NURS 3000H Lecture Notes - Lecture 5: Diuresis, Fluid Replacement, Hypervolemia
31 Oct 2018
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Document Summary
Acute complications of dm arise from events associated with hyperglycemia or hypoglycemia. Dehydration owing to illness with vomiting or diarrhea. 0. 9% nacl solution until bp stabilized and urine output. Identify history of diabetes, time of lost food, and time and amount of last insulin injection. Monitor vital signs, level consciousness, cardiac rhythm, oxygen saturation, and urine output. Monitor serum glucose, ph, and the serum potassium. Hhs as a life threatening syndrome that can occur in the patient with dm who is able to produce enough insulin to prevent dka but not enough to prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid completion. The main difference between hhs and dka is that the patient with hhs have enough circulating insulin so that ketoacidosis does not occur. Because hhs produces fewer symptoms in the earlier stages, blood glucose levels and time quite high before the problem is recognized. The higher glucose levels the more severe neurological manifestations happen.
