...association (2011) defines diabetic ketoacidosis (DKA) as a medical emergency that can progress to a diabetic coma and death if not rapidly diagnosed and treated (American diabetes association (ADA), 2011). DKA is a complication associated with diabetes mellitus (DM) and is characterized by hyperglycemia due to a deficiency in insulin (Urden, Stacey, & Lough, 2010). Rapid diagnosis and aggressive treatment of DKA is crucial because it is potentially life threatening (Kitabchi, Rose, 2011). Nurses in the critical care setting are responsible for understanding the disease process of DKA as well as identifying its signs and symptoms so that patients can receive prompt treatment early before it progresses. This paper will discuss DKA and explore its epidemiology, etiology, pathophysiology, assessment, diagnosis, treatment, and nursing and interventions associated with it. Epidemiology and Etiology DKA is a complication of type-one and type-two DM and is typically seen more in type-one diabetics because of they are deficient and lack the ability to produce insulin (Urden et al., 2010). Type-two diabetics can develop DKA but it is very rare and is usually precipitated in a patient who is severely ill (Diabetic ketoacidosis, 2011). Those most likely to develop DKA associated with type-two DM include Hispanics and African Americans (Diabetic ketoacidosis, 2011). The parameters that must be met for a positive diagnosis of DKA are a blood glucose greater than 250, pH less than...
Words: 2828 - Pages: 12
...will discuss the critical of patient safety and team in management for diabetes mellitus. The methodology will be in the following chapter number...
Words: 1841 - Pages: 8
...The risk factors B.Z. may have for contracting NIDDM are genetics and obesity. The case study had stated that his father and paternal grandmother had developed diabetes. The other risk factor is obesity because B.Z. is 5’8” and 210lbs, which is very much over weight for his height. The pathophysiology of NIDDM, which is a non-insulin dependent diabetes mellitus and the body stops producing enough insulin for the body. The body does not have any ketones and occurs more frequently in people over the age of 30. The signs and symptoms of NIDDM are a delay in the secretion of insulin, it gets worse with age, Muscle and adipose tissue are most resistant, you will have high blood sugar levels, and the liver will initiate gluconeogenesis. The basic defect in this type of diabetes is genetics and obesity. 2. The significance of B.Z.’s report of Polydipsia and Polyuria are that the signs and symptoms are very similar to the signs and symptoms of diabetes. The 3 P’s in diabetes are polyuria, polydipsia and polyphagia. Polyuria is increased urine output. Polydipsia is increased thirst. Polyphagia is increased eating or hunger. The water is pulled intracellular causing dehydration. - The recent weight loss of B.Z. is due to the fluid in the osmolarity levels and the loss of body tissue. - Orthostatic Hypotention is an abnormal decrease in blood pressure when a person stands up. B.Z. has orthostatic hypotension because he is not getting enough blood flow to the brain. 3...
Words: 1282 - Pages: 6
...people 2025 = 300 million diabetic people = 9% global population IDF (international diabetes federation): 2 million diabetic people in UK with over 750,000 undiagnosed NICE: 650,000 women give birth in England & Wale each year and 2-5% (13,000-32,500) involves women with diabetes, of these: * 87.5% are Gestational Diabetes (GD) * 7.5% are Type 1 * 5% are Type 2 From 1997-2003 there was 74% rise in new cases in the UK with the West Midlands being one of the highest areas (News, 2009) Treatment: Aim: to maintain glycaemic control – regular monitoring is required Lifestyle: diet, exercise Medication – tablet or injection e.g. Insulin, rapid acting insulin analogues (Aspart, Lispro) and/or hypoglycaemic agents (Metformin and Glibenclamide) Diabetes health complications: Hypoglycaemia: Too much insulin; which can cause low blood sugar Symptoms: Paleness, shaking, hunger, sweating Specialist will advise what to do e.g. consume sugary soft drink Occasionally can cause loss of consciousness – an injection will be needed Diabetic Ketoacidosis (DKA)/Hyperglycaemia: A life-threatening complication. Near complete deficiency...
Words: 2919 - Pages: 12
...| Type 1 Diabetes Mellitus | | | | Type 1 Diabetes Mellitus Diabetes Mellitus (DM) is a metabolic disorder that is rising at an alarming rate across all age groups in the United States and around the world. Because of the surge of new diagnoses of DM, medical journals are referring to this disorder as an epidemic and pandemic. According to Brass (2014), “diabetes kills one individual every six seconds across the globe, and it is expected to rise 55 percent in the next 20 years” (p. 6). The article goes on to state that according to the American Diabetes Association (ADA), “about 26 million individuals in the U.S. or 83 percent of the population have had a diabetes diagnosis (p. 6). Unfortunately this number will only begin to keep climbing and affect future generations to come. Professor Nam Han Cho wrote in a report on diabetes that “if current demographic patterns continue, more than 592 million people (worldwide) will be affected with diabetes within a generation” (Brass, 2014, p.7). Diabetes can be divided up into four categories including the following: Type 1 DM, Type 2 DM, gestational diabetes, and pre-diabetes. This paper will discuss the aspects of Type 1 diabetes. Information from the article Primary and secondary prevention of Type 1 diabetes was obtained from the Wiley Online Library database using the search terms diabetes type 1, and prevention. The Wiley Online Library database was also used to obtain information from the article titled...
Words: 2346 - Pages: 10
...Student number 213059356 HND 701 pathophysiology of Diabetes Assignment 1 Word count 2130 Student name Trevor Clemens Student number 213059356 Page 1 of 17 Student number 213059356 Many aspects must be taken into consideration in attaining knowledge and understanding of diabetes, it is not just a metabolic process. There are multiple risk factors that precipitate the metabolic process leading to a diagnosis. The following analyses relevant data in relation to pathophysiology, presenting signs, symptoms and underpinning principles of Type One Diabetes Mellitus (T1DM) and Type Two Diabetes Mellitus (T2DM), their prevalence and incidence, metabolic abnormalities and associated risk factors are also examined. Diagnostic criteria is also examined along with advantages and disadvantages of differing testing screen methods and results. The Australian Bureau of Statistics (ABS), Australian Health Survey 2012, reported that in 2011 – 12 the prevalence of all reported diabetes was at 4.0% (875,400 people) and had remained the same as the 2007/’08 period. Of these people 12.4% had T1DM, 85.3% had T2DM while the remaining 2.3% had diabetes of another kind. Tanamas S, et al. (2013) stated that the prevalence of type two diabetes in peoples over the age of 25 years in Australia is 7.4% and that a further 7.4% remain undiagnosed. The dominance of western lifestyles and diets has contributed to a dramatic rise in obesity within the population. It is contended...
Words: 4252 - Pages: 18
...Final Exam Study Guide Important to Know the function of anterior and posterior pituitary gland. Anterior Pituitary Gland: (Adenohypophysis) The anterior pituitary gland regulates several physiological processes including stress, growth, reproduction and lactation (Adrenal, liver, bone, thryroid and gonads). -It is regulated by negative feedback and the hypothalamus. Major hormones: ACTH: Stimulates the adrenal cortex. TSH: Thyroid stimulating hormone, promotes secretion of thyroid hormone. FSH: Follicle-stimulating hormone, promotes growth of reproductive system. LH: Luteinizing hormone. Promotes sex hormone production GH: Growth hormone, promotes growth, lipid and carbohydrate metabolism. PRL: Prolactin, Milk production and progesterone/estrogen. -Hormones are secreted from the hypothalamus to the A. Pituitary so these hormones can be released. Posterior Pituitary Gland: Mainly axons extended from the hypothalamus. These axons contain and release neurohypophysial hormones oxytocin and vasopressin. Oxytocin: Targets the uterus, and mammary glands causing contractions and lactation. Vasopressin (ADH): Antidiuretic hormone, arginine vasopressin, argipressin. Stimulates water retention absorbs it back into blood causing raises blood pressure by contracting arterioles, and inducing male aggression. Very Important to know and understand Diabetic Ketoacidosis Pathophysiology: -In DKA, the lack of insulin prevents glucose from being utilized by the tissues...
Words: 4739 - Pages: 19
...both (ADA], Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 2003. Causes for Diabetes Mellitus The cause of both type 1 and type 2 diabetes remains unknown, although genetic factors may play a role. Diabetes mellitus results from insulin deficiency or resistance. Insulin transports glucose into the cell for use as energy and storage as glycogen. It also stimulates protein synthesis and free fatty acid storage. Insulin deficiency or resistance compromises the body tissues’ access to essential nutrients for fuel and storage. The resulting hyperglycemia can damage many of the body’s organs and tissues. Type 1 diabetes is due to pancreatic islet B cell destruction predominantly by an autoimmune process, and these patients are prone to ketoacidosis. Type 2 diabetes is the more prevalent form and results from insulin resistance with a defect in compensatory insulin secretion Insulin, a hormone produced by the pancreas, controls the level of glucose in the blood by...
Words: 5609 - Pages: 23
...E-Booklet David W. Woodruff, MSN, RN-BC, CNS, CEN www.Ed4Nurses.com ©1997-2009 Ed4Nurses, Inc. 6 Easy Steps to ABG Analysis ©2003-2009 Ed4Nurses, Inc. WELCOME TO THE 6 EASY STEPS TO ABG ANALYSIS! BY: DAVID W. WOODRUFF, MSN, RN-BC, CNS, CEN Nurses often have difficulty interpreting arterial blood gases (ABGs). Confusion often begins with trying to remember many random rules and lacking a standardized approach to ABGs. In addition, nurses often attempt to analyze too many components of the ABG at the same time. The result is often confusion and an incorrect diagnosis. Therefore, the “6 Easy Steps to ABG Analysis” were developed to provide nurses with an accurate and systematic method of easily interpreting arterial blood gases. The “6 Easy Steps to ABG Analysis” are listed below for easy reference, and will be explained in more detail in the sections that follow. Lastly, examples will be presented with a systematic review of pertinent findings. The 6 Easy Steps to ABG Analysis: 1. Is the pH normal? 2. Is the CO2 normal? 3. Is the HCO3 normal? 4. Match the CO2 or the HCO3 with the pH 5. Does the CO2 or the HCO3 go the opposite direction of the pH? 6. Are the pO2 and the O2 saturation normal? In order for our analysis to be effective, notes will have to be written next to the results on our lab slip. Alternately, the ABG results can be transcribed onto another paper for analysis (see example one below for the format). www.Ed4Nurses.com 1 6 Easy Steps...
Words: 2358 - Pages: 10
...Crystalloid Resuscitation Chapter 14 - Acute Heart Failure Syndromes Chapter 15 - Cardiac Arrest Chapter 16 - Hemodynamic Drug Infusions Section VI - Critical Care Cardiology Critical Care Cardiology Chapter 17 - Early Management of Acute Coronary Syndromes Chapter 18 - Tachyarrhythmias Section VII - Acute Respiratory Failure Acute Respiratory Failure Chapter 19 - Hypoxemia and Hypercapnia Chapter 20 - Oximetry and Capnography Chapter 21 - Oxygen Inhalation Therapy Chapter 22 - Acute Respiratory Distress Syndrome Chapter 23 - Severe Airflow Obstruction Section VIII - Mechanical Ventilation Mechanical Ventilation Chapter 24 - Principles of Mechanical Ventilation Chapter 25 - Modes of Assisted Ventilation Chapter 26 - The Ventilator-Dependent Patient Chapter 27 -...
Words: 91543 - Pages: 367
...Diabetes transition Assessment of current best practice and development of a future work programme to improve transition processes for young people with diabetes. Transition in healthcare is only one part of the evolution from dependent child to independent adult (David, 2001). Submitted by Ruth Gordon, Ruth Gordon Associates Ltd to NHS Diabetes. Supporting, Improving, Caring August 2012 Acknowledgements This project was funded by NHS Diabetes and supported by Gillian Johnson, North East Regional Programme Manager. The expert panel was made up of a group of clinicians and others who provided information, commented on the process and contributed to the views included in this final report. Others have influenced the later stages of the work and will be involved in planning how to take this project forwards. Therefore thanks go to: • Fiona Campbell • Deborah Christie • Chris Cooper • Julie Cropper • Gail Dovey-Pearce • Jane Edmunds • Gavin Eyres • Sue Greenhalgh • Peter Hammond • Gillian Johnson • Susannah Rowles • Carolyn Stephenson • Helen Thornton • Peter Winocour • Alison Woodhead Without the two clinical leads, Peter Hammond from Harrogate and Fiona Campbell from Leeds, this work and report would not have been possible. Contents Executive summary Context Background and rationale Aims of the project Timing of the project Process undertaken for the project Evidence base and policy background Results from the snapshot research Good practice Examples of good practice...
Words: 11252 - Pages: 46
...dehydrationMod dehydrationSevere dehydrationReplacing ongoing losses | MAJOR TEACHING POINTS | NURSING CONSIDERATIONS | Teach parents at well childcare visits in first yearKeep 24 hour supply of ORT in homeBegin with first sign of diarrheaReplace with ½ cup ORT for each diarrheal stoolSeek medical attention prn signs or dehydrationAfter re-hydration resume breast/formula feeding or normal diet in the older childAdvise them never to try to formulate an OR solution themselves.Teach personal hygiene/ hand washingProper preparation and storage of breast milk or formulaCareful food preparationImmunization for RotavirusAvoid unnecessary antibiotic usage | Acute diarrhea is leading cause of illness in children <5 years (10’s of millions cases in US)65% of hospitalizations and 85% of...
Words: 6492 - Pages: 26
...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
Words: 72133 - Pages: 289
...Essentials Ruth E. McCall, BS, MT (ASCP) Retired Program Director and Instructor Central New Mexico Community College Albuquerque, New Mexico President, NuHealth Educators, LLC Faculty, Emeritus Phoenix College Phoenix, Arizona Fifth Edition Cathee M. Tankersley, BS, MT (ASCP) Acquisitions Editor: Peter Sabatini Product Manager: Meredith L. Brittain Marketing Manager: Shauna Kelley Designer: Holly McLaughlin Production Services: Aptara, Inc. Fifth Edition Copyright © 2012, 2008 by Lippincott Williams & Wilkins, a Wolters Kluwer business. Two Commerce Square 2001 Market Street Philadelphia, PA 19103 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress...
Words: 129902 - Pages: 520
...Dear nutrition student, Thank you for inquiring about my RD/DTR study guide. And yes, there is no catch, the study guide is COMPLETELY FREE! All I ask for is some feedback. So feel free to shoot me any questions/comments! A little background: This study guide is the culmination of years of my own research. And after careful thought, I put into the study guide what I feel are the most important concepts you need to know for the RD/DTR exam. If you notice, I spent much time teaching you in detail the concepts you need to know, not just “spitting” you questions with little or no explanation. I believe this is important. I know you might be thinking “oh, how am I going to absorb and learn all this material?” I say, just read and answer the questions at your own pace. Simply test yourself and of course take some breaks along the way. Just take it one concept at a time. After you have mastered one concept, then move on to the next. I know if you study whole-heartedly what I have outlined in this study guide, you are sure to pass! GOOD LUCK! YOU CAN DO IT! ϑ Your nutrition friend, -Jonathan Brown, B.S, DTR THE “NO FLUFF” RD/DTR STUDY GUIDE *Updated as of July 2011 The “NO FLUFF” RD/DTR STUDY GUIDE Tips for taking the RD/DTR exam 1. PERIODICALLY CHECK THE CLOCK TO MAKE SURE YOU’RE GOOD ON TIME! If you wish, get a basic digital watch with a timer for...
Words: 20721 - Pages: 83
