Diabetes Complications: Hypoglycemia, DKA, HHS - Medical-Surgical (Endocrine) | @LevelUpRN

Level Up RN2 minutes read

Hypoglycemia is characterized by low blood glucose levels and can lead to various symptoms; nursing care involves administering carbohydrates and monitoring glucose levels closely. Diabetic ketoacidosis is a severe complication in Type 1 diabetics with high blood glucose levels, ketones, metabolic acidosis, and hyperkalemia, while Hyperglycemic hyperosmolar state is more common in Type 2 diabetics and requires IV fluids, insulin, and potassium monitoring.

Insights

  • Hypoglycemia, defined as low blood glucose levels, can result from various factors like excess insulin or skipped meals, leading to symptoms such as hunger, confusion, and shakiness.
  • Diabetic ketoacidosis (DKA) and Hyperglycemic hyperosmolar state (HHS) are severe complications of diabetes, with DKA more prevalent in Type 1 diabetics and characterized by high blood glucose and ketones, while HHS is common in Type 2 diabetics, presenting with extreme hyperglycemia and dehydration, necessitating specific treatments tailored to each condition.

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Recent questions

  • What is hypoglycemia and its causes?

    Hypoglycemia is defined as blood glucose under 70 mg/dL and can be caused by excess insulin, skipped meals, decreased food intake, exercise, or excess alcohol.

  • What are the signs of hypoglycemia?

    Signs of hypoglycemia include hunger, irritability, confusion, diaphoresis, headache, shakiness, blurred vision, pale, cool skin, and decreased consciousness.

  • How should conscious hypoglycemic patients be cared for?

    Nursing care for conscious hypoglycemic patients involves giving 15 grams of carbohydrates, rechecking blood glucose in 15 minutes, and providing a protein-carbohydrate snack once levels are over 70.

  • What is the treatment for unconscious hypoglycemic patients?

    Unconscious hypoglycemic patients require glucagon administration, with a repeat dose if consciousness isn't regained within 10 minutes.

  • What are the characteristics of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS)?

    Diabetic ketoacidosis (DKA) is a life-threatening complication more common in Type 1 diabetics, characterized by elevated blood glucose over 300, ketones in urine and blood, metabolic acidosis, and hyperkalemia. Hyperglycemic hyperosmolar state (HHS) is more common in Type 2 diabetics, with blood glucose over 600, severe dehydration, and no ketones or metabolic acidosis, requiring treatment with IV fluids, insulin, and close monitoring of potassium levels.

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Summary

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Managing Hypoglycemia and Diabetic Complications

  • Hypoglycemia is defined as blood glucose under 70 mg/dL and can be caused by excess insulin, skipped meals, decreased food intake, exercise, or excess alcohol.
  • Signs of hypoglycemia include hunger, irritability, confusion, diaphoresis, headache, shakiness, blurred vision, pale, cool skin, and decreased consciousness.
  • Nursing care for conscious hypoglycemic patients involves giving 15 grams of carbohydrates, rechecking blood glucose in 15 minutes, and providing a protein-carbohydrate snack once levels are over 70.
  • Unconscious hypoglycemic patients require glucagon administration, with a repeat dose if consciousness isn't regained within 10 minutes.
  • Diabetic ketoacidosis (DKA) is a life-threatening complication more common in Type 1 diabetics, characterized by elevated blood glucose over 300, ketones in urine and blood, metabolic acidosis, and hyperkalemia.
  • Hyperglycemic hyperosmolar state (HHS) is more common in Type 2 diabetics, with blood glucose over 600, severe dehydration, and no ketones or metabolic acidosis, requiring treatment with IV fluids, insulin, and close monitoring of potassium levels.
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