Case Study 1
1.) Define hypoglycemia. What are hypoglycemic blood glucose values in an adult?
Hypoglycemia: Low blood glucose level that results from too much insulin, not enough food, or excess activity. It is defined as the presence of Whipple’s triad: manifestations consistent with low blood glucose, a low plasma glucose concentration, and resolution of symptoms or signs after plasma glucose concentration is raised. Four common causes are: 1.) excess insulin, 2.) deficient intake or absorption of food, 3.) exercise, and 4.) alcohol intake.
When blood glucose falls below 70 mg/dl or when the blood glucose level drops rapidly from an elevated level.
2.) Describe the clinical manifestations of hypoglycemia. How low does a
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Exercise usually causes blood glucose levels to fall in a patient with type 1 DM. Prolonged exercise increases cellular glucose uptake for several hours after exercise.
4.) Briefly define hypothermia, and explain why the client with hypoglycemia is often hypothermic.
Hypothermia: marked cooling of core temperature that is below the required normal for normal metabolism and body functions. This is generally considered to be 95.0’F. Produces depression of the central nervous and respiratory systems, vasoconstriction, alterations in microcirculation and coagulation, and ischemic tissue damage.
Cold stress increases metabolism. Increased metabolism increases the use of glucose. Once the circulating glucose is used, the body turns to the glycogen stores and if it goes on for too long depletes glycogen stores leading to hypoglycemia.
5.) If an IV access site could not be established, could the 50% dextrose be administered intramuscularly? What is another medication that the HCP might prescribe to treat the client’s hypoglycemia, and what is the medication’s most common adverse effect?
No, 50% dextrose cannot be administered IM. It needs to be given slowly and carefully to avoid extravasation because it is hyperosmolar and can damage tissue.
Glucagon: Can be given subcutaneously or IM. It is the main counterregulatory hormone and is used as therapy for severe
Low blood sugar also known as hypoglycemia quickly manifests in individuals who use insulin. Common symptoms come about when the blood sugar levels fall below 70 mg/dL. Symptoms include headache, hunger, nervousness, rapid heartbeat, shaking, sweating, and weakness. (Eckman 2011).
ii. Hypothermia can cause adverse cardiovascular, hematologic, immunologic, metabolic, and neurologic effects extending acuity and length of stay (Phillips, 2013).
Diabetes is a metabolic disease in which the body’s inability to produce any or enough insulin. This causes elevated levels of glucose in the blood. This can be a very life threatening disease if left un treated. One of the symptoms are hunger and fatigue. If your body can’t get enough insulin the glucose
Having too much glucose (sugar) in the bloodstream or a blood sugar level consistently over 126 milligrams of glucose per deciliter means that individual is diabetic. Healthy non diabetics will have a
Diet and some medications are leading factors for this disease. Symptoms of hypoglycemia most often happen in people when their blood sugar level is 70 mg or lower. Dizziness, sweating, weakness, pale skin, and anxiety are all symptoms. People who have diabetes have to put insulin in their body manually. If they do not take the right amount of insulin for the amount of their carbohydrate intake, they can develop hypoglycemia. This works the same way for people who do not have diabetes. If your body does not maintain the right ratio of carbohydrates to insulin, you can develop this disease. So it is very important to eat your meals and have a healthy
The state of which there is not enough sugar in the blood is called hypoglycemia. The state where there is too much sugar in the blood is called hyperglycemia. Both of these states of low and high sugar in the blood should be monitored in people that have the disease of diabetes. The symptoms of hypoglycemia are; blurred vision, headache, cold clammy skin, sweating and irritability. The symptoms of hyperglycemia are; hot dry skin, kussmaul’s respirations, vomiting, polyuria, polyphagia, and polydipsia. Hypoglycemia in the person with the disease of diabetes is caused by not enough sugar in the blood, or too much insulin in the blood. Hyperglycemia in the person with the disease of diabetes is caused by too much sugar in the blood stream (Stanbridge College, Diabetes Powerpoint pg. 8).
Severe hypoglycemia is when your blood glucose level is at or below 54 mg/dL (3 mmol/L). Severe hypoglycemia is an
An hour after the patient consumed glucose, their results climax to 1.5 absorbance showing their body has consumed it all, but has not been able to process it completely. Right after the results climax, the blood glucose levels begin to decrease and return back to normal. It is not safe for this process to take this long because the more glucose that is in the patient’s body for a long period of time, the more likely the patient is to suffer from damaged blood vessels, organs, and many other complications.
With the result of his BGL less than 4mmol/L, I would give the appropriate form of glucose, eg. jelly beans, liquid glucose or drink of cordial (not diabetic). With a BGL of less than 4 mmol/L, he would require a 15gram fast acting portion of carbohydrate like, 6-7 jellybeans, half a can of non-diet soft drink, cordial or juice OR 3 teaspoons of honey, sugar or glucose tablets to equal a dose of 15grams
Diabetes is caused by reduced production of insulin, or by decreased ability to use insulin. Insulin is a hormone produced by the beta cells in the pancreas which allows the blood sugar cells to be able to use blood sugar. It is necessary for glucose to go from the blood to the inside of the body cells. Because of the poor insulin, glucose builds up in the bloodstream. The body is unable to use glucose for energy. When you are diagnosed with diabetes the doctor should try to stabilize the metabolism and eliminate the symptoms of high blood glucose because of the rapid onset of symptoms. The effects of diabetes are thirst, urination, vomiting, fatigue, and hunger which are the most common symptoms for. The extra sugar remains in the blood and
The surplus glucose continues to build up n the blood. This internal chaos in the body is informed to the outer body by different signs and symptoms. The foremost among them are
Controlling hyperglycemia in type 2 DM has proven to be beneficial because there is better b-cell preservation. Controlling glucose has been proven to reduce the risk of complications often encountered with DM. Topics that need to be considered when thinking about starting with combination
C.S. is a morbidly obese 32-year-old female admitted to the hospital on 8/26/05 with an admitting diagnosis of poly-drug overdose. According to the patient, the last thing she remembers is going to bed and then waking up in the hospital 2 days later without any recollection of what had happened. She has a history of suicide twice in the past, but denies suicidal ideations this time. C.S. also has a history of Diabetes type II that is normally controlled with oral medications. She states that she checks her blood glucose at home and it has been in the 200mg/dl range for the past month. Current blood glucose is 256mg/dl. C.S. is to be discharged tomorrow with a new prescription for insulin.
Diabetic Retinopathy, or damage to the blood vessels of the retina, potentially leading to blindness
The exact cause of type 1 diabetes mellitus, previously known as insulin dependent diabetes mellitus, is unknown. What we know today is that in most people with type 1, their body’s own immune system which normally fights against infections mistakenly destroys the beta cells of the pancreas making insulin secretion impossible. Genetics also plays a role in this process, and exposure to certain viruses could trigger the disease. Whatever the cause, once 90% or more of the beta cells are destroyed, the pancreas will produce little or no insulin. In type 1 diabetes due to the lack of insulin, the glucose is not able to enter the cells to be used for energy and instead it builds up into the bloodstream, where it can cause life-threatening complications.