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Diabetes 1 & 2

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mattisensept's version from 2017-06-04 01:22

Fluids

Question Answer
Loss of fluids Monitor I & O, weight trend, BP down if dehydrated & HR up
Assess lips and mucous membranesThey will be dry and cracked
Monitor Serum glucose, BUN, HCT, Specific gravity, A1C for blood glucose (60-100 if not diabetic, 120 if diabetic) --> fasting. Have not eaten in last 8 hours
Drinking Drink water, ETOH is sugar
memorize

Integumentary

Question Answer
Infection/integumentaryMonitor temp and trend, signs of URI, UTI, signs of infection in wound
Proper foot careWearing protective shoes, no pedicure, toenails cut by pediatrist, take bath and check temp, look at feet everynight
Assessskin breakdown and redness
TeachCan't heal as well. bacteria loves sugar.
memorize

Food malnutrition

Question Answer
MonitorWeight loss and trend, Serum glucose, dietary practices
Assessand monitor fatigue
memorize

Electrolytes/acidosis

Question Answer
LabsComplete metabolic panel. K too low--> cramping, too high--> skiping heart beats
MonitorCardiac changes, assess clients understanding
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Diabetic ketoacidosis (hyperglycemia)

Question Answer
Happens to?type 1
What ?Complications of an extreme elevation in blood sugar, breakdown in fat since no insulin is present and body needs energy
ChangesK, water loss and ketones in urine
BodyThinks you are starving and starts to break down fat and you get ketones.
SymptomsHigh sugar and K levels. BG >300
NeuroConfusion--> coma
GIAbdominal pain, N/V, anorexia, diarrhea
Skin tempWarm, dry and flushed
CVTachycarida, Weak
Respiratory systemDeep and Rapid--> Kussmaul respirations, fruity breath
memorize
Renal system--> Increased

HHNS (hyperglycemia)

Question Answer
Happens to?Type 2
What?Complications that occur primarily in the adult client with type 2. No breakdown in fat since insulin is present
Lead to?Dehydration, hyperosmality, and elevation in BUN levels.
SymptomsBG > 600
NeuroMore severe
GINormal w/ no GI changes
Skin tempWarm, dry, flushed
CVTachycardia
RespiratoryTachypnea, normal breaths
Renal systemincreased
memorize

Hypoglycemia

Question Answer
NeuroDifficulty concentration, coordinating
GINormal, may be hungry
Skin tempCold and Clammy
CVTachycarida
RespiratoryShallow, normal breaths
RenalNormal
memorize

Specifics and similarities

Question Answer
Both DKA & HHNSPriority: hydrate to maintain perfusion of vital organs, regular insulin needs to be administered IV, do not decrease BG faster than 100mg/hr, monitor every hour
Only DKAMonitor for hyperkalemia due to acidosis, Monitor Ph for Acidosis.
Only HHNSMonitor for hypokalemia, monitor outputs, when starting IV K supplement bust be administered slowly. DO NOT administer IVP or bolus
Only hypoglycemiaGive carbohydrates (15-20 gm by mouth ), milk is preferred, If unconscious--> glucagon is administered.
Sick day managementContinue to take your meds, check blood sugar more frequently, call if unable to keep anything down, do not increase carb intake, meds may change d/t stress
memorize

Type 1 & 2

Question Answer
Labs/diagnosticCasual blood glucose, hemoglobin A1C, Glucose tolerance test, postpradndial test, ketone in urine
Nursing interventionsMonitor BG, skin assessment, patient education, assess medication regimen
Pt./Family teachingCheck BG, med admin, foot care, carb counting, signs and symptoms of high and low BG
MedicationsInsulin asparte/metformin, insulin glargineg/glipizide, injectable type 2 meds
memorize

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