New User Special Price Expires in

Let's log you in.

Sign in with Facebook


Don't have a StudySoup account? Create one here!


Create a StudySoup account

Be part of our community, it's free to join!

Sign up with Facebook


Create your account
By creating an account you agree to StudySoup's terms and conditions and privacy policy

Already have a StudySoup account? Login here


by: Onie McDermott
Onie McDermott
GPA 3.75

Joann Eland

Almost Ready


These notes were just uploaded, and will be ready to view shortly.

Purchase these notes here, or revisit this page.

Either way, we'll remind you when they're ready :)

Preview These Notes for FREE

Get a free preview of these Notes, just enter your email below.

Unlock Preview
Unlock Preview

Preview these materials now for free

Why put in your email? Get access to more of this material and other relevant free materials for your school

View Preview

About this Document

Joann Eland
Class Notes
25 ?




Popular in Course

Popular in Nursing and Health Sciences

This 3 page Class Notes was uploaded by Onie McDermott on Friday October 23, 2015. The Class Notes belongs to 096 139 at University of Iowa taught by Joann Eland in Fall. Since its upload, it has received 22 views. For similar materials see /class/228011/096-139-university-of-iowa in Nursing and Health Sciences at University of Iowa.

Popular in Nursing and Health Sciences


Reviews for Parent


Report this Material


What is Karma?


Karma is the currency of StudySoup.

You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!

Date Created: 10/23/15
Diabetes Mellitus Chapter 38 1 Iquot S P Equot 9 N 9 5 Chronic disorder of metabolism characterized by a partial or complete deficiency of the hormone insulin a Most common metabolic disease Type characterized by destruction of the pancreatic B cells which produce insulin a Usually leads to absolute insulin deficiency b Autoimmune disease Person with genetic predisposition is exposed to a precipitating event c Most predominant form in pediatric agegroup Type II usually arises because of insulin resistance a Body fails to use insulin properly b More likely to be influenced by stronger genetic factors c Changes in food consumption and exercise have increased the rate of type II diabetes in children Ketoacidosis when glucose is unavailable for cellular metabolism and the body chooses alternate sources of energy fat a Fat berak down into fatty acids and glycerol in the fat cells is converted by the liver into ketone bodies i Excess is eliminated in the urine or lungs ii Ketone bodies in the blood are strong acids that lower pH producing ketoacidosis b Respiratory system attempts to eliminate the excess carbon dioxide to raise pH i Kussmaul respiration c Cellular death results in potassium being released from the cell into the blood stream and is excreted through the kidney i Total body K is decreased but the serum potassium level may be elevated Long Term Complications a Microvascular may occur as early as 253 yr after diagnosis with bad disease management i Microvascular changes begin occurring after puberty Clinical Manifestations a Hyperglycemia weight loss acidosis polyphagia polydipsia and polyuria Diagnostic Evaluation three candidate groups a Children who have glycosuria polyuria and a history of weight loss b Those with transient or persistent glycosuria c Those who display manifestations of metabolic acidosis with or without stupor or coma Diagnosis a An 8 hour flasting blood glucose level of 126 or more b A random blood glucose value of 200 or more accompanied by classic signs of diabetes c Oral glucose tolerance test with a finding of 200 or more in the 2 hour sample Therapeutic Management a Insulin i Tailored to each child based on home blood glucose monitoring ii Low but steady basal rate with superimposed bursts of short acting insulin that coincide with intake of nutrients similar to pancreatic cells b Dosage i Conventionaltwice daily regimen consisting of a combination of rapidacting and intermediateacting insulin ii Intensive multiple injections throughout the day with once or twice daily dose of long acting insulin 10 Monitoring a Blood glucose levels b A1C i Values should be between 65 and 8 c Urinetest for ketonuria H H Nutrition nutritional needs are the same as those of healthy children a Meals and snacks must be eaten according to peak insulin action b Calories and portions should be consistent from day to day c Three meals per day plus snacks between meals and at bedtime H N Exercise should be included as part of diabetic management a Regular exercise aids in utilization of food and often results n a reduction of insulin requirements b Vigorous muscular contraction increases regional blood flow and accelerates absorption i Administer insulin in nonexercised sights 13 Hypoglycemiamost common cause are bursts of physical activity without additional food or delayed omitted or incompletely consumed meals a ssx nervousness pallor tremulousness palpitations sweating hunger weakness dizziness headache drowsiness irritability loss of coordination seizures and coma i often difficult to distinguish between hyper and hypoglycemiaalways test blood glucose b treat with 1015 grams of simple carbohydrate i may repeat in 1015 minutes if sugars don t return to normal 14 Illness Management a Goal is to restore euglycemia treat urinary ketones and maintain hydration i Ketones should be monitored every 3 hours b Never omit insulin dosage requirements may increase decrease or remain unchanged 15 Therapeutic management of Ketoacidosis a Management 39 Rapid assessment Administer adequate insulin to reduce the elevated blood glucose level Administer fluids to overcome dehydration iv Replace electrolytes especially K 57 Fluid and Electrolyte Therapy All suffer from dehydrationprompt and adequate rehydration restores tissue perfusion and suppresses the elevated levels of stress hormones 1 Rehydrate with 9 NS and replace evenly over 24 to 48 hrs to prevent cerebral edema Serum K levels may be normal on admission but after fluid and insulin administration the return of K to the cells can deplete serum levels 1 As soon as the child has established renal function vigorous K replacement is implemented I Continuous IV regular insulin is given after the initial rehydration bolus is given 1 Once BS levels fall to 250 to 300 mgdl dextrose is added to the IV solution 2 Goal BS is between 120 and 240 16 Nursing care of DM a Hospital management keep careful records of vital signs weight IV fluids electrolytes insulin blood glucose levels and intake and output b Most children should be able to administer their own insulin at 9 yr of age 17 Child and Family Education a Assess the families learning ability b For children keep sessions no longer than 15 to 20 minutes and for parents no more than 1 hr c Participation is the most effective learning method d Teach essential or survival information first and intense information 1 month later to enhance understanding and learning 18 Meal Planning a Normal nutrition is a major aspect of education b Emphasis on adequate intake for age consistent menus complex carbs and consistent eating times 19 Injections a Initially teach on orange b Practice giving injections with NS on each other c Teach insulin injection techniques i 90 degree angle SQ injection clean site d Children may be more comfortable with a syringeloaded injector e Mixing insulin i Always draw rapid acting clear insulin up first ii Mixture should be injected in less than 5 minutes or more than 15 minutes 20 Hypergylcemia mange by increasing insulin soon after the increased glucose level is noted exercise and increasing fluid intake may also decrease BS


Buy Material

Are you sure you want to buy this material for

25 Karma

Buy Material

BOOM! Enjoy Your Free Notes!

We've added these Notes to your profile, click here to view them now.


You're already Subscribed!

Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'

Why people love StudySoup

Bentley McCaw University of Florida

"I was shooting for a perfect 4.0 GPA this semester. Having StudySoup as a study aid was critical to helping me achieve my goal...and I nailed it!"

Amaris Trozzo George Washington University

"I made $350 in just two days after posting my first study guide."

Steve Martinelli UC Los Angeles

"There's no way I would have passed my Organic Chemistry class this semester without the notes and study guides I got from StudySoup."

Parker Thompson 500 Startups

"It's a great way for students to improve their educational experience and it seemed like a product that everybody wants, so all the people participating are winning."

Become an Elite Notetaker and start selling your notes online!

Refund Policy


All subscriptions to StudySoup are paid in full at the time of subscribing. To change your credit card information or to cancel your subscription, go to "Edit Settings". All credit card information will be available there. If you should decide to cancel your subscription, it will continue to be valid until the next payment period, as all payments for the current period were made in advance. For special circumstances, please email


StudySoup has more than 1 million course-specific study resources to help students study smarter. If you’re having trouble finding what you’re looking for, our customer support team can help you find what you need! Feel free to contact them here:

Recurring Subscriptions: If you have canceled your recurring subscription on the day of renewal and have not downloaded any documents, you may request a refund by submitting an email to

Satisfaction Guarantee: If you’re not satisfied with your subscription, you can contact us for further help. Contact must be made within 3 business days of your subscription purchase and your refund request will be subject for review.

Please Note: Refunds can never be provided more than 30 days after the initial purchase date regardless of your activity on the site.