Chapter 30 1286-1289

Front 1

DKA reflects amplification of the same physiologic mechanism as ______

Back 1

ketosis
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Front 2

As the body switches to fat-based metabolism, the blood level of ketones ______

Back 2

rises
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Front 3

In DKA when the ph balance is from 7.4 to ____ the pt is hours from death if left untreated

Back 3

6.9
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Front 4

The onset of clinically obvious DKA is slow usually lasting from ___ to ___ hours

Back 4

12-24 hours
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Front 5

Signs and Symptoms of DKA

Back 5

Diuresis, increased urine production, dry warm skin and mucous membranes, general malaise, tachycardia, physical weakness
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Front 6

Name a major compensatory mechanism as ketoacidosis appears, it helps expel cardon dioxide

Back 6

Kussmaul's respirations
(rapid deep breathing pattern)
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Front 7

A hallmark sign of DKA is ?

Back 7

A sweet fruity odor on the pt's breath
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Front 8

Hyperglycemia, acidic pH, electrolyte abnormalities, low bicarb levels, hypokalemia all occur in

Back 8

DKA
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Front 9

True or False
A fever is characteristic of ketoacidosis

Back 9

False
a fever is a signal of infection
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Front 10

It is not uncommon for pts w/ketoacidosis to have BGL in excess of

Back 10

300mg/dl
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Front 11

Field management for DKA:

Back 11

Maintenance of ABC's and fluid resuscitation to counteract dehydration
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Front 12

HHNK coma develops when 2 conditions occur:

Back 12

1-sustained hyperglycemia
2-dialysis, high-osmolarity feeding supplements, infection, drugs can also be associated
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Front 13

HHNK's level of hyperglycemia is often much higher than that of DKA usually around

Back 13

1000 mg/dl
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Front 14

The mortality rate for HHNK ranges between ___ to ___%

Back 14

40-70%
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Front 15

HHNK primarily affects the ____

Back 15

elderly
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Front 16

Onset of HHNK is slower than DKA, onset development occurring ____

Back 16

over several days
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Front 17

Signs and Symptoms of HHNK

Back 17

Increased urication and thirst, orthostatic hypotension, dry skin and mucous membranes, tachycardia
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Front 18

True or False
Kussmaul's respirations are often seen in pts with HHNK

Back 18

False
Kussmaul's is rarely seen because of the lack of acidosis
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Front 19

Management of HHNK

Back 19

Same as DKA, ABC's & fluid resuscitation, expedited transport
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Front 20

As hypoglycemia lengthens, risk rises that brain cells will be permanetly damaged due to lack of

Back 20

glucose
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Front 21

Glucagon may be ineffective in raising BGL because of

Back 21

high insulin levels
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Front 22

Almost half of glucose normally produced is of ____ origin and the activity is stimulated by ______

Back 22

Renal origin
epinephrine
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Front 23

The most important sign/symptom of hypogycemia

Back 23

Altered Mental Status
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Front 24

Signs and symptoms of hypoglycemia

Back 24

bizarre behavior, diaphoresis, tachycardia, Altered mental status, may have a hypoglycemic seizure
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Front 25

Management of hypoglycemia

Back 25

BGL<60: IV on NS, admin 50-100ml of D50 IV, if pt is conscious and can swallow use dextrose paste
If BGL cannot be obtained: IV of NS, admin 50-100ml of D50, if alcoholism is suspected admin 100mg of thiamine
If IV cannot be started: admin 0.5-1.0 mg of glucagon IM
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Front 26

You are more likely to see thyroid disfunction as part of the _____ than as an emergency

Back 26

Medical history
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Front 27

Name the 4 most common thyroid disorders

Back 27

1-Hyperthyroidism
2-Thyrotoxicosis
3-Hyptothyroidism
4-Myxedema
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Front 28

More than 95% of thyrotoxicosis are due to _____

Back 28

Graves' disease
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Front 29

Graves' disease has a strong hereditary role and is about ___ times more common in women than men

Back 29

6
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Front 30

Signs and symptoms of Graves' disease

Back 30

Agitation, emotional changeabilty, insomnia, poor heat tolerance, weight loss, weakness, dyspnea, tachycardia, new-onset of A-Fib,
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Front 31

Nervous symptoms tend to be more common in _____, where cardiovascular symptoms tend to be common in ____

Back 31

young adults
older individuals
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Front 32

Management of Graves' disease

Back 32

Reducing cardiac stress and dealing with cardiac dysfunction
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Front 33

____ is probably the most likely context w/in an emergency call may arise in Graves' disease

Back 33

Cardiac dysfunction
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