glycosylated hemoglobin (hbA1c): blood test; gives an average of what your blood sugar has been over the past ____
3 months
illness= think (diabetes)
DKA
should you aspirate insulin?
NO , to reduce the trauma of the skin
insulin infusion pump:
-only ____insulin is used in infusion pump.
alternate to insulin injections
rapid acting
____ is the only insulin that can be given in IV fluid as an intravenous infusion.
____ is the only insulin that can be given via SQ insulin infusion pump. insulin infusion pump are small computerized device worn by the client that provide both a ____ dosing of rapid-acting insulin and on-demand (bolud) dosing.
regular insulin
rapid acting insulin
continuous
s/s of hypoglycemia
cool clamy confusion HA nervous increase pulse shaky nausea
if hypogylcemic, what should client do?
glucose absorbtion is delayed in food with lots of __.
once the blood sugar is up, what should they do?
eat simple sugar
fat
eat complex carb and protein
what is important about d5w?
hard to push, if you have a choice you need a large bore IV
for prevention of hypoglycemia, teach the client to
eat
take insulin regular
know sign of hypoglycemia
check blood sugar regularly
hypoglycemia is a glucose level of ____
70 or less
diabetic ketoacidosis:
anything that increases blood sugar can throw a client into DKA (illness, infection, skipping insulin)
- DKA may be the first sign of type 1
- have all the usual s/s of type 1
- patho: absent or inadequate insulin–blood sugar goes sky high–polyuria,polydipsia,polyphagia– fat breakdown(acidosis)–kussmaul’s respiration (trying to blow off co2 to compensate for the met. acidosis), also, as the client becomes more acidotic, the LOC does DOWN!
treatment for DKA
- find the cause
- hourly blood sugar and potassium level
- IV insulin (insulin decreases glucose and potassium by driving them out of the vascular space into the cell)
- ECG
- ABGs
- IVFs–start with NS.. then when the blood sugar gets down to about 300, switch to d5w to prevent throwing the client into hypoglycemia
- anticipate that the physician will want to add potassium to the iv solution at some point
HHNK or HHS is…
Hyperosmolar hyperglycemic nonketosis or hyperglycemic hyperosmolar state
- looks like dka, but no acidosis
- making just enough insulin so they are not breaking down fat. no fat breakdown…no acidosis, no ketones…no acidosis
- no fruity breath odor
- no kussmauls respirations
DKA happens in ___ whereas HHNK (HHS) happens in ___.
type 1
type 2
DKA and HHNK are both hyperosmolar state caused by ____ and ____, but there is no ____ with HHNK.
hyperglycemia
dehydration
acidosis
what is gastroparesis?
stomach empyting is delayed so there is an increased risk for aspiration
what is the complications of diabetes?
DKA HHNK (HHS) vascular problems neuropathy increased risk for infection
