Diabetes Complications - PowerPoint PPT Presentation

1 / 30
About This Presentation
Title:

Diabetes Complications

Description:

Auscultation of lungs. 9. IV Fluids in DKA. Hour 1. N/S or Ringer's lactate (15-20ml/kg) ... Reduce fluid intake to 7.5ml/kg, use half-strength NS. Hour 4 ... – PowerPoint PPT presentation

Number of Views:507
Avg rating:3.0/5.0
Slides: 31
Provided by: kountryc
Category:

less

Transcript and Presenter's Notes

Title: Diabetes Complications


1
Diabetes Complications
  • Dr. Kathleen Ethridge
  • Northeast Texas Community College

2
DKA
  • Diabetic Ketoacidosis
  • Most serious complication in Type 1 diabetes

3
Precipitating Causes
  • Not enough insulin
  • Skipping insulin
  • Stress, trauma
  • Insulin resistance

4
Pathophysiology of DKA
  • See chart
  • Ketosis
  • Dehydration
  • Electrolyte imbalance

5
Symptoms of DKA
  • Abdominal pain
  • Anorexia
  • Dehydration
  • Fuity breath
  • Kussmauls
  • Change LOC
  • Hypotension
  • NV
  • Polyuria
  • Somnolence
  • Tachycardia
  • Thirst
  • Visual disturbances
  • Warm, dry skin
  • Weakness
  • Wt. loss

6
Assessment DKA
  • Hyperglycemia
  • Hyperosmolality
  • Dehydration
  • Electrolyte imbalances
  • Metabolic acidosis
  • Hypoglycemia
  • Fluid overload

7
Intervention
  • Rehydrate
  • Reverse shock
  • Give Potassium
  • Corret pH
  • Give insulin

8
Critical Monitoring
  • Rehydration
  • I O, Daily Weight
  • Skin turgor, LOC, VS
  • CVP measurement
  • Auscultation of lungs

9
IV Fluids in DKA
  • Hour 1
  • N/S or Ringers lactate (15-20ml/kg)
  • Hour 2
  • Continue fluid, consider half-strength NS
  • Hour 3
  • Reduce fluid intake to 7.5ml/kg, use
    half-strength NS
  • Hour 4
  • Consider urine output in adjusting fluids

10
Potassium Replacement in DKA
  • Look at EKG
  • Replacement is based on plasma potassium level
  • Recheck potassium q 2 hours

11
Correct pH/Give Insulin
  • Give IV Insulin
  • Give Regular Insulin only
  • Initial bolus IV (0.15u/kg)
  • Then Regular Insulin IV drip

12
HHNKHyperglycemic, Hyperosmolar Noketotic
Syndrome
  • Most commonly occurs in older adults with Type II
    diabetes
  • Always look for precipitating factors

13
Factors Associated with HHNK
  • Drugs
  • Procedures
  • Chronic illness
  • Acute illness

14
Four Major Clinical Features
  • Severe hyperglycemia
  • No or slight ketosis
  • Profound dehydration
  • Hyperosmolality

15
Treatment
  • Similar to DKA
  • Find underlying cause

16
Hypoglycemia
  • Also known as insulin reaction or hypoglycemic
    reaction

17
Risk Factors
  • Overdose of insulin
  • Omitting a meal
  • Overexertion
  • Nausea and vomiting
  • Alcohol intake

18
Symptoms of Hypoglycemia
  • Adrenergic
  • Shakiness
  • Irritability
  • Nervousness
  • Tachycardia
  • Tremor
  • Hunger
  • Diaphoresis
  • Pallor
  • Paresthesias
  • Neuroglycopenic
  • Headache
  • Mental illness
  • Inability to concentrate
  • Slurred speech
  • Blurred vision
  • Confusion
  • Irrational behavior
  • Lethargy
  • LOC, coma, seizure

19
Interventions
  • Mild
  • carbohydrate 10-15 gram
  • Moderate
  • 20-30 gram of carbs
  • Glucagon, 1 mg SC or IM
  • Severe
  • 50 dextrose 25 g IV
  • Glucagon 1 mg IM or IV

20
Acute Complications of Diabetes
  • Compare
  • DKA
  • HHNK
  • Hypoglycemia
  • see chart for comparison

21
Other Complications
  • Hypoglycemic Unawareness
  • Somogyi Phenomenon
  • Dawn Phenomenon

22
Chronic Complications
  • Macrovascular Complications
  • Microvascular Complications
  • Neuropathic Complications
  • Mixed

23
Foot Infections with Diabetes
  • Inspection
  • Footwear
  • Foot Care

24
Microvascular Complications
  • Retinopathy
  • Nephropathy

25
Visual Complications of Diabetes
  • Education of client
  • Diabetic retinopathy can lead to blindness
  • Check blood sugar
  • Check blood pressure
  • Regular eye exam with ophthalmologist
  • Laser photocoagulation therapy

26
Neuropathy
  • Mononeuropathy
  • Polyneuropathy

27
Diabetic Client and Surgery
  • Preoperative care
  • Intraoperative care
  • Postoperative care

28
Sick Days and Diabetes
  • Individualized plan
  • Monitoring
  • glucose levels
  • ketones
  • insulin
  • nutrition
  • fluids
  • Know when to call the Doctor

29
Children with Diabetes
30
Vacation, Travel and Diabetes
Write a Comment
User Comments (0)
About PowerShow.com