k k k k k k k k k k
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– Care of Patients with Diabetes Mellitus
k k k k k k
● S/S: 3 Ps (polydipsia, polyphagia, polyuria), ketones, fruity breath, Kussmaul’s resp
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o Polydipsia: increased thirst as the cells are dehydrated and thirst
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y as a result ofnot enough fluids
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o Polyphagia: increased hunger as the cells are starved of nutrient k k k k k k k k k
s as a result ofnot getting insulin and glucose into the cells.
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o Polyuria: the patient has increased urination k k k k k
o Ketones: present when the body needs to get energy from fat as t
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he glucose cells do not work. Causes the byproduct to be increas
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ed and ketones to presentin the urine.
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o Acetone Fruity Breath: with DKA as a result of getting increased a
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mounts of acidout of the body
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o Kussmaul's respirations: increased and deep ventilations hen the
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diabetic patienttries to breathe off excess acid in the body from inc
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reased hydrogen ions in metabolic acidosis.
k k k k k
● S/S of hypoglycemia vs. hyperglycemia
k k k k
Hypoglycemia - k Hyperglycemia - k
k cold and clammy needscandy
k k k k hot and dry, sugar high
k k k k k
NUR2392 MDC 2 FINAL EXAM STUDY GUIDE LATEST UPDATE 2021/2022 GRAD
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,NUR2392 MDC 2 FINAL EXAM STUDY GUIDE LATEST UPDATE 2021/2022 GRAD
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● From a BG level less than 70
k k k k k k ● FromkakBGklevelkthatkiskabove
● S/S: 110
k
○ Sweating ● S/S:
○ Pallor o Drykmouth
○ Irritability o Flushedkskin
○ Hunger o Polydipsia
○ Lack of Coordination k k o Polyuria
○ Fatigue o Polyphagia
○ Cold o Weakness
● Emergency as if sugar is not k k k k k o Headache
k therethe cells can die.
k k k k o BlurrykVision
o Rule of 15: occurs for patients in hypoglycemia. If the patient che
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cks their BG level and it is less than 70, the nurse should give the p
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atient 15 g of a carb to eator D50 if NPO and retest the sugar in 15
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mins. If rechecked, and BG level is still below 70, give the patient a
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nother 15 g of carbs or D50 and recheck and call the provider. If sti
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ll too low on the tired check, give D50 and call the provider and oft
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en RRT. k
● DKA Vs HHS
k k
DKA - Diabetic Ketoacidosis
k k k HHS-
NUR2392 MDC 2 FINAL EXAM STUDY GUIDE LATEST UPDATE 2021/2022 GRAD
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,NUR2392 MDC 2 FINAL EXAM STUDY GUIDE LATEST UPDATE 2021/2022 GRAD
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ED A+ k
k Hyperosmolar HyperglycemicNon k k
ketotic Syndrome
k
● Type 1 Diabetics k k ● Type 2 Diabetics
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● From a failure to take insuli
k k k k k ● From extreme hyperglyce
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n or increase insulin usage d
k k k k k mia andhyperosmolarity
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ue to stress, illness, confusi
k k k k ● If not treated, death can occu
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on, or if they
k k k r
NUR2392 MDC 2 FINAL EXAM STUDY GUIDE LATEST UPDATE 2021/2022 GRAD
k k k k k k k k k k
ED A+ k
, NUR2392 MDC 2 FINAL EXAM STUDY GUIDE LATEST UPDATE 2021/2022 GRAD
k k k k k k k k k k
ED A+ k
do not know they have diabet
k k k k k ● At risk:k
es. ○ Older patients with illnk k k
● S/S: polyuria, polyphagia, p
k k k ess
olydipsia, ketones present i k k k ○ Inability to drink fluids k k k
n the urine, dehydration, tac
k k k k ● The urine volume will fa
k k k k
hycardia, orthostatic hypote k k ll andglucose cannot be
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nsion, abdominalcramping,k k k k excreted.
nausea, vomiting, acetone f k k k ● Will cause CNS dysfuncti
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ruity breath, Kussmaul respi
k k k on andfluid intake impair
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rations, and hyperventilatio k k ment
n, confusion.
k ● NO KETONES k
● Labs: ● S/S: extreme dehydr k k
○ BG: above 300 k k ation,orthostatic hyp k k
○ BUN/Creatinine: abo k ertension, confusion, k k
ve 30and 1.5
k k k seizures, coma,weak k k
○ Metabolic acidosis- k ness or paralysis, hyp
k k k
k low pH,normal or co
k k k k erreflexia, areflexia. k
mpensated Co2, low k k k ● Labs:
HCO3 ○ BG: above 600 k k
○ Ketones present i k k ○ NA level is normal or lo
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n theurine
k k w
○ Hyperosmolarity ○ K level is norma
k k k
NUR2392 MDC 2 FINAL EXAM STUDY GUIDE LATEST UPDATE 2021/2022 GRAD
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ED A+ k