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14 Cards in this Set
- Front
- Back
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DM Type 1
- age of onset - type of onset - family Hx - s/s - nutritional status |
- 20 YO
- abrupt - sometimes - 3 Ps (polyphagia, polydipsia, polyuria) - underweight |
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DM Type 2
- age of onset - type of onset - family Hx - s/s - nutritional status |
- younger children
- gradual - frequent - may be related to long term complication - overweight |
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when is regular insulin best administered
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30 mins before eating
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what is the best method for administering insuline
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subcutaneous, site rotation
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nutrition Tx
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- time food consuption with insulin
- btw. meal and bedtime snacks - avoid concentrated sugars - fat <30% - high carb, high fiber |
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exercise Tx
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- encourage exercise
- extra snacks before exercise - athletes need to adjust insulin prior to strenuous activity |
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complications
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hypoglycemia (very common) & hyperglycemia
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hypoglycemia CM
- onset - mood - mental status - skin - mucous membranes - RR - pulse - breath odor |
- rapid
- labile, iritable, nervous, weepy - difficulty concentrating speaking, focusin, coordinating - pallow, sweating - shallow, normal - tachycardia, palpitations - normal |
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hyperglycemia CM
- onset - mood - mental status - skin - mucous membranes - RR - pulse - breath odor |
- gradual
- lethargic - dulled sensorium - flushed - dry, crusty - deep, rapid - less rapid, weak - fruity, acetone |
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DKA management (fluid replacement)
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- over 24-48 H
- goal: 25 ml/hr urine output |
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DKA management (insulin)
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- given after urine ketones and serum glucose are measured
- given after initial rehydration bolus - goal: maintain blood glucose levels at 120-240 |
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DKA management (K replacement)
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- serum K measure at admission
- never give bolus of K - monitor ECG, look for change in T wave |
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widening QT interval, flat T wave, U wave present
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hypokalemia
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shortening QT interval, elevated T wave
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hyperkalemia
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