265 Diabetes/DKA Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
Symptoms for mild hypoglycemia | BG<60;trembling,shaking, sweating,rapid HR, headache,hunger tingling of extremities, |
Symptoms for Severe hypoglycemia | BG<40; confusion, strange behavior, slurred speech, blurry vision, numbness, trouble concentrating, irriability, seizure, coma |
What is the signifigance of beta blockers with diabetic patients? | they cause less severe/obvious symptoms |
examples of beta blockers | Propandolol (Inderal, Dentensol) |
treatment for sulfonyurea-induced hypoglycemia | Diazoxide (Proglycem) or Sandostatin |
Drug Treatment Hypoglycemia (patients that cannot swallow) | Glucagon (IM,SUBQ, causes voimiting) with D50, if pt cant swallow (avoid extravasation) |
Dawn Phenomenon | nighttime release of GH that causes hypoglycemia between 5-6am--give intermediate insulin @HS |
Somogyi Phenomenon | morning hyperglycemia from counterregulatory response to nighttime hypoglycemia--give food@night |
Sick day rules | tell MD that u are sick, monitor BGq4h, test ketones when BG=240; keep taking meds, prevent dehydration,cant eat--liquids=carb content of usual meal |
Sick day rules--Call MD if... | Persistent N&V, mod-large ketones, BG rises after 2 doses of insulin, High temp (over 101.5) for more than 24rs |
Counter regulatory hormoes | Glucagon (main), GH, epinephrine, norepinephrine, cortisol |
Polyuria | frequent/excessive urine results from osmotic diuresis caused by excessive glucose in urine |
Polydipsia | excessive thirst; result of diuresis--Sodium, chloride, potassium are excreted, H20 loss is severe-->dehydration |
Polyphagia | cells have no glucose, starvation occurs, they will stay in starvation mode until insulin is available to move glucose into cells |
Dehydration that occurs with diabetes leads to... | Hemoconcentration, Hyperviscosity, hypovolemia, hypoperfusion & hypoxia |
Hypoxic cells dont metaboiize glucose effectively so what occurs | Kreb cycle is blocked, lactic acid increases causing more acidosis |
Metabolic acidosis | excess acid causes an increase in Hydrogen ions & carbon dioxide levels in blood |
Kussmauls | respirations increaes in rate & depth to try & get rid of CO2 & acid |
metabolic acidosis ABGs show | decreased pH & decreased bicarb (HCO3) |
Risk factors for Metabolic syndrome | FBG>100;BP>120/80;Triglyceride>150; Large waist circumference-men40, women35; decreased in HDL-men40, women-50 |
Interventions for Metabolic syndrome | healthy heart diet (DASH); Loss of 5-10% of body wt, smoking cessaion, exercise |
what do counter regulatory horomes do? | inhibit isulin production--raise BG levels |
Hemoglobin A1c (normal) | 5.7 |
Hemoglobin A1c (pre-diabetic) | 5.7-6.4 |
hemoglobin A1c (diabetes) | 6.5 or higher |
Alpha cell secrete | Glucagon (sustains glucose when fasting) |
Beta cells secrete | Insulin |
Delta cell secrete | Somatostatin |
Type I | Beta cells make little/no insulin--autoimmune |
Type II | decreased production/utlization--increased insulin resistance |
Gestational | Placenta hormones need more insulin (3times); secretes excessive epinephrine &norephinreine (not enuff to stablize BG levels) |
Basal insulin | 24 insulin production(intermediate & long acting) Lantus, NPH, Levemir |
Prandial | needed during meeal (short & rapid) regular, novolog, humalong, apidra |
How is diabetes diagnosed? | FBG of 126 on 2 more occasion (fast 8h); 3hr glucose tolerance test--over 200 |
How is pre-diabetes diagnosed? | FBG of 100-125; 2hr post load glucose 140-199 (fast for 10-12hrs) |
What is DKA? | absence/inadequate amt of insulin--results in disorders in metabolisms of carbs, fats proteins |
DKA--How does body respond to insulin deficit? | pulls from stored glycogen, protein & fat stores for energy |
Byproduct of fatty metabolism | FFA--Glycerol--Ketones(drops pH)-Metabolic acidosis |
DKA--Signs & symptoms | 3Ps, blurry vision, fatique, dehydation, dry mouth, itchy skin, low BP, increased HR, weakness, altered LOC, NV, abd pain, Kussmauls, coma, death |
DKA--Management--drug therapy | goal to lower BG by 75-150/hr; MILD-subQ Moderate to severe--reg. insulin by continous IV OR inital bolus 0.1unit/kg followed by IV insulin drip 0.1 unit/kg/hr; assess BG qhr |
DKA--management--assesments | 1st assess airway, LOC, hydration status, electrolytes & BG levels; Check BP,RR,HR q15min; stable--q4h; urine output, temp & LOC q1h |
DKA--Fluid management | 1st-1L NS over 30-60min,(2nd liter given in next half hr, restores volume & maintains perfusion) 2nd-).45%NS slowly (replaces total body fluid loss |
DKA--acidosis management | assess for hypokalemia; before giving IV K+ patient needs 30ml urine/hr, bicarb is used only in severe acidosis; sodium bicarb given slowly IV over several hrs pH<7 & HC03<3 |
DKA--signs of hypokalemia | fatigue, confusio, muscle weakness, shallow res, abd distention, paralytic ileus, hypotension, weak pulse |
DKA--why is bicarbonate only given in severe cases? | can reverse acidosis too fast, & lead to severe hypokalemia |
DKA--patient/family teaching | check BG q4-6hr, check ketones, drink 3L, with nausea-liquids w/glucose & electrolytes, vomiting-8-12oz calorie free liquids, 150g of carb, |
Only insulin that can be given IV | regular |
In acute stages insulin can be given | SubQ & IM |
Management of DKA (Basham) | electrolyte replacement, check renal function, foley (stict I&O), ABGs (bicarb may/may not be given), EKG, correction scale |
DKA--ABGs show | decreased HCO3, CO2, and pH |
fatty acids are used when... it is stored? | glucose is not available; stored in cells |
incretin hormones are secreted in response to...increases what secretion? stops what? slows what? | food in tummy, increases insulin secretion, stops glucagon & slows rate of of gastric emptying |
Main fuel for CNS | Glucose, brain cant store/make much of it, it needs constant supply to prevent neural dysfunction & cell death |
Insulin is needed to move____into cell; without it body breaksdown____ | glucose; w/o it body breaks down fats/proteins |
Created by:
DitziDame
Popular Nursing sets