University:
York University
Course:
NURSING 2534 | Pathophysiology
Academic year:

2023
Views:

427

Pages:

3
Author:

Niklas

Diabetes Mellitus: Ambulatory Care Self-monitoring of Blood Glucose (SMBG): Enables decisions regarding food intake Accumulates record of glucose fluctuations Frequency of testing varies according to: Goals Ability to independently check glucose Willingness/ability When to measure: Before meals At bedtime Before/after exercise When ill or with illness Hyperglycemia: Causes: Illness, infection Corticosteroids Too much food, too little meds Inactivity Prevention: Take meds as prescribed Choose healthy foods Check glucose Be active Acute Complications: Hypoglycemia: clammy, thirst, confusion, seizures, coma, death Hyperglycemia: urination, weakness, fatigue, abdominal cramps DKA HHS Treatment: Hypoglycemia: 15-15 Rule: Test blood glucose Consume 15g of fast-acting carbs Wait 15 mins, recheck glucose Continue until >70 mg/dL Prevention: Take meds on time Accurately administer insulin Coordinate insulin with meals Carry simple carbs Wear or carry diabetes ID Hyperglycemia: Drink fluids Get medical care Diabetic Ketoacidosis (DKA): Caused by profound insulin deficiency Most likely to occur with Type 1 Precipitating Factors: Undiagnosed DM Inadequate insulin dosage Illness, infection Characterized by: Hyperglycemia Ketosis Acidosis Dehydration Assessment Findings: Abdominal pain Fruity breath Dry mouth Restlessness Kussmaul respiration Urination/dehydration Eyes sunken Interventions: Airway, breathing, circulation Give O₂ via nasal cannula or non-rebreather mask Begin continuous regular insulin drip Monitor VS Assess for fluid overload Give potassium to correct hypokalemia Add dextrose IV Hyperosmolar Hyperglycemic Syndrome (HHS): Common with Type 2 Person produces enough insulin to avoid DKA, but not hyperglycemia No ketones, + glucose levels (400+) serum osmolarity Neuro S/S seizures Treatment: Similar to DKA but more fluids due to severe neurologic manifestations Common Causes: UTI, pneumonia, sepsis Newly diagnosed Impaired thirst sensation Chronic Diabetes: Complications Damage to Vessels: Nephropathy Retinopathy: microvascular disease → leads to blindness Diabetic Peripheral Neuropathy: damaged unmyelinated nerve fibers Neuropathy: Sensory: Neuropathic pain: burning, tingling, cramping, paresthesia Management: gabapentin, annual monofilament testing Autonomic: Affects nearly all body systems Hypoglycemic unawareness Gastroparesis Diarrhea Erectile dysfunction Cardiovascular Autonomic: Hypotension, falls Resting tachycardia Painless MI Diabetic Dermopathy: Red, brown, round, oval patches Scaly, then flat Acanthosis nigricans: insulin resistance Velvety, light brown skin thickening Foot/Lower Extremity: Most common cause of hospitalization Annual screening → proteinuria If albuminuria → drug therapy ACE inhibitors → protein clearance Risk Factors: Genetics Smoking Chronic hyperglycemia