Term
What is the diagnostic criteria for Hypoglycemia |
|
Definition
| blood suger < 50 or rapid deciline when glucose is high |
|
|
Term
| What are the S/S of Hypoglycemia |
|
Definition
rapid onset HA, change in LOC, uncordinated,
stress response- realse of catacholamines- shaking, cold and clammy, tachycardia |
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|
Term
What is Cardio-metabolic Syndrome
Endocrine component |
|
Definition
also called prediabetes
pt have hyperlipademia, obesity, insulin resistances |
|
|
Term
What is Cardio-metabolic Syndrome
Cardiac component |
|
Definition
| HTN, pro-inflamitory, pro-thrombotic |
|
|
Term
| What are the risk factors of Cardio-metabolic Syndrome |
|
Definition
obesity-waist circumference > 35
dyslipidemia
HTN- >130/85
pro-throbotic- ↑ fibrinogen
pro-inflammatory- ↑ C reactive proteins |
|
|
Term
| What types of pts get DKA |
|
Definition
|
|
Term
|
Definition
fast onset
serum glucose 300-500
urine + for ketones
serum osmolarity < 340 normal
anion gap- + (>17)- r/t lactic acidosis
chang in LOC
somulent
fast deep breathing |
|
|
Term
|
Definition
inadaquate glucose control
insuline, diet, or exercise imbalance
or
secondary to illness |
|
|
Term
| What type of pts get HHNS (Hyperglycemic Hyperosmolar Non-ketonic Syndrome) |
|
Definition
|
|
Term
| What are the S/S of HHNS (Hyperglycemic Hyperosmolar Non-ketonic Syndrome) |
|
Definition
develops over days
glucose > 700
ketones are neg
serum osmolarity >340 high
Anion gap neg (<17) |
|
|
Term
| What si HHNS (Hyperglycemic Hyperosmolar Non-ketonic Syndrome) caused by |
|
Definition
indaquate glucose control
meds diet
secondary to illness |
|
|
Term
| What is the number 1 reason a diabetic pt will lose control of their blood sugar? |
|
Definition
|
|
Term
| How does the stress response effect blood sugar? |
|
Definition
catacholamines -inhibit insuline secretion
cortisol- increases gluconeeogensis
proinflammatory cytokines- increase insulin resistance
|
|
|
Term
| What medications can elevate blood sugar |
|
Definition
glucocrticoids
sympathomimetics
Ca blockers
phenytion |
|
|
Term
| What are the two goals of treating hyperglycemia? |
|
Definition
| hydrate, decrease glucose |
|
|
Term
| How should a pt with hyperglycemia be hydrated? |
|
Definition
give 100 CC/Kg
1/2 of that given in 8 hrs
moniter for fluid overload |
|
|
Term
| How should you decrease a pts glucose who has hyperglycemia |
|
Definition
USE IV only (regular)
no > 20 units IV bolus
goal to decrease 50-75mg/dl/hr
Never more then 100mg/dl in one hour!!!!!! |
|
|
Term
| What complictions can arise if glucose falls faster then 100mg/hr |
|
Definition
| cerebral edema and electrolyte imbalances |
|
|
Term
| in a pt that is critacaly ill where do you want their blood sugar to be? |
|
Definition
|
|
Term
| What benifists do pts recive from having tighter BS peramiters in the ICU |
|
Definition
decrease size of MI
low risk of infection
decreased mortality rates in cardio pts |
|
|
Term
|
Definition
|
|
Term
| What will the GFR be in renal insufficincy |
|
Definition
|
|
Term
| What will the GFR be in renal failure |
|
Definition
|
|
Term
| What will the GFR be in ESRD |
|
Definition
|
|
Term
| What are the causes of pre-renal failure |
|
Definition
Hypotension, hypovolemia,
stricture or CA of renal artery |
|
|
Term
| What are the common cause of intr-renal failure |
|
Definition
infection or ischemia
acute tubler nicrosis
nephrotoxic drugs
|
|
|
Term
| What are the common cause of post-renal failure |
|
Definition
urinary obstruction
tummers
stones
|
|
|
Term
| What are the four stages of ARF |
|
Definition
onset
oliguric/anuric
diuretic
convalescent |
|
|
Term
|
Definition
initial injury up 48 hours pt appears acutely ill
will have symtomes r/t the cause of ARF |
|
|
Term
| What is the oliguric/anuric phase? |
|
Definition
may continue up to 2 weeks
pt producese < 400cc/24 hr
the most damage can happen in this fase, try to move the pt quickly throught this phase |
|
|
Term
| What is the diurtic phase |
|
Definition
may continue for upi to 4 weeks
pt produces large amounts of poor quality urin
looks diluted
BUN/Creat- stabilize → normalize
|
|
|
Term
| What is the convalescent phase |
|
Definition
may continue for up to one year
output is normal
all labs may be normal- but still may only have 10% of function |
|
|
Term
| What is a significant weight change in a pt with ARF |
|
Definition
|
|
Term
| What is the best lab to assess kidney function? |
|
Definition
Creatinine
most sensitive |
|
|
Term
| What are the normal ranges of Serum Creatinine for men and women |
|
Definition
men- 0.5-1.5
women- 0.6-1.2 |
|
|
Term
| What is the normal range for the BUN |
|
Definition
|
|
Term
| What electrolytes are elivated in ARF |
|
Definition
|
|
Term
| What electrolytes are decreased in ARF |
|
Definition
|
|
Term
| What is the prefeared form of dialysis? |
|
Definition
|
|
Term
| What type of pt need CRRT |
|
Definition
| hemodynamically unstable pts |
|
|
Term
| What are the advantages of CRRT |
|
Definition
| it is driven by the pts own BP will not make the pt unstable |
|
|
Term
| What are the disadvantages of CRRT |
|
Definition
pts need more antiquagulents- risk of bleeding
have to be hooked up 24/7 |
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