What are the S/S of DM 1?
polyuria, polyphagia, polydipsia, diabetic shock, blurry vision,
slow healing wounds, and increase risk of infection
What happens to a person when they're sugar is too high and not
under control?
sugar will coat the blood vessels--can lead to peripheral
neuropathy (parastesia--numbness, tingling, pain in feet, toes,
and hands)
What is the treatment for DM 1?
insulin
What is DM 1?
when little to no insulin is being produced because of the
destruction of pancreatic beta cells
What blood sugar values should we assess for a patient with DM
1?
elevated fasting, random, and HbA1C
,what determines if someone has an elevated fasting blood
glucose level?
the sugar is >126 on two different occasions (patient fasts for 8
hours before blood draw (levels 100-125 = prediabetes)
what random blood glucose level determines that someone has
DM 1?
a value greater than 200
what HbA1C level indicates a client has DM 1?
greater than or equal to 6.5% (views glucose control over the
last three months)
what is a life threatening complication of DM 1?
DKA; the liver breaks down fat into ketones to act as a fuel
source when cells stop absorbing insulin. ketones are acidic,
thus causing acid/base imbalance
what is the nursing management for DKA?
rehydration (0.9% NS)
restoring electrolytes (monitor K+)
reversing acidosis (with insulin)--once insulin therapy begins,
K+ goes into the cell.
what are some other complications of DM?
,diabetic neuropathy, hypoglycemia, CAD (coronary artery
disease), CVD (cardiovascular disease), PVD (peripheral
vascular disease), retinopathy, and neuropathy
what are the 5 clinical manifestations of DKA?
Hyperglycemia (usually 600-700)
Ketosis (ketone bodies = fruity breath)--decrease in bicarbs and
pH (7.35 or less)
Dehydration (polyuria--called osmotic diuresis; reason for the
excessive urination, dehydration, and excessive thirst
Abnormal electrolyte levels (Na, K, Cl)
Metabolic acidosis(repidly breathing out CO2--> Kussumal
breathing)
what is a normal potassium level?
3.5-5
what is a normal Na level?
135-145
What is a normal calcium level?
97-107
what are the symptoms of DM 2?
frequent urination, thirst, fatigue, diabetic coma, insulin shock,
blurry vision, and slow healing wounds (symptoms develop
gradually)
, what is the treatment for DM 2?
start with: lifestyle changes
next: hypoglycemic agents (oral)
final: insulin
What is a life-threatening complication of DM 2?
HHNS (Hyperosmolar hyperglycemic nonketoic syndrome)
What are the S/S of HHNS?
hyperosmoality (at least 340)
hyperglycemia (600)
Alterations in LOC
Ketosis is minimal or absent (due to fat break down)
abnormal electrolyte levels (NA, K, Cl)
what are some nursing diagnoses for a patient with DM 2?
imbalanced nutrition, risk for impaired skin integrity, risk for
infection, and deficient knowledge
what is the nursing management of HHNS?
rehydration (initially 0.9%)
restoring electrolytes (potassium is huge concern)
what happens when a patient's sugar is so high and we rehydrate
them?
Their bg level will decrease (insulin plays less important role
here vs DKA)
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