NURS 3444 Lecture Notes - Lecture 33: Ketoacidosis, Hirsutism, Tachypnea
Document Summary
Objectives: the learner will be able to, describe a few nursing interventions geared to dealing with this difficult population, including. Identify the key similarities and differences between type 1 and type 2 diabetes the potential role of motivational interviewing. Consider use of metformin to prevent progression to type 2 dm: correlation of a1c and average glucose (ag, goal=6. 5-8, ideally <7, medical management of type 2, metformin- 1st drug of choice. Hco3- 15 mmol/l: weakness, lethargy, weak pulses, diminished reflexes and rapid, ketones in urine, deep respiration with acetone/fruity odor due to ketones (kussmaul respirations) Dka management: rapid iv fluid replacement 0. 9% to maintain perfusions to organs, electrolyte replacement since lack of insulin influences na+, k+, ca++, phosphate. Road blocks encountered: teenagers - hormonal changes impact behaviors and natural insulin resistance, support & encourage lifestyle changes, high risk population- minorities, low income, family history of non compliance with healthy lifestyle recommendations, at ccmc- approx.
