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Endocrine Diseases and Conditions - PowerPoint PPT Presentation


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Diabetes August 2012. Endocrine Diseases and Conditions. Type I or Type II. Symptoms – Type I Frequent urination Unusual thirst Extreme hunger Unusual weight loss Extreme fatigue and irritability. Symptoms – Type II Any of the type I symptoms Frequent infections Blurred vision

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Presentation Transcript
slide3

Symptoms – Type I

Frequent urination

Unusual thirst

Extreme hunger

Unusual weight loss

Extreme fatigue and irritability

slide4

Symptoms – Type II

Any of the type I symptoms

Frequent infections

Blurred vision

Cuts and bruises that are slow to heal

Tingling or numbness in the hands or feet

Recurring skin, gum or bladder infections

slide5

Prevention

Type II can be prevented or delayed

Lead a healthy lifestyle

Change your diet

Increase your physical activity

Maintain a health weight

slide6

Myths

  • Diabetes is not that serious of a disease
  • If you are over weight you will eventually develop type II diabetes
  • Eating too much sugar can cause diabetes
  • People with diabetes must eat special foods
  • People with diabetes cannot eat carbs or sugars
  • It is ok to eat as much fruit as you want because it is healthy
slide7

Diabetic Ketoacidosis (DKA)

Insulin deficiency and excessive stress hormone

Typically in Type I but can be in Type II

Elevated glucose promotes osmotic diuresis and dehydration

slide8

Stress hormones stimulate free fatty acids which cause a release of ketones

  • Causes decreased myocardial contractility and cerebral function
  • Usually brought on by infection and stress
slide9

Interventions

  • Gradually return to normal metabolic balances
  • FSBS and notify the MD of the results
  • 2 large bore IV’s
  • NS at a rate of 1 liter per hour
  • O2 and maintain ABC’s
  • Insulin drip per protocol
  • Monitor patient every 5-15 minutes until stable
  • Closely monitor intake and output
  • Cardiac monitor
slide10

Hyperglycemic Hyperosmolar Nonketotic Coma (HHNC)

  • Occurs in type II
  • Profound dehydration from elevated glucose and osmotic diuresis
  • No ketones-not enough insulin to start the process
  • Can be caused by infection, stroke or sepsis
  • High mortality rates
slide11

Interventions

  • FSBS and notify the MD of the results
  • May require intubation
  • 2 large bore IV’s
  • NS 1 liter over 1 hour
  • Insulin drip per protocol
  • Monitor the patient every 5-15 minutes until stable
  • Closely monitor the intake and output
  • Cardiac monitor
slide12

Hyperglycemia

  • Serum glucose drops below 50
  • Below 35-the brain cannot adequately extract oxygen
  • Results in hypoxia and eventually coma
  • Any person with an altered level of consciousness should be considered to have low glucose until proven otherwise
slide13

Interventions

  • O2 and maintain ABC’s
  • FSBS and notify MD of results
  • If alert and oriented x3, give oral glucose solutions (oj, milk, etc. )
  • Establish IV
  • ½ to 1 amp of 50% dextrose (D50) per MD’s orders
  • Monitor the mental status closely
  • Monitor the FSBS every 15-30 minutes
  • Order a meal tray STAT
  • Cardiac Monitor
slide14

References

American Diabetic Association

Emergency Nursing Core Curriculum, ENA

Fundamentals of Nursing, Potter and Perry