Acute Chronic Exam 1
what do we need to assess in patients with DKA or HHS 3
1. renal status (urine output, BUN, creatnine)
2. cardiopulmonary status
3. LOC
what needs to be monitored in DKA and HHS? 5
1. glucose- watching for hypoglycemia due to insulin administration
2. urine
3. IV fluids
4. insulin therapy
5. potassium
what is normal blood glucose?
70-100
hypoglycemia levels
under 70
hyperglycemia levels
over 100
onset differences between type I and II diabetes
type I= abrupt onset
type II= longer because it happens over time due to lifestyle choices and
genetics
what is often the first sign of type I diabetes
DKA
symptoms of type I diabetes 6
1. polydipsia (thirst)
,2. polyphagia (hunger),
3. polyuria,
4. blurred vision
5. breath smell of acetone
6. weight loss
explain DKA
caused by major insulin deficiency making the body burn fat as fuel creating a
state of metabolic acidosis. and KETONES are in urine!!!!!!
glucose levels for DKA vs HHS
DKA= 250 or more
HHS= 600 or more
how does HHS occur
type II diabetes
explain HHS
medical emergency of a hyperglycemia episode
what does insulin regulate
potassium and glucose
normal range for potassium
3.5-5.0
what is the treatment for hypoglycemia if the patient is conscious vs
unconscious?
conscious= eat or drink something
unconscious= administer D50
s/s of hypoglycemia 7
, everything is fast (shakiness, palpitations, diaphoresis (sweating), anxiety,
pallor, tachycardia, altered mental status
s/s of hyperglycemia 4
dry skin, nerve damage like tingling, delayed wound healing, DKA or HHS
what is the only IV insulin
regular insulin
a wife brings her husband into the ED. she tells the nurse that she has noticed
her husband's breath smells fruity, and you notice this too. The patient is also
presenting with Kussmaul respirations. You take the pts blood sugar and it
reads 300. what is your immediate priority?
a. raise the head of bed
b. administer oxygen
c. obtain IV access
d. give the pt water to drink
a
you have been handed report by the night shift nurse. Which of the following
patients do you see first?
a. pt with blood sugar reading of 125
b. pt with blood sugar of 45
c. pt who needs to use the bathroom
d. pt who is waiting on their morning medication
b
The nurse is reviewing laboratory results and notes that a client's serum
sodium level is 150 meq/L (150 mmol/L). The nurse reports the serum sodium
level to the health care provider (HCP) and the HCP prescribes dietary
instructions based on the sodium level. Which acceptable food items does the
nurse instruct the client to consume? Select all that apply
what do we need to assess in patients with DKA or HHS 3
1. renal status (urine output, BUN, creatnine)
2. cardiopulmonary status
3. LOC
what needs to be monitored in DKA and HHS? 5
1. glucose- watching for hypoglycemia due to insulin administration
2. urine
3. IV fluids
4. insulin therapy
5. potassium
what is normal blood glucose?
70-100
hypoglycemia levels
under 70
hyperglycemia levels
over 100
onset differences between type I and II diabetes
type I= abrupt onset
type II= longer because it happens over time due to lifestyle choices and
genetics
what is often the first sign of type I diabetes
DKA
symptoms of type I diabetes 6
1. polydipsia (thirst)
,2. polyphagia (hunger),
3. polyuria,
4. blurred vision
5. breath smell of acetone
6. weight loss
explain DKA
caused by major insulin deficiency making the body burn fat as fuel creating a
state of metabolic acidosis. and KETONES are in urine!!!!!!
glucose levels for DKA vs HHS
DKA= 250 or more
HHS= 600 or more
how does HHS occur
type II diabetes
explain HHS
medical emergency of a hyperglycemia episode
what does insulin regulate
potassium and glucose
normal range for potassium
3.5-5.0
what is the treatment for hypoglycemia if the patient is conscious vs
unconscious?
conscious= eat or drink something
unconscious= administer D50
s/s of hypoglycemia 7
, everything is fast (shakiness, palpitations, diaphoresis (sweating), anxiety,
pallor, tachycardia, altered mental status
s/s of hyperglycemia 4
dry skin, nerve damage like tingling, delayed wound healing, DKA or HHS
what is the only IV insulin
regular insulin
a wife brings her husband into the ED. she tells the nurse that she has noticed
her husband's breath smells fruity, and you notice this too. The patient is also
presenting with Kussmaul respirations. You take the pts blood sugar and it
reads 300. what is your immediate priority?
a. raise the head of bed
b. administer oxygen
c. obtain IV access
d. give the pt water to drink
a
you have been handed report by the night shift nurse. Which of the following
patients do you see first?
a. pt with blood sugar reading of 125
b. pt with blood sugar of 45
c. pt who needs to use the bathroom
d. pt who is waiting on their morning medication
b
The nurse is reviewing laboratory results and notes that a client's serum
sodium level is 150 meq/L (150 mmol/L). The nurse reports the serum sodium
level to the health care provider (HCP) and the HCP prescribes dietary
instructions based on the sodium level. Which acceptable food items does the
nurse instruct the client to consume? Select all that apply
