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Diabetes
BC3 - General Diabetic Info
| Question | Answer |
|---|---|
| Problems with Insulin | Hypoglycemia, Lipodystrophy, Somagyi effect & Dawn Phenomenon, Allergic reactions |
| Lipodystrophy | scarring at injection sites |
| Localized allergic reactions | itching, erythema, burning, lipodystrophy |
| Systemic allergic reactions | urticaria, anaphylatic shock |
| Somagyi Effect | Too much insulin in evening |
| S/S of Somagyi Effect | HA when awakening |
| S/S of Somagyi Effect | Night Sweats/ Nightmares |
| Somagyi Effect | undetected hypoglycemia at night |
| Somagyi Effect | wide differences in early morning fasting blood glucose levels |
| Tx of Somagyi effect | decrease insulin dose |
| Tx of Somagyi effect | may need hs snack |
| Somagyi effect | must check blood glucose levels between 2 - 4 am to determine hypoglycemia |
| Dawn Phenomenon | hyperglycemia is present upon awakening |
| Dawn Phenomenon | happens more in young |
| Dawn Phenomenon | cause is release of growth hormone and/or cortisole |
| S/S of Dawn Phenomenon | Hyperglycemia in the am |
| S/S of Dawn Phenomenon | elevated BS during the night |
| Tx of Dawn Phenomenon | Adjust timing of insulin or increase the dosage |
| For acute illness & surgery | check blood glucose ever 4 hours |
| If glucose is >240 | check for ketones |
| If patient is sick | do not withhold medications, do not take extra pills, keep them eating and drinking |
| S/S of DKA | dehydration/ loss of electrolytes/ potassium |
| S/S of DKA | Skin is dry/ loose |
| S/S of DKA | hypotension because of fluid loss |
| S/S of DKA | Vomiting from acidosis/ more fluid loss |
| S/S of DKA | fruity breath |
| S/S of DKA | Kussmaul's respiration, coma, death |
| Care of DKA | Regular insulin in IV, replace lytes, correct hypovolemia |
| Insuline r/t DKA | treat with regular IV insulin until blood glucose is 250mg/dl then 5-10% Glucose in NSS |
| S/S of HHNK | BS at least 400 |
| S/S of HHNK | usually no ketones |
| S/S of HHNK | extracellular dehydration |
| S/s of HHNK | Neurological abnormalities (aphasia or hemiparesis) |
| Tx of Hypoglycemia | ingest 5-20g fast acting carbs |
| Tx of Hypoglycemia | IV glucose until patient regains consciousness |
| Macrovascular Disease | Disease of medium and large blood vessels (CVA, PVD CV disease); anybody can get macroagiopathy |
| Microvascular Disease | small blood vessels - Specific to DM - affects eyes, kidneys and skin |
| Microvascular Disease | does not usually appear for 15-20 years after Dx - go into renal failure and/or go blind |
| PVD | Combination ofr microangiopathy & macroangiopathy; clotting abnormalities |
| S/S of PVD | intermittent claudication, pain at rest, cold feet, loss of hair, delayed capillary refill, dependent rubor |
| Dependent rubor | reddish look to skin |
| Leading cause of end stage renal disease | nephropathy |
| Most common complicationn of DM | neuropathy |
| Problems of neuropathy | GI abnormalities, urinary bladder abnormalities, sexual dysfunction, pain, paresthesia |
Created by:
okrecota
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