Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

High-Risk Pregnacy of a Diabetic Mother

Posted by Laura on March 16, 2010

Diabetes mellitus .pdf

Insulin Shock & DKA

metabolic condition

causes

symptoms

interventions

hypoglycemia or insulin shock excess insulin

insufficient food – missed or delayed

excessive exercise or work

indigestion, diarrhea, vomiting

irritability

hunger

sweating

nervousness

personality change

weakness

fatigue

blurred or double vision

dizziness

headache

pallor, clammy skin

shallow respirations

rapid pulse

lab: urine = negative for sugar & acetone; Blood glucose < 60mg/dl

check b.g.level. eat:

< 60 mg/dl foods that contain 10-15 g of simple carbohydrates:

½ cup unsweetened fruit juice

½ cup (4 oz) regular soda

5 -6 LifeSavers candies

1 tablespoon honey or corn syrup

1 8oz glass  milk

2-3 glucose tablets

recheck b.g.l. q 15 min until stabilized. If no change – notify primary HCP. If unconscious 50% dextrose IV push, 5-10% dextrose in water IV drip or glucagon

ketoacidosis DKA metabolism stressed by illness or infection

tocolytic drugs such as terbutaline

failure to take insulin appropriately

insufficient exercise

Emotional stress

Excess or wrong kinds of food

thirst

nausea or vomiting

abdominal pain

constipation

drowsiness

dim vision

increased urination

headache

flushed, dry skin

rapid breathing

weak, rapid pulse

acetone (fruity) breath odor

Lab: urine = pos for sugar & acetone; Blood glucose = >200 mg/dl

Notify PCG. Admin insulin in accordance with b.g.l. med chart.

Give IVF NS or 1/2NS, K+ when urinary output is inadequate; bicarbonate for pH < 7.

Monitor labs of blood & urine

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