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The Pathophysiology for type 1 Vs type 2 diabetes

Type 1: Autoimmune disease, destroys beta cells → lack of insulin

Type 2: Slow, progressive, insulin resistant, loss of beta-cell in the pancreas

What are the s/s of hypoglycemia

Tremors, nervousness, tachycardia, diaphoresis, palpitations

Teachings for hypo/hyperglycemia

• Tight Blood glucose control

• Normal BP + Cholesterol Levels

• No Smoking 

• Regular eye exams

What should you do with a patient who’s asleep or awake with hypoglycemia 

• Awake: Cardbs like Apple/orange juice, skim milk, sugar, honey, life savers/candy, glucose tablet/gel

• Unconscious: injectable glucagon

What is the tx for a patient who’s hyperglycemic

Insulin

What are the s/s of hyperglycemia

Dry mouth, dehydration, polyuria, drowsiness, bed wetting, stomach pain

What are teachings and contraindications for metformin?

• Used for type 2 Diabetes

• Metformin and contrast do not mix (pummels kidneys)

What is DKA? Why does it happen (risks)?

Life threatening emergency caused by: ineffective amt/complete lack of insulin
Risks

• Dehydration

• Electrolyte imbalance

• Acidosis

What is hypoglycemia-associated autonomic failure? What happens to the patient?

• Affects the sympathetic and parasympathetic nervous system

  • Cardiovascular: hypotension, tachycardia, exercise intolerance

  • GI: constipation, D/N/V, anorexia, gastric reflux, bloating after meals

  • Genitourinary: urinary retention, erectile dysfunction, painful intercourse (women)

Why does diabetic neuropathy happen on the foot?

poor circulation 

hyperglycemia —> poor healing

what are teaching about foot complications for diabetic patients?

• Check feet q day for: sores, bruises

• No lotion in between the toes

• Wear shoes 24/7

• Protect from heat + cold

Types of headaches

Cluster, tension, migraine

Types of seizures?

• Tonic Clonic 

  • tonic phase stiffens the muscles w/ loss of conscious

  • Clonic phase rhythmic movement of extremities

• Aura 

  • Precedes seizure (warning)

  • s/s: dizziness, numbness, visual or heating disturbances, odor perception or pain

• Absence: Brief periods of loss of consciousness. Daydreaming appearance

• Myoclonic

• Atonic

What is an Aura? And postictal mean?

Aura: Focal seizure that affects enough of the cortex to cause symptoms, but not enough to result in unconsciousness 

Postictal: When seizure activity ceases

Seizure precautions and what to do when a patient is having a seizure

patient may vomit, when they’re seizing, don’t put them on their side; watch for injury, respiration

S/S of increased ICP

• Changes of LOC - agitation/drowsiness/unresponsiveness 

• Pupil - dilated, no response to light

• Motor - hemiparesis/plegia 

• Sensory - change of temperature

• VS - widening pulse pressure, tachy/bradycardia, tissue compression of the respiratory

Types of head injuries

• Scalp: : lacerations, abrasions, hematomas

• Concussion: trauma w/ no  visible injury to skull/brain

• Contusion: bruising and bleeding exists the brain tissue

• Hematoma:  Subdural or epidural hematoma

Priorities when a patient has a head injury

Head CT

S/S of meningitis

Headache, Nuchal rigidity, irritability, decreased LOC, photophobia, seizures, Kernig and Brudzinski Sign

Nursing actions meningitis

Droplet precaution

tx for meniningitis 

• Antibiotics as soon as possible

• Seizure precaution

• Monitor for intracranial pressure 

• Photophobia 

• HOB Up

what’s parkinsons

Progressive, degenerative disorder of the basal ganglia → loss of coordination and involuntary motor movement

what are the s/s of parkinsons

Tremor, rigidity, bradykinesis (slow movement), shuffling gait

what are the risks of parkinsons

• 50+ years

• Men

• Genetics

• Exposure to toxins; occupational exposure

Teaching and safety for parkinsons

• Management focused on maintaining mobility and preventing injury 

• Incurable

S/S of MS

fatigue, weakness, tingling, visual disturbances, poor coordination, bowel and bladder dysfunction, spasticity, depression

what’s the medication for MS and Teaching

Dantrolene; If medication doesn’t work w/in 3 months = stop

what’s the s/s of a migraine

Nausea, pain unilateral, behind the eye, sensitive to light

what’s the tx for a migraine

Imitrex

what’s the trigger for a migraine

menstruation, ovulation, alcohol, some foods, and stress

what’s the trigger for a cluster

stress and anxiety

what’s the s/s of a cluster

Intensely painful but shorter in duration than migraines 

what’s the tx for cluster

Cold application, indomethacin (indocin), tricyclic antidepressants

what’s the s/s of tension

N/V, Dizziness, tinnitus

what’s the trigger for tension

stress, anxiety, brain tumor, abscess tooth

what’s tx for tension

Analgesics, therapy, relaxation, heat