Endocrine Disorders Study GuideDiabetes Mellitus:Type I Insulin dependent-onset under age 30 but can happen at any ageType II Non-insulin Dependent- onset age 40+yearsEtiology:Origin considered: autoimmune, viral, or genetic Strong hereditary component, obesity Diagnostics:Fasting blood glucose over 140 mg/dl on 2 occassions, glycosuria, clinical signs & symptomsHgb A1c: blood test to monitor glucose control over 3 months (120days)S & S: polydipsia, polyuria, polyphagia, fatigue, weight loss, poor wound healing, chronic urinary infections or genital infections i.e. yeast Nursing Management:Monitor blood sugars, administer oral hypoglycemics and/or insulins; observe for hypoglycemia and intervene, patient & education on diet, exercise, foot care, eye caredental care, self-insulin injectionsDiabetic Ketoacidosis (DKA):Acute complication of DM: hyperglycemia, ketonuria, acidosis, dehydrationEtiology:Inadequate amountsof endogenous insulin in the undiagnosed patientORInadequate amountsexogenous insulin in times of stress, infection, surgery, pregnancyDiagnostics:Serum glucose levelsElectrolytesBUN, Creatinine, problems with target organ systemsserum osmolality,+ ketonuriaS & S: serum glucose above 300-1000 mg/dl(early) malaise, drowsiness to coma, muscle cramps, N/V, anorexia, (late) fruity sweet breath, hypotension, weak pulseKussmaul RespirationsNursing Management:Manage insulin drips until blood glucose falls below 250. administer IV fluids, maintain patient safety,airway & ventilation, electrolyte replacement,monitor cardiac rhythm7 neurological changes
Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNKS):Acute complication of DM, particularly Type 2Etiology:Prolonged hyperglycemia above 300-1000 mg/dl from poor control of hyperglycemia, or use of therapeutic drugs that blood glucose small amount of insulin production prevents ketoacidosisDiagnostics:Serum glucose levelsElectrolytesBUN, Creatinine,serum osmolalitylittle ketonuria or absentS & S: serum glucose above 300-1000 mg/dl(early) N/V, fatigue, malaise; (late) stupor, hyperthermia, coma, muscle weakness, seizuresNursing Management:Correct fluids and electrolytes, monitor insulin drip, patient re-education on better glycemic control and management of diabetes.
You've reached the end of your free preview.
Want to read all 7 pages?
- Winter '09
- Endocrine System, Cortisol, serum glucose, Hyperglycemia, serum osmolality, TSH Panel