Adult 2 - Exam 3 (Delirium & DM)

what does PAD stand for?

Pain, agitation, delirium

what kind of drugs can cause delirium?

anticholinergics, opioids, psychoactive drugs

what can cause delirium in the elderly?

fluid and electrolyte imbalance, infection, diarrhea, fecal impaction, insomnia, loss, disorders causing hypoxia, hypoglycemia, tremors, ventilation, sepsis, nutritional deficiencies.

renal changes can cause

increase thirst, dehydration, and hyperkalemia

what changes predispose elderly to DM

beta cells that secrete insulin become less active, and insulin resistance (high glucose after meals)

drugs that increase BG readings

dopamine, acetaminophen, mannitol, corticosteroids

BG serum testing is best for

shock, perph edema, insulin infusion

subQ insulin

sliding scale, not rapid acting, not for hemodynamically unstable pts

hyperglycemia in critically ill pts

pts in the ICU w/ hyperglycemia has a worse prognosis than pts with known DM. increases r/f infections

hyperglycemia lowers…

immune resistance, BUT increases inflammation, and causes platelet aggregation

s/s of DKA

3 polys, rotten fruit breath, confusion, edema, decrease blood pH, increase ketones, and acidosis. kaussmals respirations.

tx for DKA

insulin therapy, intitial bolus then cont infusion. subQ is given when pt is able to tolerate fluids and is not longer in ketosis.

when is DKA resolved?

when BG is less than 200