Diabetic Ketoacidosis (DKA) is a serious disease with complications that may have fatal results in some cases. DKA is defined as an insulin deficiency that occurs when glucose fails to enter insulin into muscles such as: liver and adipose tissue. When there is an accumulation of ketones, it leads to metabolic acidosis which causes nausea and vomiting, as a result fluid and electrolytes are lost (Gibbs). There are many complications of diabetic ketoacidosis, some of the most prevalent are: Cerebral Edema, Hypoglycemia, and Acute Pancreatitis.
Cerebral Edema is a rare but fatal complication of diabetic ketoacidosis. To thoroughly describe the clinical signs of cerebral edema is characterized by “deterioration in the level of consciousness, with lethargy, decrease in arousal and headache. The timing of the development of cerebral edema is variable, within most cases occurring 4 to 12 hours after starting treatment. Several case reports showed the presence of cerebral edema before the initiation of therapy. A method of clinical diagnosis based on bedside evaluation of a neurological state in DKA have been developed” (Pandey).
Primarily, cerebral edema occurs in children. Studies show that the largest reported cases are 95% within patient’s younger than 20 years of age. One third of these cases occurs in patient’s younger than 5 years of age. Generally, after the initiation of therapy, within 3-12 hours it occurs in children who seem to be metabolically returning to normal (Pandey). Insulin was discovered in 1922, prior to, “the mortality due to DKA was virtually 100%. With the discovery of insulin, antibiotics, intravenous potassium replacement and use of norepinephrine for blood pressure support, rates ranging from 2....
... middle of paper ...
...n production in people with type 1 diabetes or even reversing the condition” (Forecast).
Diabetic Ketoacidosis (DKA) is defined as an insulin deficiency that occurs when glucose fails to enter insulin into muscle. Some complications of diabetic ketoacidosis may include: Cerebral Edema, Hypoglycemia, and Acute Pancreatitis. “The key to managing DKA is to prevent it from occurring” (Thompson). The challenge of making modifications in your diet, as well as, incorporating an exercise regimen in your daily routine, is not easy.
Learning how to inject yourself with insulin, is also a difficult task. It is a struggle dealing with this terrible disease, however, through maintaining of a healthy, and nutritious diet, taking all medication as prescribed, and exercising as needed, may someday reverse the conditions of this disease. Being disciplined is the key.
Your breath can have a sweet smell caused by the high levels of ketones in the body. Being a diabetic you are also prone to losing sensation in the lower extremities causing it to be difficult to notice any pain or injury in your feet. It can also cause your skin to dry and crack on your feet. It is extremely important to keep an eye on your feet to make sure no damage is done.
The pathophysiology of diabetes mellitus in is related to the insulin hormone. Insulin is secreted by cells in the pancreas and is responsible for regulating the level of glucose in the bloodstream. It also aids the body in breaking down the glucose to be used as energy. When someone suffers from diabetes, however, the body does not break down the glucose in the blood as a result of abnormal insulin metabolism. When there are elevated levels of glucose in the blood, it is known as hyperglycemia. If the levels continue to remain high over an extended period of time, damage can be done to the kidneys, cardiovascular systems; you can get eye disorders, or even cause nerve damage. When the glucose levels are low in one’s body, it is called hypoglycemia. A person begins to feel very jittery, and possibly dizzy. If that occurs over a period of time, the person can possibly faint. Diabetes mellitus occurs in three different forms - type 1, type 2, and gestational.
So how do you manage Type 1 diabetes? Type 1 diabetes can be managed with insulin injections multiple times a day and checking blood sugar levels at various times of the day. Although lifestyle choices aren’t known to cause Type 1 diabetes, your choice may help reduce the impact of diabetes-related complications. 12
Diabetes is a disease in which a person’s body in unable to make or utilize insulin properly which affects blood sugar levels. Insulin is a hormone that is produced in the pancreas, which helps to regulate glucose (sugar) levels, break down carbohydrates and fats, and is essential to produce the body’s energy. The CDC (2013) offers reliable insight, summarized here, into the different types of diabetes, some causes, and health complications that may arise from the disease.
My interest in this topic is a result of recent experiences with Diabetes Mellitus, Type 1 (DMI), especially with the following two instances: a young adult patient admitted at the hospital following a DKA episode during one of my nursing rotations and one of my instructors with type 1 diabetes. Also, my father was diagnosed with type 2 diabetes, this has increased my eagerness to study and explore more about the disease.
Now that we have a general idea of how our body regulates sugar intake we can discuss exactly what diabetes is. It is a disease in which your body is unable to use glucose for energy, resulting in elevated blood glucose levels. There are a few different types of diabetes. In some cases, a person’s body does not make insulin at all. Thus, there is no insulin to tell your cells to use the glucose for energy. This is called type 1 diabetes, or it was previously known as juvenile diabetes. Only 5 to 10% of diabetes cases are diagnosed as type 1 (Grosvenor & Smolin, 93). It is usually discovered before a pers...
1. Type 1 diabetes is a result from the body’s failure to produce insulin, which requires the individual to inject insulin in other ways (RCT).
Patients in the Intensive Care Unit are at a high risk to develop delirium. It is one of the most common conditions encountered by the staff in an Intensive Care Unit. Delirium can be hyperactive or hypo active according to the patients’ behavior. Disorientation, agitation, hallucinations, or delusions are characteristics that may be observed in the patient with hyperactive delirium. Apathy, quietly confused, withdrawal, lethargy, and even total lack of responsiveness are all symptoms of hypoactive delirium. Some or all of these symptoms may occur at any time.
Neu, A; Hofer, S.E., MD; Karges, Beate; Oeverink, Rudolf; Rosenbauer, J; Holl, R.W., MD. (Sept. 2009). Ketoacidosis at Diabetes Onset Is Still Frequent in Children and Adolescents: A multicenter analysis of 14,664 patients from 106 institutions. Diabetes Care, 32(9) 1647-8. Scholarly Journals. Retrieved from ProQuest Research Library.
Although diabetes can be genetic, that doesn’t necessarily mean you’re prone to get it. Controlling and checking your blood sugar helps to treat diabetes, as well as insulin therapy, regular check-ups/monitoring, and exercising. If you’re diabetic, you’ll find that at first, it’s frustrating and time consuming to treat for your diabetes. You’ll get the hang of it soon enough.
...tracranial pressure from brain edema. Interventions include administering osmotic diuretics, maintaining partial pressure of carbon dioxide, and positioning to avoid hypoxia. Other treatment measures include elevating the head of the bed to promote venous drainage and to lower ICP.
Before beginning, it is important to have a list of goals and objectives that are formulated by the nurse. The goals for this teaching are for the patient to verbalize understanding how to inject insulin and monitor the patient's blood glucose daily at home by her/him-self. Outcome determination is, therefore, a critical skill for successfully intervening with patients. Two behavioral objectives for the teaching plan. Within 30 minutes of teaching the lesson, the patient will be able to inject insulin properly.
Diabetes is a disorder of protein, carbohydrate and fat metabolism subsequent from a lack of insulin disponibility or a reduction in the insulin’s biologic effects. Diabetes can be lead by absolute insulin deficiency, impaired release of
D. standing near her room, breathing sharply. While asked what has just happened, she answered, ‘I feel dizzy and can faint!’ Mrs. D. then explained that she rose up from her chair in the television room and felt lightheaded. I decided to bring her to the room hoping she would feel less dizziness if she could sit. After consultation with my mentor and third year unit nursing student, I decided to perform measurement of her vital signs. Since only electronic sphygmomanometer was available for me that time, I had to use it for my procedure. Gladly, I discovered that I have already used such equipment in my previous nursing practice. Using the standard sized calf, I found that her blood pressure was 135/85, respirations were 16, and her pulse was 96 beats per minute (bpm). However, I decided to recheck the pulse manually, founding that it was irregular (78 bpm). The patient stated that she felt better after rest. Immediately after the incident I made a decision to explore carefully the medical chart of Mrs. D., along with her nursing care plan. That helped me to discover multiple medical diagnoses influencing her
Early reports of KRDY emphasized the association with malnutrition, as wasting or underweight was noted in 25-50% of patients. Under-nutrition at presentation could reflect in part the effects of long standing glycosuria, and may improve if insulin treatment in maintained in the presence of relatively poor protein-calorie intake. Alemu et al.. and colleagues have described the phenotype of more insulin requiring patients in 2 regions of Ethiopia as follows: lean, poor, peak age at diagnosis being approximately 25 years with male preponderance and no clinical evidence of structural pancreatic abnormalities. This phenotype resembles previous descriptions of KRDY form rather than classic Type 1