) • Blood glucose (Monitor frequently every 1h) ▯ ▯ 12. Define Hyperosmolar Nonketotic Syndrome (HHNK). • Most common with Type 2 Diabetes • Mortality rate of 5-10% • Relative insulin deficiency and resistance Body able to produce some insulin therefore the cells are NOT starving… • no ketones formed • Cause typically infection, too little insulin, to much glucose 13. Understand the pathophysiology of HHNK. • Fluid replacement/ Continuous IV • Insulin bolus and continuous/ Restore normal insulin regimen • Electrolyte Management • Blood glucose (Monitor frequently every 1-2h) • Treat precipitating cause of HHS 14. Outline the causes of HHNK. • Severe insulin resistance. ▯ ▯ ▯ ▯ ▯ ▯ ▯ ▯ ▯ ▯ ▯ ▯ ▯
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