complications of diabetes acute and chronic

what to teach pt to prevent retinopathy

-Annual eye examinations with dilation to monitor -Maintain glycemic control and manage hypertension Treatment: Laser ,Vitrectomy, medication.

DKA is characterized by

-Hyperglycemia (>300) -Ketones -Acidosis (pH in blood is low) -Dehydration

what are the cause of Diabetic Nephropathy

-Hypertension -Genetics -Smoking -Chronic hyperglycemia

nursing intervention for HHS

-More fluid replacement needed -IV insulin and NaCl infusions -Monitor serum potassium and replace as needed -assess LOC

Patient teaching to prevent foot ulcers

-Proper footwear (no bearfoot walking) -Avoidance of foot injury -Skin and nail care (cut toenails) -Daily inspection of feet -Prompt treatment of small problems

what is the treatment for sensory neuropathy

-Tight blood glucose control -drug therapy

what is the cause of hypoglycemia

-Too much insulin or oral hypoglycemic agents -Too little food -Delaying time of eating -Too much exercise

what is the cause of HHS

-UTIs, pneumonia, sepsis -Acute illness -Newly diagnosed type 2 diabetes -Impaired thirst sensation and/or inability to replace fluids

what are the manifestation DKA

-polyuria -polydipsia -dehydration -Skin dry and loose; eyes soft and sunken -N&V, abdominal pain -Kussmaul breathing -fruity breath -ketones present - tachycardia -hypotension -fatigue -confusion

what are the manifestation of Hypoglycemia

-shakiness -sweaty -palpation -nervousness -Diaphoresis -Anxiety -confusion -dizzy -double vision -hunger

what are the acute complications of Diabetes

1. Diabetic ketoacidosis (DKA) 2. Hyperosmolar hyperglycemic syndrome (HHS) 3. Hypoglycemia

what causes DKA

1. Illness and nfection 2. not taking insulin 3. undetected diabetes 4. not eating 5. Poor self-management 6. Neglect

nursing intervention for DKA pt include

1. ensure airway 2. admin O2 3. est. IV with large bore catheter 4. begin fluid 0.9% NaCl solution until BP is stablize 5. begin regular insulin drip 6. Potassium replacement as needed

what is Hypoglycemia

low blood glucose, <70

DKA is usually treated today in

out patient if b.g. levels and fluid/electrolyte not severe, if DKA pt has another illness or sick they will need to be admitted into the hospital (e.g pnuemonia or UTI)

what is the only insulin to be used in DKA pt

regular insulin drip

what is Microvascular Angiopathy

results from thickening of vessel membranes in capillaries and arterioles, they are different than Macrovascular due to that they are specific to diabetes; includes, Retinopathy, Nephropathy, Dermopathy.

what is Diabetic Retinopathy

the process of Microvascular damage to the retina as a result of hyperglycemia, nephropathy, and hypertension, common cause of blindness. are classified as non or pro-liferative.

what is the treatment for hypoglycemia

use rule if 15 -Consume 15 g of a simple carbohydrate -wait 15 mins, than check b.g -Avoid foods with fat -Avoid overtreatment -Give complex CHO after recovery (crackers w. pnut butter)

teach pt with nephropathy about

keep Control of hypertension and tight blood glucose control.

what to teach pt to prevent angiopathy

keep a tight glucose control can prevent or minimize complications

what is Diabetic Neuropathy

A type of nerve damage that can occur with diabetes. loss of sensation usually in the lower extremities, which could lead to amputation. includes sensory and autonomic neuropathy.

what is sensory neuropathy

Affects hands and/or feet bilaterally Loss of sensation, abnormal sensations, pain, and paresthesias

Microvascular and macrovascular diseases increases risk for

injury and infection

what is Macrovascular Angiopathy

is a disease of any large (macro) blood vessels in the body. It is a disease of the large blood vessels, including the coronary arteries, the aorta, and the sizable arteries in the brain and in the limbs. This sometimes occurs when a person has had diabetes for an extended period of time.

what is Diabetic Nephropathy

Damage to small blood vessels that supply the glomeruli of the kidney. Is the leading cause of end-stage kidney disease

what to teach pt to prevent macovascular angiopathy

Decrease risk factors (yearly screening) Obesity Smoking Hypertension High fat intake Sedentary lifestyle -Screen for and treat hyperlipidemia

Patient not alert enough to swallow treat with what? for hypoglycemia

Glucagon, 1 mg, IM or subcutaneously

HHS is characterized by

Hyperglycemia >600 severe dehydration Mental status changes due to dehydration

what is autonomic neuropathy

is a group of symptoms that occur when there is damage to the nerves that manage every day body functions. can effect all body system

what is HHS hyperosomolar hyperglycemia syndrome

is a life threatening syndrome, is usually seen in type 2 diabetes. a high blood sugar results in high osmolarity without significant ketoacidosis.

what is Diabetic Ketoacidosis DKA

This condition occurs when there isn't enough insulin in the body. happens suddenly an occurs mainly in type 1 diabetes pt.

Sensory neuropathy and PAD are major risk factors for

amputation

pt with diabetes are screened for Nephropathy

annually, with random spot urine collection to assess for albuminuria and measure the albumin to creatinine ratio.

what is angiopathy

chronic complication associated w. diabetes Damage to blood vessels secondary to chronic hyperglycemia; are divided into Macrovascular and microvascular.

treatment for hypoglycemia for acute care setting

give D50, 20 to 50 mL, IV push