HYPOGLYCEMI

A
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Hello!
I am Jayden Smith
I am here because I love to give presentations.
You can find me at @username
 DIABETIC
KETOACIDOSI
S
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• It is a result of insulin deficiency and stress hormone excess. It
typically occurs in insulin-dependent diabetes (type 1), but it may
also occur in non-insulin-dependent diabetes (types 2).

• 3 Main Clinical Features of DKA:

 Hyperglycemia
 Dehydration and electrolyte loss
 Acidosis
• USUAL PRECIPITATING FACTOR: infection and stressful events along 8
with omission of insulin and new-onset diabetes.

• The goal of therapy is a gradual, even return to normal metabolic balance.

• Complications of therapy that may contribute to death during treatment.
1. Cerebral edema
2. Hypoglycemia
3. Electrolyte imbalance
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Subjective Data: A
1.) History of present illness/chief complaint
a) Gradual onset from 24 hours to 2 weeks SS
b) Preceding bacterial or viral illness, current infectious process, or significant stress
c) Nausea and vomiting
E
d) Pain SS
e) Fever
f) Polyuria, polydipsia, and polyphagia
M
g) Lethargy, weakness, and fatigue E
h) Decreasing level of consciousness and altered mental status
i) Weight loss
N
2) Past medical history
a) Current or preexisting diseases/illness
T
(1) Diabetes
(2) Cardiovascular disease
b) Discontinuance or decreased dose of insulin or oral hypoglycemic agents
c) Ingestion of other medications or substances such as salicylate, methanol, ethylene glycol, or paraldehyde; other causes of
increased anion gap acidosis
d) Recent urinary tract infection
e) Complicated pregnancy
f) Recent injury, surgery
g) Recent stressful events
h) Obesity
i) Previous similar episodes
j) Medications
k) Allergies
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objective Data: A
SS
➜ 1) Physical examination
E
- a) General appearance
SS
- (1) Level of consciousness, behavior, affect: confusion, coma
M
- (2) Tachycardia
E
- (3) Orthostasis or frank hypotension
N
- (4) Kussmaul's respirations if pH less than 7.2 T
- (5) Odors: acetone of breath
- (6) Severe distress/discomfort, critically ill
- b) Inspection
- (1) Dry, hyperthermic, flushed skin
- (2) Dry mucous membranes
- c) Palpation
- (1) Poor skin turgor
- a) Serum chemistries including glucose, BUN, and creatinine 11
D
- (1) Glucose level: usually greater than 250mg/dL I
- (2) Sodium, chloride, and bicarbonate: decreased A
- (3) Potassium: normal or elevated initially; falls rapidly during treatment
G
N
- (4) BUN and creatinine levels: normal unless advance renal disease or severe dehydration is present O
- (5) Elevated anion gap (Na+-, (Cl-+HCO3): normal 10 to 14 mEq/L S
- b) Serum osmolality: greater than 310 mOsm/kg
T
I
- c) Serum acetone level: elevated C
- d) Venous or arterial pH less than 7.30
- e) CBC with differential: WBC count greater than 25,000 or marked left shift, suggests underlying bacterial
P
infection R
-
O
f) Serum phosphorus: if patient at risk for hypophosphatemia (poor nutritional status, chronic alcoholism)
C
- g) Serum amylase: may be elevated with associated pancreatitis E
- h) Cultures as indicated D
- i) Urinalysis: increased glucose and ketone levels; pregnancy test in female patients of childbearing age
U
R
- j) Chest radiograph E
- k) Head CT scan: especially in children with altered mental status
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Black
Is the color of ebony
and of outer space. It
has been the symbolic
color of elegance,
solemnity and authority.
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Lorem Ipsum

Lorem Ipsum Lorem Ipsum

Lorem Ipsum Lorem Ipsum Lorem Ipsum Lorem Ipsum

HYPEROSMOLA
R NON-KETOTIC
ACIDOSIS
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And tables to compare data

A B C

Yellow 10 20 7

Blue 30 15 10

Orange 5 24 16

Let’s review some concepts
Yellow
Is the color of gold, butter and
ripe lemons. In the spectrum of
visible light, yellow is found
between green and orange.
Yellow
Is the color of gold, butter and
ripe lemons. In the spectrum of
visible light, yellow is found
between green and orange.
Blue
Is the colour of the clear sky
and the deep sea. It is located
between violet and green on
the optical spectrum.
Blue
Is the colour of the clear sky
and the deep sea. It is located
between violet and green on
the optical spectrum.
19
Red
Is the color of blood, and
because of this it has
historically been associated
with sacrifice, danger and
courage.
Red
Is the color of blood, and
because of this it has
historically been associated
with sacrifice, danger and
courage.
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4000

3000

2000

1000

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89,526,124$
That’s a lot of money

185,244 users
And a lot of users

100%
Total success!
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