Comparison of Acute Complications of Diabetes
Hypoglycemia Diabetic Ketoacidosis Hyperosmolar Hyperglycemic Nonketotic syndrome
Clinical Manifestations
Diagnostic Data
Interventions
Patient Teaching
See attached doc for the detail worksheet.
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Citations and references required
List Clinical Manifestations that may be observed. – 1
Indicates diagnostic Data used to monitor the exemplar. – 1
Identify nursing and medical interventions that may be used to treat the exemplar, Including medications. – 2
Identify patient teaching for patients with the conditions. – 1
Total – 5 Comparison Of Acute Complications Of Diabetes
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Clinical Manifestations Hypoglycemia Diabetic Ketoacidosis Hyperosmolar Hyperglycemic Nonketotic syndrome
Symptoms Shakiness, palpitations, sweating, anxiety, confusion, seizures Thirst, polyuria, abdominal pain, nausea, vomiting, fruity breath, Kussmaul respirations, confusion Weakness, altered mental status, seizures, coma, polyuria, polydipsia, blurry vision
Signs Tachycardia, tachypnea, cool and clammy skin, altered mental status Dehydration, hypotension, tachycardia, Kussmaul respirations, fruity breath Dehydration, hypotension, tachycardia, altered mental status, coma
Diagnostic Data Hypoglycemia Diabetic Ketoacidosis Hyperosmolar Hyperglycemic Nonketotic syndrome
Blood glucose level < 70 mg/dL > 250 mg/dL > 600 mg/dL
Arterial blood gas (ABG) Not routinely indicated, may show low blood glucose and high lactate levels pH < 7.3, low bicarbonate levels, high anion gap pH > 7.3, high serum osmolality, elevated blood glucose
Serum electrolyte levels Normal or low potassium, low sodium, low magnesium, low phosphate Low potassium, low sodium, low bicarbonate, high anion gap, high ketones High sodium, high osmolality, high glucose, elevated serum urea nitrogen (BUN) and creatinine
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Interventions Hypoglycemia Diabetic Ketoacidosis Hyperosmolar Hyperglycemic Nonketotic syndrome
Medical Administer fast-acting glucose, glucagon, IV dextrose Administer IV fluids, insulin, electrolyte replacement Administer IV fluids, insulin, electrolyte replacement, correct underlying cause
Nursing Monitor blood glucose, vital signs, neurologic status, administer medications and treatments as ordered Monitor blood glucose, vital signs, ABG, electrolyte levels, administer medications and treatments as ordered Monitor blood glucose, vital signs, ABG, electrolyte levels, administer medications and treatments as ordered
Patient Teaching Hypoglycemia Diabetic Ketoacidosis Hyperosmolar Hyperglycemic Nonketotic syndrome
Prevention and recognition of hypoglycemia symptoms, carry fast-acting glucose, regular monitoring of blood glucose levels Importance of insulin compliance, recognition of DKA symptoms, regular monitoring of blood glucose levels Importance of fluid intake and recognition of symptoms of dehydration and hyperglycemia, regular monitoring of blood glucose levels
References:
American Diabetes Association. (2021). Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement 1), S1-S232.
Kitabchi, A. E., Umpierrez, G. E., Miles, J. M., & Fisher, J. N. (2009). Hyperglycemic crises in adult patients with diabetes. Diabetes Care, 32(7), 1335-1343.
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