Hyperosmolar hyperglycemic syndrome:
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less common than DKA, often occurs in type 2, Patient has enough
circulating insulin that ketoacidosis does not occur, produces fewer
symptoms in earlier stages - Neurologic manifestations occur because of ↑
serum osmolality
Usually history of inadequate fluid intake, Increasing mental depression,
Polyuria
Laboratory values: Blood glucose >400 mg/dL, Increase in serum
osmolality, absent/minimal ketone bodies
Therapy similar to DKA except greater fluid replacement
Metabolic Alkalosis:
,Example ABG: pH 7.50, PaCO2 40, HCO3 34
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Causes:
Too much bicarb or too little acid
Antacids, blood transfusions, sodium bicarbonate, TPN, prolonged
vomiting, NGT suctioning, thiazide diuretics.
Principle #2:
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A substance disorder or psychiatric illness should be considered
secondary only if it resolves when the co-occurring disorder is at baseline.
Stage 1 Pressure Injury:
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Non-blanchable erythema of intact skin
Antianxiety agents, works best before benzodiazepines are tried
Give this one a try later!
Buspar, hydroxyzine
Pros: Delivers anxiolytic actions with less central nervous system sedation,
does not produce physical/psychological dependence
, Cons: Will be less likely to effective if the patient has already been
sensitized to a benzodiazepine, requires 3 weeks or longer to be effective
DKA characterized by:
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hyperglycemia, ketosis, acidosis, dehydration, most likely occurs in type 1
Overall goals of therapy for HF:
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Decrease pt symptoms
Improve LV function
Reverse ventricular remodeling (hypertrophy)
Improve quality of life
Decrease mortality and morbidity
Complications:
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, · Patients without complications of cirrhosis have compensated cirrhosis.
Those who have one or more complications of their liver disease have
decompensated cirrhosis
· portal hypertension with resultant esophageal and gastric varices
· peripheral edema and ascites
· hepatic encephalopathy (mental status changes, including coma)
o Caused by increased ammonia levels
· hepatorenal syndrome- It is a type of renal failure with advancing
azotemia (elevated BUN and creatinine), oliguria, and intractable ascites.
Parasomnias
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Nightmares, Night terrors, Sleepwalking
Unstageable Pressure Injury:
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Obscured full-thickness skin and tissue loss
Stage 3 Pressure Injury:
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Full-thickness skin loss
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less common than DKA, often occurs in type 2, Patient has enough
circulating insulin that ketoacidosis does not occur, produces fewer
symptoms in earlier stages - Neurologic manifestations occur because of ↑
serum osmolality
Usually history of inadequate fluid intake, Increasing mental depression,
Polyuria
Laboratory values: Blood glucose >400 mg/dL, Increase in serum
osmolality, absent/minimal ketone bodies
Therapy similar to DKA except greater fluid replacement
Metabolic Alkalosis:
,Example ABG: pH 7.50, PaCO2 40, HCO3 34
Give this one a try later!
Causes:
Too much bicarb or too little acid
Antacids, blood transfusions, sodium bicarbonate, TPN, prolonged
vomiting, NGT suctioning, thiazide diuretics.
Principle #2:
Give this one a try later!
A substance disorder or psychiatric illness should be considered
secondary only if it resolves when the co-occurring disorder is at baseline.
Stage 1 Pressure Injury:
Give this one a try later!
Non-blanchable erythema of intact skin
Antianxiety agents, works best before benzodiazepines are tried
Give this one a try later!
Buspar, hydroxyzine
Pros: Delivers anxiolytic actions with less central nervous system sedation,
does not produce physical/psychological dependence
, Cons: Will be less likely to effective if the patient has already been
sensitized to a benzodiazepine, requires 3 weeks or longer to be effective
DKA characterized by:
Give this one a try later!
hyperglycemia, ketosis, acidosis, dehydration, most likely occurs in type 1
Overall goals of therapy for HF:
Give this one a try later!
Decrease pt symptoms
Improve LV function
Reverse ventricular remodeling (hypertrophy)
Improve quality of life
Decrease mortality and morbidity
Complications:
Give this one a try later!
, · Patients without complications of cirrhosis have compensated cirrhosis.
Those who have one or more complications of their liver disease have
decompensated cirrhosis
· portal hypertension with resultant esophageal and gastric varices
· peripheral edema and ascites
· hepatic encephalopathy (mental status changes, including coma)
o Caused by increased ammonia levels
· hepatorenal syndrome- It is a type of renal failure with advancing
azotemia (elevated BUN and creatinine), oliguria, and intractable ascites.
Parasomnias
Give this one a try later!
Nightmares, Night terrors, Sleepwalking
Unstageable Pressure Injury:
Give this one a try later!
Obscured full-thickness skin and tissue loss
Stage 3 Pressure Injury:
Give this one a try later!
Full-thickness skin loss
