265 Diabetes
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| show | BG<60;trembling,shaking, sweating,rapid HR, headache,hunger tingling of extremities,
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| show | BG<40; confusion, strange behavior, slurred speech, blurry vision, numbness, trouble concentrating, irriability, seizure, coma
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| What is the signifigance of beta blockers with diabetic patients? | show 🗑
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| examples of beta blockers | show 🗑
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| show | Diazoxide (Proglycem) or Sandostatin
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| Drug Treatment Hypoglycemia (patients that cannot swallow) | show 🗑
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| Dawn Phenomenon | show 🗑
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| Somogyi Phenomenon | show 🗑
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| show | 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
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| show | Persistent N&V, mod-large ketones, BG rises after 2 doses of insulin, High temp (over 101.5) for more than 24rs
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| Counter regulatory hormoes | show 🗑
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| Polyuria | show 🗑
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| show | excessive thirst; result of diuresis--Sodium, chloride, potassium are excreted, H20 loss is severe-->dehydration
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| Polyphagia | show 🗑
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| show | Hemoconcentration, Hyperviscosity, hypovolemia, hypoperfusion & hypoxia
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| show | Kreb cycle is blocked, lactic acid increases causing more acidosis
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| Metabolic acidosis | show 🗑
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| show | respirations increaes in rate & depth to try & get rid of CO2 & acid
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| metabolic acidosis ABGs show | show 🗑
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| Risk factors for Metabolic syndrome | show 🗑
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| Interventions for Metabolic syndrome | show 🗑
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| show | inhibit isulin production--raise BG levels
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| Hemoglobin A1c (normal) | show 🗑
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| show | 5.7-6.4
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| hemoglobin A1c (diabetes) | show 🗑
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| Alpha cell secrete | show 🗑
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| Beta cells secrete | show 🗑
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| show | Somatostatin
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| Type I | show 🗑
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| show | decreased production/utlization--increased insulin resistance
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| show | Placenta hormones need more insulin (3times); secretes excessive epinephrine &norephinreine (not enuff to stablize BG levels)
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| show | 24 insulin production(intermediate & long acting) Lantus, NPH, Levemir
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| show | needed during meeal (short & rapid) regular, novolog, humalong, apidra
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| show | FBG of 126 on 2 more occasion (fast 8h); 3hr glucose tolerance test--over 200
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| show | FBG of 100-125; 2hr post load glucose 140-199 (fast for 10-12hrs)
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| What is DKA? | show 🗑
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| show | pulls from stored glycogen, protein & fat stores for energy
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| Byproduct of fatty metabolism | show 🗑
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| show | 3Ps, blurry vision, fatique, dehydation, dry mouth, itchy skin, low BP, increased HR, weakness, altered LOC, NV, abd pain, Kussmauls, coma, death
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| DKA--Management--drug therapy | show 🗑
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| show | 1st assess airway, LOC, hydration status, electrolytes & BG levels; Check BP,RR,HR q15min; stable--q4h; urine output, temp & LOC q1h
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| show | 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
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| DKA--acidosis management | show 🗑
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| show | fatigue, confusio, muscle weakness, shallow res, abd distention, paralytic ileus, hypotension, weak pulse
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| DKA--why is bicarbonate only given in severe cases? | show 🗑
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| show | check BG q4-6hr, check ketones, drink 3L, with nausea-liquids w/glucose & electrolytes, vomiting-8-12oz calorie free liquids, 150g of carb,
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| show | regular
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| In acute stages insulin can be given | show 🗑
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| show | electrolyte replacement, check renal function, foley (stict I&O), ABGs (bicarb may/may not be given), EKG, correction scale
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| show | decreased HCO3, CO2, and pH
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| show | glucose is not available; stored in cells
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| incretin hormones are secreted in response to...increases what secretion? stops what? slows what? | show 🗑
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| show | Glucose, brain cant store/make much of it, it needs constant supply to prevent neural dysfunction & cell death
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| Insulin is needed to move____into cell; without it body breaksdown____ | show 🗑
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