Chapter 21: Diabetic Emergencies And Altered Mental Status

Front 1

What is the Reticular Activating System? (RAS)

Back 1

Series of neurologic circuits in the brain that control the functions of staying awake,

paying attention,

and sleeping.

Front 2

What is neededto perfuse,

nourish,

and hydrate brain tissue?

Back 2

Oxygen to perfuse

Glucose to nourish

Water to hydrate

Front 3

What is glucose?

Back 3

A form of sugar,

the body's basic source

of energy.

Front 4

What is insulin?

Back 4

A hormone

produced by the pancreas

or taken as a medication

by many diabetics.

Front 5

What is 'diabetes mellitus'?

Back 5

'Sugar diabetes' or just diabetes. This condition is brought about by decreased insulin production or the inability of the body's cells to use insulin properly.

Front 6

How many types

of diabetes are there?

Back 6

Two,

Type 1 diabetes, and

type 2 diabetes.

Front 7

What is type one diabetes?

Back 7

AKA 'insulin-dependent' diabetes, it occurs when pancreatic cells fail

to function properly

and insulin is not secreted normally.

Front 8

What is type two diabetes?

Back 8

AKA 'non insulin-dependent' diabetes, It occurs when the body's cells fail to utilize insulin properly.

Front 9

What is hypoglycemia?

Back 9

Low blood sugar.

Front 10

What causes hypoglycemia?

Back 10

When a diabetic: Takes too much insulin
Reduces sugar intake by not eating
Over exercises or over exerts himself
Vomits a meal, emptying the stomach of sugar.

Front 11

What is hyperglycemia?

Back 11

High blood sugar.

Front 12

What are some factors

that can cause

hyperglycemia?

Back 12

Insulin injections may have been forgotten
Infection
Stress
Increasing dietary intake

Front 13

What is diabetic ketoacidosis?

Back 13

A condition that occurs as the result of hyperglycemia. It's characterized by dehydration, altered mental status, and shock.

Front 14

What is the waste product

of ketoacidosis?

Back 14

Ketones

Front 15

What are some

signs and symptoms

of a diabetic emergency?

Back 15

Rapid onset of altered mental status
Intoxicated appearance, Cold, clammy skin
Elevated heart rate, Hunger
Uncharacteristic behavior, Anxiety
Combativeness Seizures

Front 16

True or false:

Diabetic children are more at risk for medical emergencies.

Back 16

True.

Children are more active, and therefore exhaust their blood sugar levels more easily.

Front 17

Which has a faster onset,

Hypo or Hyperglycemia?

Back 17

Hypoglycemia

comes on suddenly,

whereas hyperglycemia

occurs over time.

Front 18

How might the skin present

in a patient suffering

from hyperglycemia?

Back 18

Warm,

Red and Dry.

Front 19

How might the skin present

in a patient suffering

from hypoglycemia?

Back 19

Cold, Pale,

moist, clammy skin.

Front 20

What is different about the breath of a patient

suffering from hyperglycemia?

Back 20

Breath will smell sweet,

like nail polish remover.

This is due to the ketones.

Front 21

What is a seizure?

Back 21

A sudden change in sensation, behavior, or movement. The most severe form of seizure produces violent muscle contractions called convulsions.

Front 22

What is a partial seizure?

Back 22

A seizure that affects only one part or one side of the brain.

Front 23

What is a generalized seizure?

Back 23

A seizure that affects

both sides of the brain.

Front 24

What is a tonic-clonic seizure?

Back 24

A generalized seizure in which the patient loses consciousness and has jerking movements

of paired muscle groups.

Front 25

What is the postictal phase?

Back 25

The period of time immediately following a tonic-clonic seizure in which the patient goes from full loss of consciousness to full mental status.

Front 26

What is an aura?

Back 26

A sensation experienced by a seizure patient right before

the seizure, which might be

a smell, sound, or general feeling.

Front 27

What happens in the tonic phase?

Back 27

The body becomes rigid, stiffening for

no more than 30 seconds. Breathing may stop, the patient may bite his tongue, and bowel and bladder control could be lost.

Front 28

What happens in the clonic phase?

Back 28

The body jerks violently,

usually for no more than 1 or 2 minutes (some can last 5 minutes). The patient may foam at the mouth and drool. His face and lips often become cyanotic.

Front 29

What happens in the

postictal phase?

Back 29

This phase begins when convulsions stop.

The patient may regain consciousness immediately and enter a state of

drowsiness and confusion, or he may remain unconscious for several hours.

Headache is common.

Front 30

What are some causes

of seizures?

Back 30

Hypoxia
Stroke
Traumatic brain injury
Toxins
Hypoglycemia
Brain tumor
Congenital brain defects
Infection
Metabolic
Idiopathic (spontaneous with unknown causes).

Front 31

What is epilepsy?

Back 31

A medical condition that causes seizures.
An umbrella term used for when a person has multiple seizures with unknown cause.

Front 32

What is status epilepticus?

Back 32

A prolonged seizure or situation when a person suffers two or more convulsive seizures without regaining full consciousness.

Front 33

What is an absence seizure?

(Petit mal)

Back 33

A seizure that is brief, usually lasting only 1 to 10 seconds. Patient experiences a temporary loss of concentration or awareness.

Front 34

What is a stroke?

Back 34

A condition of altered function caused when an artery in the brain is blocked or ruptured, disrupting the supply of oxygenated blood or causing bleeding into the brain.

Front 35

What is a hemorrhagic stroke?

Back 35

A stroke that is caused

by bleeding into the brain.

Front 36

What does CVA stand for?

Back 36

Cerebrovascular Accident.

Front 37

What is a TIA?

Back 37

Transient Ischemic Attack.
Patients look like they are having a stroke due to similar signs and symptoms. Although the symptoms are completely resolved within 24 hours with no treatment.

Front 38

What are the components of

the Cincinnati Pre-hospital

Stroke Scale?

Back 38

Facial droop
Arm droop
Slurred Speech

Front 39

What are

the signs and symptoms

of a stroke?

Back 39

Confusion
Dizziness
Numbness, weakness, or paralysis (usually on one side of the body)
Loss of bowel or bladder control
Impaired vision
High blood pressure
Difficult respiration or snoring
Nausea or vomiting
Seizures
Unequal pupils
Headache
Loss of vision in one eye
Sometimes unconciousness

Front 40

What is syncope?

Back 40

Fainting.
A brief loss of consciousness with spontaneous recovery.

Front 41

What are some types

of syncope causes?

Back 41

Hypovolemic
Metabolic and structural
Environmental/toxicological
Cardiovascular
Other- Undetermined