Posted on August 14th, 2007 by gabriel
The treatment goals for DKA are to replace fluid and electrolytes, provide enough insulin to maintain normal glucose metabolism, and prevent complications.
Replacing Fluids and Electrolytes
Your patient with DKA needs fluid therapy to increase her circulating blood volume and to enhance glucose excretion through the kidneys. The fluid of choice is usually I.V. 0.9% normal saline [...]
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Filed under: Acute Complication
Posted on August 13th, 2007 by gabriel
When you take the health history of a patient who has diabetes, you need to ask specific questions about her regimen-her medications, diet, exercise program, and glucose monitoring. If your patient uses insulin, ask her to demonstrate her injection technique. And have all patients with diabetes demonstrate their blood glucose monitoring technique., select the appropriate [...]
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Filed under: Diabetes
Posted on August 11th, 2007 by gabriel
Your patient’s medical history may help you uncover risk factors for diabetes, complications of diabetes, and problems that may affect her ability to manage the disease.Risk factors for diabetes include obesity (especially central or android obesity in which weight accumulates around the abdomen, giving the patient an apple shape), impaired glucose tolerance, previous gestational diabetes, [...]
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Filed under: Diabetes
Posted on August 10th, 2007 by gabriel
During acute DKA, the patient probably can’t grasp educational information very well, so don’t overwhelm her or her family with information right away. Keep your explanations simple and brief; you may have to repeat them several times. Explain care little by little, as you provide it. Tell her why it’s important to replace fluids and [...]
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Filed under: Acute Complication
Posted on August 9th, 2007 by gabriel
The target heart rate, which is 70% to 85% of your patient’s maximum heart rate, determines the intensity of exercise. A physician may order an exercise stress test to determine your patient’s target heart rate. Some patients with diabetes have silent ischemia. Their maximum heart rates may be 15% to 20% lower than those of [...]
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Filed under: Diabetes Treatment
Posted on August 8th, 2007 by gabriel
Abnormalities of the kidneys and bladder are usually detected during the health history and through diagnostic tests. For example, a history of frequent urinary tract infections (UTls) may be an early sign of kidney disease. When examined, a urine sample may be foul smelling and cloudy, suggesting a UTI. Long-standing diabetes can also cause neurogenic [...]
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Filed under: Physical Examination
Posted on August 7th, 2007 by gabriel
Along with a diet plan and a medication regimen, a patient with diabetes needs an exercise program. Exercise can help her control her blood glucose levels, improve her body’s use of insulin and glucose, and control her weight. Your patient with diabetes has much to gain from regular exercise, but inform her of the risks [...]
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Filed under: Diabetes Treatment
Posted on August 4th, 2007 by gabriel
Diabetes has lifelong financial and lifestyle implications for your patient and her family. The financial burden of paying for treatment supplies or obtaining adequate health care coverage can make it difficult for your patient to keep up with other financial responsibilities. In many cases, these adjustments and financial burdens affect the family, and anger and [...]
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Filed under: Diabetes