Hypoglycemia
This is defined as a blood glucose level less than 70mg/dL.
What is level 1 Hypoglycemia?
New onset of Type 1 DM or acute complication of Type 1 DM.
What is Diabetic Ketoacidosis (DKA)?
This is an acute complication, characterized by high blood glucose levels (600 - greater than 1,000mg/dL) but no ketone production occurs.
What is Hyperosmolar Nonketotic Syndrome (HHNS)?
This acute complication affects the small blood vessels in the retina, leading to impaired vision or blindness.
What is Diabetic Retinopathy?
It is important to remove these completely when assessing a patient with DM.
What are socks?
Shakiness, tremors, slurred speech, diaphoresis, etc.
What are clinical manifestations of hypoglycemia?
This is a common assessment of DKA related to increased ketone production.
What is Acetone breath (fruity)?
*What other clinical manifestations will the patient experience?*
An elevated blood osmolarity, above 350, puts the patient at an increased risk of what?
What is a coma?
Impaired blood flow to the lower extremities, increasing the risk for infections and amputations, is a characteristic of what type of macrovascular damage.
What is Peripheral Vascular Disease?
It is important for a diabetic to do this to reduce injury risk on their feet.
What is wear well fitting socks and shoes, do not go barefoot, have a podiatrist cut toenails/treat calluses.
Given SQ or IM, this medication is used to increase blood glucose by breaking down glycogen.
What is glucagon?
This insulin is given IV when a patient is diagnosed with DKA.
What is regular insulin?
*what is the initial infusion rate?*
This type of diabetes is more associated with HHNS.
What is type 2 DM?
This complication of diabetes involves damage to the kidney filtration mechanism, leading to protein leaking into the urine.
What is Diabetic Nephropathy?
The phenomenon where blood glucose is normal at bedtime but starts to rise around 3:00 AM due to nocturnal surges in growth hormone is known as what?
What is the Dawn Phenomenon?
What is 25ml-50ml of 50% dextrose in water?
*What rate?*
What is an IV fluid with dextrose?
*What specifically?*
Serum osmolarity will be higher than this when a patient is experiencing HHNS.
What is greater than 320 mOsml?
What five lifestyle modifications and risk factor reductions are crucial in preventing macrovascular damage in diabetes.
What are diet, exercise, smoking cessation, management of hypertension, and management of hyperlipidemia?
This occurs when there is a normal or elevated blood glucose at bedtime, then deceases to hypoglycemic levels around 2-3am.
What is Somogyi effect?
You are to give 15-20g of fast-acting concentrated source of glucose if a patient is displaying what symptoms?
What is if a patient is conscious with hypoglycemia?
This may be low due to osmotic diuresis leading to loss of electrolytes.
What is Sodium (Na)?
This occurs when high blood glucose levels cause osmotic diuresis, leading to excess excretion of water and electrolytes.
These are two key interventions nurses should teach patients regarding foot care to prevent complications from diabetic neuropathy.
What is daily inspection, washing feet daily, applying lotion (not between toes), preventing injury, wearing proper shoes/socks, promoting good circulation, and reporting injuries to a healthcare provider?
This education technique is essential to assessing any knowledge gaps of the patient with diabetes when it comes to the management of their disease.
What is the teach back method?