Diabetes

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Diabetes Fluid Electrolyte Acid
BaseConnections

• Meg Wilson RN, MSN, Ed.D.

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  Glucose Metabolism Of Diabetes

deficiency / resistance to insulin by cells
insulin blood levels increase
hyperglycemia The 3 Ps POLYDISPIA, POLYURIA,
POLYPHAGIA
n  
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Fluid Changesof Diabetes

• Blood viscosity increases
• increased osmolarity
• pulls fluid into blood stream
• stimulates thirst mechanism
• polydipsia!!!!!

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Fluid Mechanisms Triggered by Diabetes

• Blood Passes through kidneys
• Increased Osmolarity
• Increased osmolarity from increased blood glucose
• Glucose excreted from kidneys
• Along with FE
• Polyuria!!!

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Cells Unable to Use Insulin

• stored fat muscle protein used for energy
• sends hunger signals to brain
• Polyphagia!!!

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Hyperglycemia Signs SymptomsThree (3)Ps

• Polydipsia Polyphagia Polyuria
• Dehydration
• Flushed,dry skin
• Abdominal cramps/ NV
• Weak,rapid pulse/Arrhythmias
• Hypotension
• TachypneaKussmalsacetone breath
• Decreased LOC RestlessnessHeadacheStuporComa
  

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POTASSIUM IMBALANCE

• Weak,rapid pulse
• Arrhythmias
• PVCS

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Potassium Acidosis

• Potassium is a relative loss-not a real loss.
• It has just moved out of the cell
• WHY????
• Acidosis
• The metabolism of diabetes leaves acid and less
  energy
• (Krebs Cycle is anaerobic and leaves behind
  lactic acid therefore acidosis.)

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Acidosis Potassium Movement

• In any state of cellular acidosis (Hydrogen Ions)
  the Potassium moves out of the cell to keep Anion
  and Cation balance
• Hydrogen Ion needs a balancing opposite force so
  potassium moves out of the cell
• Potassium is now in the intracellular or
  (interstitium) and then will move over time to
  plasma and is unavailable for the action
  potential of the cell
• So the symptoms of poor cardiac conduction, GI
  function, muscle weakness

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Nursing Care

• Acidosis must be reversed
• Glucose must get into the cell
• Insulin must be given
• Potassium must be forced back into the cell