#Hyperglycemic Hyperosmolar Syndrome | Explore Tumblr Posts and Blogs

aggedyann · 3 years

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Time for a Study Break

just an idea that popped into my head while I study for my certification (in an entirely different specialty than Ethan). Test questions are from the certification packet I found on line.

“Hatshoo!”

Tim popped in at the irritated sneeze coming from the living room. “Ready for a break?”

Setting his tissue down, Ethan Tim with a hard Look that did little to faze him. “I told you. My recertification exam is tomorrow. I have to study.” He picked up his tissue and scrubbed his nose again. Between his allergies and Tim today, he was struggling to get anything done. He’d agreed to spend the morning with Tim before studying and was, now, regretting not swapping the order. They’d had to walk a few blocks to and from breakfast; that had kickstarted his allergies on a high pollen weekend, and they had only amped up since. Now he was trying to study, staring down an allergy attack.

“All you’ve done for the last two weeks has been study.” Tim pointed out.

Ethan sighed. “We are not hahh…” He held up a finger, turning his head. “Ahtshoo!” He finished. “We are not having the ‘you feeling neglected’ conversation right now. Not while I’m trying to study. Not during an allergy fit.” He punctuated his statement by blowing his nose.

“Bless you.” Tim went and slumped on the couch, turning on the TV.

“Tim!” Ethan hissed, exasperated. Tim looked at him blankly. “I’m trying to study.”

“So I can’t watch TV in here?”

“You can watch in your bedroom. Which is where I was going to study…before you decided to take a nap. Then I was in the kitchen where you decided to bake cheesecake -“

“Which smell amazing.”

“Can’t tell. Can’t eat it. Don’t care. Anyway, I came out here specifically Because you can watch TV in your bedroom. Which you agreed to do.”

“I got lonely.”

“So go call a friend. I’m not your sole means of entertainment.” Ethan’s nose crinkled and he pressed the back of his hand against it, failing 2 seconds later to stop the sneeze. “Ahshoo!”

“Maybe you should take a break until your allergies let up? You’re pretty irritable.”

Ethan blew his nose. “I. Wonder. Why.”

“Just pointing out. It’s hard to study when you can’t stop sneezing.”

“Used to it.” Ethan wiped his eyes, not wanting to admit Tim was right. His head throbbed, and oh, he wanted to stop, but the test was tomorrow…

“At least, let me help you.”

“You don’t know the first thing about diabetes. How can you help me study?”

“I can use your flash cards.”

Ethan sighed, but realizing Tim wasn’t going to let up, handed him a stack of flash cards.

“Okay,” Tim cleared his throat. “One of the most important keys to successful management of type 2 diabetes is educating the person on A. meal planning. B. regular urine testing. C. signs and treatment of hypoglycemia. D. selection and use of over-the-counter medications.”

“A.” Ethan nodded. “Give me something harder.

Tim flipped through the cards until he found one he thought would be hard for Ethan. At least, it had a lot of big words. “Okay, Which of the following is a major clinical feature of hyperosmolar hyperglycemic nonket…nonketo..keto…Ethan, how do I say this?” He thrust the card at Ethan.

“Nonketotic. Hyperosmolar, hyperglycemic, nonketotic syndrome.” He hesitated a second, not to deliberate, but for yet another sneeze. “HahChoo! Answer is C.” He flipped the card over to verify. “Yes, C.”

“See, you know what you’re doing. I mean, you passed this test before.”

“Well, yeah. I just need to be sure I know it.”

“You teach it every day.”

Ethan nodded. “Yeah.” He wiped his watery eyes again.

“You know you can study too much.”

Ethan laughed. “That’s just what people say.”

Tim shrugged. “Happened to me.” He looked straight at Ethan. “Failed a biology test. Studied every minute I could for a week; made Mark tutor me. Still failed Had to repeat the course. So take a break.” He paused. “You know you want too.”

Ethan sighed. He did want too. Between the sneezing, and the headache, and the watery eyes, studying was getting harder. And, looking at his watch, it was time for a snack Maybe that and trying to nap until dinner wouldn’t be that bad. He pushed his chair back. “I have to eat.” Was all he said, digging string cheese out of the fridge.

“And then?”

“Atchoo. I guess I could take a break.”

“Wanna watch a movie?”

“I was hoping a little bit more for a nap.”

“Movie in the bedroom? You can lay down.”

Ethan looked up at Tim. “My head is absolutely pounding, sweetheart.”

“Skip the movie. Have a nap. I guess if I can’t sleep again, I can read a book.”

“Probably should read a book; two naps, you’ll be up half the night.”

“Come on. Let’s see if you mumble about this stuff in your sleep again like you did last night.”

“Let’s see if I stop sneezing first.” Ethan grumbled, taking his tissue box and following Tim to the bedroom.

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mantracarehospital · 2 years

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Hyperosmolar Hyperglycemic Nonketotic Syndrome

Hyperosmolar hyperglycemic nonketotic syndrome, or HONKS for short, is a type of hyperglycemia that occurs when the blood sugar levels are so high they can’t be in control with insulin.

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crush-aesthetic · 3 years

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A patient has developed several complications of diabetes. The patient is curren

A patient has developed several complications of diabetes. The patient is currently being seen in the emergency department with diabetic ketoacidosis. Use the nursing process as a framework to prepare an education summary about diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome What is diabetic ketoacidosis? What is hyperglycemic hyperosmolar syndrome?

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faithfulwomanofgod · 3 years

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A patient has developed several complications of diabetes. The patient is curren

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your-dietician · 3 years

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Hyperglycemia Complications: Identifying the Cause

New Post has been published on https://depression-md.com/hyperglycemia-complications-identifying-the-cause/

Hyperglycemia Complications: Identifying the Cause

Hyperglycemia occurs when there is too much sugar or glucose in the bloodstream. It is often associated with diabetes mellitus. Typically, hyperglycemia is a result of insulin deficiency, insulin resistance, or a combination of both.

However, people who do not have diabetes can also experience hyperglycemia. It’s usually caused by another underlying medical condition, stress (like surgery or trauma), or by certain medications.

Here is an overview of what you should know about acute and chronic hyperglycemia.

ljubaphoto / Getty Images

Who Is At Risk?

About 1.5 million Americans are diagnosed with diabetes each year, which puts them at risk of developing hyperglycemia.

According to the American Diabetes Association (ADA), diabetes continues to impact seniors over age 65, as well as Asian Americans, Hispanics, non-Hispanic Blacks, and American Indians/Alaskan Natives at higher rates than other ages and racial/ethnic groups.

Family History and Genetics

Having a family member with diabetes also increases your risk of developing diabetes. While there seems to be a genetic predisposition to all forms of diabetes, just because someone in your family has diabetes does not mean that you will get it.

The ADA states that while type 2 diabetes has a stronger link to family history than type 1 diabetes, environmental and behavioral factors also play a role. There are interventions that can help prevent or delay a diabetes diagnosis.

Medications

Medication use can also contribute to high blood sugar. For example, prolonged use of medications such as steroids can increase the risk of developing high blood sugar.

Health Conditions

Certain health conditions other than diabetes can increase a person’s risk of hyperglycemia. For example, people with Cushing’s syndrome and polycystic ovarian syndrome (PCOS) are at an increased risk of developing hyperglycemia because of increased insulin resistance.

Other health-related factors that can increase the risk of developing diabetes include age, weight, and cardiovascular risk factors, such as metabolic syndrome, heart disease, and a sedentary lifestyle.

Surgery, trauma, and infections are other instances in which a person is at an increased risk of developing high blood sugar.

Identifying Symptoms and When to Be Concerned

The most common symptoms of hyperglycemia include excessive thirst, hunger, and urination.

However, in the case of diabetes—specifically, type 2 diabetes—people may not have symptoms for many years. In fact, the Centers for Disease Control and Prevention (CDC) estimates that 7.3 million Americans—about 2.8% of the population—have undiagnosed diabetes.

Screening for diabetes, particularly in at-risk populations, is essential to diagnosing and treating the condition.

Common Symptoms

Some of the more common symptoms of hyperglycemia include:

Numbness and tingling in the hands and feet

Dry mouth

Dry, itchy skin

Frequent infections such as yeast infections or infections of the oral cavity

Acanthosis nigricans, which are dark, “velvety” patches of skin on the armpits, groin, neck folds, and over the joints of the fingers and toes. These patches are an indicator of high insulin seen most often in the Black population and in people with prediabetes or type 2 diabetes.

Fatigue

Wounds that are slow to heal

Rapid heartbeat

Confusion

Irritability

Blurred vision

Weight loss (most common in type 1 diabetes, but can occur in type 2 diabetes that has gone undetected for a long time)

Bedwetting (more common in kids with type 1 diabetes)

Serious Symptoms

Acute complications of high blood sugars, such as diabetic ketoacidosis (more common in people with type 1 diabetes) or hyperglycemic hyperosmolar nonketotic syndrome (more common in people with type 2 diabetes) may also occur. If not treated right away, these complications can result in coma or death.

Diabetic ketoacidosis typically occurs quickly and is characterized by hyperglycemia, elevated ketones, and metabolic acidosis. If a person has the following symptoms of diabetic ketoacidosis, they need emergency medical care:

Fruity breath

Nausea

Vomiting

Abdominal pain

Rapid, shallow breathing

Complications

Having a random blood sugar level that is elevated after a large carbohydrate meal or during an illness or stressful day is not necessarily a reason to panic. However, having consistently elevated blood sugars can cause acute and chronic complications.

Excess blood sugar can affect the small and large vessels in the body, which increases the risk of developing complications of the eyes, heart, nerves, kidneys, and brain.

If you have diabetes and are having elevated blood sugars regularly, you should talk to your doctor about your treatment. If you do not have diabetes but are experiencing symptoms and have risk factors for the condition, it’s important to let your doctor know.

People with Diabetes: Acute Hyperglycemia

Acute hyperglycemia can be addressed through diabetes self-management education and making changes to your treatment plan.

There are many causes of acute hyperglycemia, including medication mistakes, too many carbohydrates, weight gain, lack of exercise, illness, and stress.

Medication

Acute hyperglycemia can happen if you are not matching your medication to your meals, you miss a dose of medication, you are not on the right kind of medication, you are receiving an incorrect dosage, or you are using an improper injection technique (if you are on insulin or non-insulin injectables).

For example, for people with diabetes who take insulin, simply rotating injection sites or avoiding lumpy areas may help to reduce their blood sugars.

If you are currently experiencing hyperglycemia and have been taking your medication as directed, your doctor might suggest a different type of medication or a higher dose (if needed).

Carbohydrate Intake

Carbohydrates get broken down into glucose and are the body’s preferred source of energy. Most people with diabetes need to modify their intake of carbohydrates to keep their blood sugars from getting too high.

Acute hyperglycemia can happen if you are eating too many carbohydrates at a meal. In this case, reducing carbohydrates at the next meal may help to lower your blood sugar levels.

If you are having trouble figuring out which foods are triggering your blood sugars, make an appointment to meet with a registered dietitian (RD) or certified diabetes care and education specialist (CDCES).

Weight Gain

Gaining weight can increase insulin resistance in people with diabetes, which in turn can increase the risk of high blood sugars.

Lack of Physical Activity

If you have diabetes and are typically active, then reducing your physical activity can result in an increase in blood sugars.

Exercise helps to lower blood sugar by increasing insulin sensitivity. When cells are sensitive to insulin, glucose can be taken from the bloodstream to the cells to use for energy.

Pancreatitis

Elevated blood sugars can lead to pancreatitis. There seems to be a correlation between diabetes and pancreatitis, which might be related to insulin resistance and elevated blood sugars.

Illness and Stress

Being sick or stressed increases blood sugars by activating cortisol, which increases insulin resistance. People with type 1 diabetes need to work with their doctor to develop a “sick day regimen” to help prevent their blood sugars from going too high.

People with type 1 diabetes sometimes think that they should avoid taking insulin when they are sick because they are not eating or having gastrointestinal issues. However, this is not advised as insulin omission can lead to diabetic ketoacidosis.

If you are ill, make sure that you let your doctor know. They will be able to guide you on how to adjust your insulin, test for ketones, and stay hydrated.

People With Diabetes: Chronic Hyperglycemia

Chronically elevated blood sugars can lead to complications of the eyes, heart, kidneys, nerves, and brain.

Retinopathy

Prolonged periods of hyperglycemia can damage the small vessels in the eye, ultimately leading to diabetic retinopathy.

Diabetic retinopathy can begin to occur even before a diabetes diagnosis, which is one reason why the ADA recommends that all people newly diagnosed with type 2 diabetes receive a dilated eye exam shortly after they are diagnosed.

Adults with type 1 diabetes should have an eye examination within five years of being diagnosed. Caregivers of children with type 1 diabetes should ask their child’s pediatrician when and how often an eye exam is needed.

Nephropathy

Nephropathy is the medical term for kidney disease. High blood sugars can damage the vessels in the kidneys and prevent them from being able to filter waste products. The inability to filter properly results in protein building up and spilling into the urine (microalbuminuria).

If caught early, kidney disease can be treated and further damage prevented. However, long-standing kidney disease accompanied by high blood pressure and high blood sugar may lead to end-stage renal disease (ESRD), which can lead to the need for dialysis or a kidney transplant.

Cardiovascular Disease

Cardiovascular disease is the number one cause of death in people with diabetes. Some types of heart disease include atherosclerosis (hardening of the arteries), arrhythmias, and heart failure.

People with poorly controlled diabetes who are overweight, have a family history of heart disease, and have high blood pressure, elevated cholesterol, and high triglycerides are at increased risk of developing heart disease.

Neuropathy

Elevated blood sugars can lead to nerve damage all over the body. Some common types of nerve damage include peripheral neuropathy, gastroparesis, and autonomic neuropathy.

Neuropathy (particularly peripheral neuropathy) can be painful and increases a person’s risk of developing skin infections.

Dementia

According to the ADA’s Standards of Care, “People with diabetes have higher incidences of all-cause dementia, Alzheimer’s disease, and vascular dementia than people with normal glucose tolerance.”

However, the increased incidence may not be limited to people with diabetes. Some studies have shown that high blood glucose levels in people with and without diabetes increase the risk of dementia.

In a prospective, community-based cohort study of 2,067 participants, researchers found that higher glucose levels were associated with an increased risk of dementia in populations without and with diabetes.

More research is needed to determine the relationship between high blood sugars and cognitive impairment in people without diabetes.

Complications of High Blood Sugars for People Who Don’t Have Diabetes

When blood sugars are elevated for an extended time, it can damage blood vessels and organs.

If you have hyperglycemia that is caused by something other than diabetes, getting your sugars under control can prevent you from developing prediabetes or diabetes, and can also reduce your risk of developing complications.

Certain conditions, situations, and medications can increase the risk of high blood sugar in people without diabetes. Some contributing factors include:

Cushing’s syndrome

Polycystic ovarian syndrome

Cystic fibrosis

Pancreatic diseases

Surgery and stress

Trauma

Medications

Overweight and obesity

Lifestyle factors that increase the risk of prediabetes or insulin resistance, including sedentary behavior, poor diet, and smoking

A Word From Verywell

High blood sugar, or hyperglycemia, is usually linked to prediabetes and diabetes mellitus. If you have diabetes and are experiencing high blood sugars, it’s important to discuss your treatment plan with your doctor.

Adjusting your regimen can help you maintain adequate blood glucose control and delay or prevent diabetes complications. It can also help to prevent an emergency hyperglycemic event, such as diabetic ketoacidosis.

If you have not been diagnosed with diabetes, but think that you are having symptoms of high blood sugar, such as increased urination and fatigue, ask your doctor if you should be tested for hyperglycemia.

High blood sugar is not always related to diabetes. It can also happen if you have surgery, have another health condition, or after a traumatic event.

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crayon-dust · 4 years

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Signs Of Higher Blood Sugar Level And Also Therapy

What is high blood sugar?

Hyperglycemia may be the clinical term describing the abnormally high blood sugar amount. Blood glucose is measured in a sample of blood obtained from a vein or from a finger rod sample of blood. It may be quantified in a laboratory alone or together along with other blood tests, or it could be measured employing a handheld glucometer, a little device that allows frequent monitoring of blood glucose levels without even the demand to get laboratory or a doctor's office. Health practitioners usually are indicate to swallow bloodsugar supplement.

Hyperglycemia or superior blood sugar is a brand new sign of diabetes (either type 1 diabetes and type two diabetes) and prediabetes. Normal ranges for blood glucose measurements can vary somewhat among different labs, but in general a fasting (premature a.m. earlier break fast ) sugar level is deemed ordinary if it's between 70-100 mg/dL. Glucose levels may rise over this array after having dinner. Random blood sugar dimensions are usually lesser than one hundred twenty five mg/dL.

10 Indicators and indications of high blood glucose

The principal signs of hyperglycemia are raised appetite and also a frequent need to urinate. Other signs that can occur with Higher blood glucose levels:

Headaches.

Tiredness.

Blurred eyesight.

Hunger.

Trouble with believing or concentrating.

Frequent urination

Sun Burns. Pain in the sunburn induces pain, which improves blood glucoses.

Coffee. Many people with diabetes have another sensitivity.

Oral disease. Celiac disease is a complication of diabetesand may cause blood sugars rise.

Losing rest. Going two or a evening without sleep could cause your human body to use insulin.

Nose spray. Some sprays include compounds that trigger the liver to earn additional blood sugarlevels.

Drastically elevated blood sugar levels can result in a health emergency ("diabetic coma"). This can occur in equally humans together with type 1 and also those with type 2 diabetes. People who have type 1 diabetes may grow diabetic ketoacidosis (DKA), and those with type two diabetes can form hyperglycemic hyperosmolar nonketotic syndrome. These alleged hyperglycemia disasters are conditions that will be life threatening if not dealt with. Crises cause about 2,400 deaths each calendar year.

Over the years, hyperglycemia often leads to harm to organs and tissues. Hyperglycemia could impair the immune answer, resulting in bad healing of cuts and wounds. Additionally, it may trigger injury, vision problems, and nerve damage to kidneys as well as the blood vessels. Before getting bloodsugar supplement, you can easily take a look at Blood Boost Formula Reviews, that offer you assurance regarding the quality of the item.

What can cause high blood glucose?

Quite a few health care illnesses can induce hyperglycemia, but the most popular by far would be diabetes mellitus. Diabetes impacts more than 8% of the whole population. Blood glucose levels grow while there is an inadequate amount of insulin in your own human body and also your body can't use insulin nicely. By choosing bloodsugar supplement, you can normalize your blood glucose glucoselevels. Normally, the pancreas releases insulin after a meal therefore that glucose can be utilized by their body's cells . This retains blood sugar amounts in the standard variety.

Type1 diabetes is trustworthy for about 5 percent of most cases of diabetes and results from injury into the pancreas' insulin-secreting cells. Type 2 diabetes is far more common and is related to the overall body's incapacity to effectively use insulin. Besides type 1 and type two diabetes diabetes, gestational diabetes can be just a type of diabetes which develops in women. Studies also show that in between 2 percent to 10% of pregnant women get breast cancer diabetes.

What is the treatment for high blood sugar?

Hyperglycemia or Gentle might perhaps not need treatment, based on the cause. By integrating dietary and changes in lifestyle, people with pre-diabetes or sugar can lower their glucose levels. Use or Explore any dietary or lifestyle changes to make trusted resources such as the American Diabetes Association.

Insulin is also your procedure of choice for those with type 1 ) diabetes and also to get long term increases in blood glucose ranges. People with type two diabetes could be managed with a combo of injectable medicines and distinct oral. Glucose levels is also taken by Many people who have type two diabetes.

Substantial blood sugar due to conditions apart from diabetes is medicated by fixing the underlying condition responsible for the glucose. In a few cases, insulin may be needed to stabilize blood sugar levels.

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atleastthisusernamewasnttaken · 4 years

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Exactly How Can High Blood Glucose Feel And When To See A Medical Professional?

What is high blood glucose?

Hyperglycemia may be your term. Blood sugar has been quantified in a sample of blood taken from a vein or by a little finger rod sample of bloodstream. It can be measured in a lab either alone or together along with other blood examinations, or it can be quantified utilizing a glucometer, a tiny device that makes it possible for frequent tracking of blood glucose levels without the demand to get lab or a physician's office. Medical practioners usually are suggest to consume Blood Boost Formula.

Hyperglycemia or superior blood glucose is a hallmark sign of diabetes (both type 1 diabetes and type two diabetes) and prediabetes. Typical ranges for blood glucose dimensions may vary somewhat between different labs, however, in general a fasting (early noodle earlier breakfast) sugar level is deemed ordinary if it's between 70100 mg/dL. Glucose levels may grow over this selection after dinner. Random blood sugar measurements are lesser than one hundred twenty five mg/dL.

10 Signs and Symptoms and indications of high blood glucose

The indicators of hyperglycemia have also a frequent need to urinate and raised thirst. Other symptoms That Can Happen with Higher blood sugar levels:

Head Aches.

Tiredness.

Blurred eyesight.

Hunger.

Trouble with focusing or thinking.

Regular urination

Sunburns. Pain from a sunburn induces annoyance, which boosts blood glucoses.

Coffee. Many individuals with diabetes have another sensitivity.

Oral disorder. Celiac disease is a complication of diabetesand may cause blood sugars increase.

Loosing slumber. Going a night or two can create your human system to use insulin efficiently.

Nose spray. Some sprays include chemicals that trigger the liver to make blood sugarlevels.

Seriously elevated blood glucose levels can result in a health crisis ("diabetic coma"). This will happen in people that have type 2 diabetes and also the two humans with Type1. People with type 1 diabetes could develop diabetic ketoacidosis (DKA), and those with type two diabetes can form hyperglycemic hyperosmolar nonketotic syndrome. These hyperglycemia disasters are conditions that will be life threatening if not treated. Roughly 2,400 fatalities every year are caused by disasters.

With time, hyperglycemia can lead to injury to tissues and organs. Hyperglycemia can inhibit the immune reply, leading to bad healing of cuts and wounds. In addition, it can lead to damage, vision complications, and nerve damage to glands as well as the arteries. Before purchasing blood sugar supplement, you may have a look at Blood Boost Formula Review, which offer you confidence concerning the product quality.

What can cause high blood glucose?

Hyperglycemia can be caused by Numerous health illnesses, however, probably the most popular by far would be diabetes mellitus. Diabetes affects more than 8% of their whole populace. Blood glucose levels rise because there's an inadequate amount of insulin in the body and also your body cannot use insulin. By accepting bloodsugar supplement, you can normalize your blood glucose glucose. Normally, insulin is released by the pancreas after meals so that their body's cells is able to use glucose for fuel. This keeps blood sugar amounts within the normal selection.

Type 1 diabetes is responsible for about 5% of cases of diabetes and leads to injury into the cells of the pancreas. Type two diabetes is much more common and can be related to the overall body's lack of ability to effectively use insulin. In addition to type 1 ) and type two diabetes diabetes can be actually just a kind of diabetes that develops in women. Studies reveal that in among 2 percent to 10% of pregnant women get gestational diabetes.

What is the treatment for high blood glucose?

Mild or hyperglycemia may perhaps not require treatment, depending on the reason. By incorporating diet and changes in lifestyle, people with pre-diabetes or sugar can lower their glucose levels. Utilize or Go over lifestyle or any dietary changes to assure reputable resources like the American Diabetes Association.

Insulin is the treatment of choice for people who have type 1 diabetes and also to get gains in glucose ranges. People with type 2 diabetes could be handled with a mix of diverse injectable and oral medications. Some people who have type two diabetes additionally take glucose levels.

Large blood glucose due to conditions other than diabetes is normally medicated by fixing the underlying illness accountable for its glucose. In some instances, insulin could possibly be required to stabilize glucose levels during this treatment.

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xoannieboss · 4 years

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Over the last two weeks, we’ve rotated through three new clinical sites, each representing a different level of care. Mount Meru Regional, where we spent our first two weeks, is the highest level of care. Tengeru District Hospital, our next stop, is a smaller district center with less resources and fewer departments. There, I spent my time in pediatrics. It was a more relaxed experience, as patient acuity was lower, however, significantly less intellectually stimulating. I would venture to say that 90% of the kids we say were being hospitalized for an upper respiratory infection or pneumonia. My three biggest takeaways:

The sick, sick kids are at Mount Meru Regional.

They prescribe antibiotics for every cough + fever, virus or not.

There’s no concern about antibiotic resistance even though I’ve only seen a handful of abx used.

Next, we spent three days at a local health center, the next level of care, and two days at a dispensary, the lowest tier. At the health center, there was only outpatient, reproductive health, pharmacy, and laboratory. I saw my first patient present with acute Malaria! Unrelated, but here’s an entertaining infographic on Ebola:

This last week, we’ve returned to the ER at Mount Meru Regional Hospital. We’re done being shy because intern doctors, with similar level of education to us, are running the department. They're preforming the same procedures that we’ve been trained for, making mistakes that we can help address with fresh eyes, and they’re willing to work with us like we’re colleagues. So we dive in.

Woman presents convulsing, one week postpartum. Eclampsia. She can’t maintain her own airway, but they do not intubate. Admit for observation, but she’ll likely never walk out of this hospital.

MVA. Grossly disfigured humoral fracture and dislocation. Scalp flap and large lower leg laceration. Diclofenac and local lidocaine only for pain control. He’ll be seen for surgery in two days.

Machete attack to the neck, hand and back. Common here. Hours worth of suturing. He’ll survive. Another machete attack survivor, pictured here (photo courtesy of Kate Varano).

A paraplegic woman (due to a hemispheric hemorrhagic stroke four years prior) presents with a possible new CVA. Her high fever and questionable vitals indicate that she’s also septic, whether the source is her turbid urine or the course crackles throughout bilateral lung fields, I’m not sure. Oh, and she’s a Type 2 Diabetic, so she’s also in HHS (hyperosmolar hyperglycemic state). Kussmaul breathing, clearly acidotic. GCS of 4. She needs to be intubated, but that’s not a consideration here because the entire hospital has only one vent. I’m not sure if it’s ever used. Interestingly enough, she would likely be a DNR patient in The States. But, despite the many patients I’ve seen treated with minimal intervention- the doctor is ordering at 250,000 TSH head CT that her husband will pay for, despite the unfortunate fact that the results will not change management nor improve prognosis.

Active TB patient with unilateral leg swelling, tachycardia, and difficulty breathing. Probable PE. Desaturating as we speak. Will be admitted for observation.

Another active TB patient, older Maasai woman with end stage AIDS, cryptococcal meningitis, coughing up copious amounts of blood. Drowning in her own blood, essentially, while we perform oral suction and watch her oxygen saturation plummet and her heart rate soar. Again, intubation is not considered despite our pleas. We wait expectantly for her heart to arrest. Miraculously, after what seemed like hours, the bleed must have clotted off. Her saturation rises to 92% and we admit her.

Noah, a fourteen year old Maasai boy who speaks only his tribal dialect and looks like he’s closer to eight years old. His dad is at his side, which is rare for pediatric patients. They’re both terrified and no one speaks a language that they can understand. The limited history we receive illustrates a cardiac anomaly at birth (no evidence on physical exam) nephrotic syndrome, and liver disease secondary to herbal medicine. He’s in respiratory distress, heart rate + blood pressure are holding stable for the time being, but his extremities are as cold as a corpse. He’s the picture of extreme septic shock. He’s grunting to breathe and manages to communicate simply “I’m tired”.

I could continue to log interesting patients for the rest of this blog post, but I can’t stop thinking about Noah. So I’m going to talk about him.

My heart shattered yesterday, not because of the limits of medicine, resources or physician competency here. That’s hard, but that’s what I’ve been coming to terms with for the last five weeks. I can wrap my mind around that. What I can’t wrap my mind around is the lack of humanity. All I could think about, while I squeeze Noah’s hand, is being hospitalized myself. The compassion and respect I was treated with. I try to mirror the empathy that I was treated with, that made my hospitalization more bearable and less terrifying/isolating/dehumanizing, for my patients. With Noah, no one spoke to him. Not while poking and prodding, not while collecting blood or urine samples, not while he gasped for breath and communicated his terror with his eyes. No one attempted to communicate with his father because they don’t speak his language. But fear is a universal language. As is compassion. I did all that I could; simply acknowledge the fear in their eyes and return their gaze with empathy and care in mine. And it wasn’t even close to enough.

He’s in the pediatric ICU now. He’s not doing well. Hanging on, though.

And I’m going to hang on to the smile I got out of him while I held his head and apologized, in broken Swahili, for being a white girl who only knows English.

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siva3155 · 5 years

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300+ TOP DIABETES Objective Questions and Answers

DIABETES Multiple Choice Questions :-

1. A patient arrives at the ED with a blood sugar of 578, serum osmolarity of 300, pH of 7.3, severe thirst, dehydration, and confusion. The patient is breathing rapidly and has a fruity breath smell. This patient has symptoms of...... A. Diabetic ketoacidosis B. hyperosmolar hyperglycemic noketotic coma C. Hypoglycemia D. diabetic neuropathy Ans: A 2. What are the micro vascular complications of uncontrolled diabetes? A. Delayed gastric emptying (Missed. B. Diarrhea C. Glomuerular injury (Missed. D. Bleeding of retinal caplillaries (Missed. E. Numbness of feet F. Impotence (Missed. Ans: B,E 3. The newly diagnosed diabetic patient asks the nurse why he needs to check his feet every day. The nurse's best response is.... A. To prevent leg amputation. B. To check for any cuts, sores, or dry cracked skin so they can be treated early to prevent infection or gangrene. C. To see if they hurt. D. You just need to do it. Ans: B 4. What are Macro vascular complications of uncontrolled diabetes? A. Pain in lower legs B. Hyperlipidemia (Missed. C. Impotence D. Ischemic heart disease (Missed. E. Aortic disection Ans: B,D 5. The nurse enters a patient's room and sees the patient breathing rapidly with a fruity breath smell. This is known as... A. Trousseau's B. Cullen's C. Kussmaul's D. Bitot's Ans: C 6. A patient with severe hypoglycemia arrives at the ED unconscious by ambulance. The nurse would first... A. Give regular insulin by IV B. Give NPH by IV C. Give 10-15 g CHO or Orange juice D. Give 1 mg glucagon Ans: D 7. The diabetic patient's lab work comes back with a pH of 7.4, serum blood sugar of 950, serum osmolarity of 460, pCO2 of 35, HCO3 of 25. The patient is confused and dehydrated. This patient is showing signs and symptoms of.... A. Diabetic ketoacidosis B. hyperosmolar hyperglycemic noketotic coma C. Hypoglycemia D. diabetic neuropathy Ans: B 8. The nurse enters a diabetic patient's room at 11:30 and notices that the patient is diaphoretic, tachycardic, anxious, states she is hungry, and doesn't remember where she is. This patient is most likely showing signs of what? A. hyperglycemic B. hypoglycemic C. diabetic ketoacidosis D. hyperosmolar hyperglycemic noketotic coma Ans: B 9. The nurse's first action upon finding a patient with mild hypoglycemia is to... A. Call the rapid response team B. Give 1 mg of glucagon C. Give 10-15 g of CHO or Orange juice D. Give insulin Ans: C 10. What is the number one complication of diabetes? A. Diabetic ketoacidosis B. Obesity C. Hypertension D. Cardiovascular disease Ans: D

DIABETES MCQs 11. A urine test in an undiagnosed diabetic may show........ A. glucose and ketones in the urine B. glucose and high amounts of bilirubin in the urine C. ketones in the urine D. ketones and adrenaline in the urine Ans: A 12. If a person has a fasting plasma glucose of 6.8mmol/L and a two-hour postprandial plasma glucose of 11.6mmol/L, should this person be suspected of having diabetes? A. Yes B. No C. Cannot decide Ans: A 13. A woman has a fasting plasma glucose of 5.9mmol/L and a two-hour postprandial plasma glucose of 7.6mmol/L. Are these values normal? A. No. B. Yes, according to the American Diabetes Association guidelines C. Yes, according to the World Health Organisation guidelines Ans: C 14. If a person has a random plasma glucose of 8mmol/L, is it normal? A. Yes B. No C. Not possible to tell Ans: C 15. There are a range of glucose values called "impaired glucose tolerance". What is the significance to a person who has impaired glucose tolerance? A. The person has an increased risk of developing diabetes B. The person has an increased cardiovascular risk C. Both the above D. None of the above Ans: C 16. Can the onset of new diabetes be prevented or delayed? A. Yes B. No Ans: A 17. Are there any laboratory tests to distinguish between Type 1 and Type 2 diabetes? A. Yes B. No Ans: A 18. Which statement below is CORRECT regarding initiation of long term insulin therapy in diabetes? A. Patients with Type 1 diabetes should be initiated on basal insulin alone B. Patients with Type 1 diabetes should be initiated on prandial insulin alone C. Patients with Type 2 diabetes should be initiated on basal insulin alone D. Patients with Type 2 diabetes should be initiated on prandial insulin alone Ans: C 19. Which statement below is TRUE with regard to these two insulin preparations: 1. Insulatard Insulin (NPH insulin. 2. Mixtard insulin (a pre-mixed combination of short acting and long acting insulin. A. Insulatard insulin and Mixtard insulin can be given at bedtime without the need for a bedtime snack B. Mixtard insulin can be given at bedtime without the need for a bedtime snack C. Insulatard insulin can be given at bedtime without the need for a bedtime snack Ans: C 20. Which of the statements below is true when initiating insulin in a Type 2 diabetic who is already on Metformin and Glibenclamide? B. Metformin must be stopped or the dose reduced C. Glibenclamide must be stopped or the dose reduced Ans: C 21. A patient with diabetes on Metformin and Glibenclamide is scheduled for a coronary angiogram. His diabetic control is good. Which of the statements below is TRUE? B. Metformin must be stopped before the procedure C. Glibenclamide must be stopped before the procedure D. No changes need to be made. He can undergo the procedure. Ans: B 22. Which statement below regarding the use of intravenous insulin for treating diabetic ketoacidosis is TRUE? A. Insulin should be given IV until the blood sugar is normal B. Insulin should be given IV until the acidotic state is controlled C. Insulin should be given IV until the patient is well hydrated Ans: B 23. What is the best method of controlling blood sugar in a diabetic who cannot take orally? A. Fixed dose insulin according to body weight given subcutaneously B. Insulin given subcutaneously according to a sliding scale C. Insulin given intravenously along with dextrose and potassium Ans: C 24. Is this statement true or false? The glycosylated hemoglobin value is a useful parameter when making decisions regarding the need for insulin in a Type 2 diabetic. A. True B. False Ans: A 25. Which type of diabetes is more common in children? A. Diabetes I B. Diabetes II Ans: B 26. Mickey's insulin gives her the lowest CBG 5 hrs after injection. Which insulin is Mickey taking? A. Novolog B. NPH C. NovologR D. Lantus Ans: D 27. The nurse has to give the pt HumologR. The nurse understands the medication when the nurse states the peak time is: A. 1-3 hr B. 2-4 hr C. 4-12 hr D. 5 hrs Ans: B 28. Ben comes into the ED with blurred vision. He has polyuria and complains of pain in his legs. Labs show that he has elevated insulin levels and high triglyceride levels. Ben also complains of always being thirsty. What type of Diabetes does Ben have? A. Diabetes I B. Diabetes II Ans: B 29. The nurse understands NovologR and when it ends by stating it ends: A. 3-5 hrs B. 3-6.5 hrs C. 5-7 hrs D. 18-24 hrs E. 24 hrs Ans: C 30. Can an infection cause a rise in GLU? A. Yes B. No Ans: A 31. Tony has to check his BG 5 days a week before breakfast and periodically at other times. He notices a rise of BG when he is sick. What type of diabetic is Tony? A. Diabetes I B. Diabetes II (Missed. C. Insulin Dependent D. Non Insulin Dependent (Missed. Ans: A,C 32. Ted is taking NPH insulin. The nurse knows Ted understands his medication when he states: A. It can start working in 10-30 minutes B. It can start working 1-2 hours after injection. (Missed. C. Peak action is 4-12 hours (Missed. D. It stays in the system 18-24 hrs. (Missed. Ans: A 33. Which type of insulin cannot be manually mixed in a syringe? A. Novolog B. Humolog C. NPH D. Regular E. Lantus Ans: E 34. The nurse understands Novolog when the nurse states the end time is: A. 3-5 hrs B. 3-6.5 hrs C. 5-7 hrs D. 18-24 hrs Ans: B 35. Nick was given Novolog insulin. The nurse knows that his breakfast should be available to Nick how many minutes after taking his meds? A. immediately to 2.5 hrs B. 2-4 hrs C. 4-12 hrs D. 5 hrs Ans: A 36. Mary has a skin infection that wont go away. Her BP is 135/90. She has dark amber urine. She also reports that she has reoccurring vaginal infections. Her GLU comes back at 135. What type of diabetes does she have? A. LADA B. Diabetes I C. Diabetes II D. Pre Diabetes Ans: D 37. NIDDM acounts for 90% of diabetics. What are some thing that a NIDDM diabetic could do to help their disease? A. Avoid exercise B. reduce body fat by 5% (Missed. C. maintain excellent skin health (Missed. D. Rub lotion in their feet, but no in between their toes. (Missed. Ans: A 38. Lucy has just given birth. She had gestational diabetes and did not have to take insulin. She is very concerned that will now have to take insulin for the rest of her life. What does a nurse say to educate Lucy about her condition? A. Proper instruction of foot care. B. 25-50% of women will eventually develop type 2 diabetes. (Missed. C. Losing the baby fat will help. (Missed. D. Education on what type of insulin she will need. Ans: A,D 39. Bill is in the ED presenting with a BP of 60/45 and is responsive to painful stimuli. His Na is 180 and BUN is 65. His wife states he is a type 2 diabetic but has been sticking to his diet. His insulin lab came back low. What is wrong with Bill? A. Hyperosmolar Hyperglycemic Nonketoitic Syndrome B. Diabetic Ketacidosis C. LADA D. Hyperglycemic Ans: A 40. Ana is a long distance runner with diabetes. She understands her need for testing when she states: A. i should test before and after exercise (Missed. B. I should test after exercise C. I should test before and after each meal and bedtime D. If I feel like my BG is low, I should test (Missed. Ans: B,C 41. Cynthia is getting NovologR. The nurse knows that Cynthia needs more education when she states: A. I need to check my BG throughout the day. B. I need to be consistent with insulin usage. C. I need to eat a large meal before taking my insulin D. My insulin can be in my system for 5-7 hours. Ans: C 42. Manifestations of hypoglycemia would entail: A. Anxiety (Missed. B. Hyperactions C. Tachycardia (Missed. D. Confusion (Missed. Ans: B 43. Insulin is measure in: A. Ml B. Dl C. units D. Tsp Ans: C 44. Which is most dangerous? A. hypoglycemia B. Hyperglycemia Ans: A 45. Nathan's AIC comes back at 9%. The nurse understands this value by stating to the pt: A. Your diabetes is under control. B. Your diabetes has shifted to Diabetes I. C. Your diabetes needs further intervention. D. Call the coroner and make an appointment if you don't plan on taking this more seriously! Ans: C 46. After giving insulin, what is the most critical observation that needs to be made? A. Tachycardia B. Bradycardia C. Hyperglycemia D. Hypoglycemia Ans: D 47. The nurse understand NPH when the nurse says NPH ends: A. after a heavy meal B. 18-24 hrs after injection C. 12 hrs after injection D. When HumologR has been injected. Ans: B 48. What risk factors increase diabetic foot problems? A. Sensory neuropathy (Missed. B. PVD (Missed. C. Smoking (Missed. D. Alcohol Ans: D 49. Humolog begins to take affect: A. 15 min B. 10-30 min C. 30-60 min D. 1-2 hrs E. 1.1 hrs (Your Answer. Ans: A 50. Linda is taking Lantus. She understands her medication when she states: A. it can start in 1.1 hr. (Missed. B. peaks 4-12 hours C. it ends in 24 hrs (Missed. D. it cannot be mixed with other insulins in the same syringe. (Missed. Ans: B DIABETES Objective type Questions with Answers 51. Lupe is in the ED. She has anorexia, abdominal pain, acetone breath, polyuria and is confused. She has ketones present in her urine. She is pre diabetic with a glu of 650. What is Lupe's problem? A. She was misdiagnosed and should be a type 1 diabetic. B. Hyperosmolar Hyperglycemic Nonketoitic Syndrome C. Diabetic Ketacidosis D. LADA Ans: C 52. Gladus is in for her physical. She is a 54 year old woman with a lot of energy. She is mildly overweight. Her BP is 130/85. As part of her physical, the doctor discovers her GLU is 350. He orders a fasting plasma glucose and her levels come back 130 the first day and 275 the second day. What does this indicate? A. Diabetes I B. Diabetes II C. LADA Ans: B 53. Nicole is a chronic alcoholic. She drinks a bottle of wine every night and hard liquor on the weekends. She has been fatigued and has blurry vision. The doctor tells her she now has diabetes II. She doesn't understand how she could have diabetes as it does not run in her family. What education would the nurse give to the patient? A. Explain that the alcohol caused her diabetes. B. Insulin will not be affected by her drinking C. Encourage her to attend AA meeting even though she doesn't want to. D. Using therapeutic communication, help her to see that this is her fault and must accept she has ruined her life. Ans: A 54. Neuropathy occurs only in type 2 diabetics? A. Yes B. No Ans: B 55. Pat is a 45 year old female presenting with 83/60 BP, and elivated BUN and a GLU of 879. She reports that she is not on a diet but has been losing weight rapidly and has fatigue. What type of diabetes does she have? A. Diabetes I B. Diabetes II C. LADA Ans: C 56. NPH insulin has been prescribed to the pt. The nurse understands NPH when the nurse states: A. NPH acts quickly. B. NPH peaks at 4-12 hrs (Missed. C. NPH is a mixture of rapid and slow acting (Missed. D. NPH low CBG will most likely be around 5 hrs. Ans: A,D 57. Hypoglycemia is related to : A. reduced insulin and increased glucose B. increased insulin and reduced glucose (Missed. C. may occur when very high blood glucose falls too rapidly (Missed. D. failure to eat (Missed. Ans: A 58. The nurse understands NPH and how quickly it starts when the nurse states: A. 10-30 min B. 30-60 min C. 1-2 hrs D. 1.1 hours Ans: C 59. HumologR has been given to Melisa at 13:30. When would Melisa need her snack or lunch? A. 14:30 B. 16:30 C. 15:30 D. 14:00 Ans: C 60. Keith has just been diagnosed with diabetes. His diabetes is an autoimmune disorder. He has lost 15 lbs in two weeks and has polyuria. His BP was 75/45 on admission. What type of diabetes does Keith have? A. Diabetes I B. Diabetes II Ans: A 61. What substance is found in the blood and urine of an undiagnosed diabetic? A. insulin B. adrenaline C. ketones D. bilirubin Ans: C 62. A normal FASTING blood glucose in a non-diabetic is A. 80 to 110 B. 40 to 80 C. 120 to 150 D. 150 to 200 Ans: A 63. Hyperglycemia is when...... A. the blood sugar is too low B. the blood sugar is normal C. there is sugar in the urine D. the blood sugar is too high Ans: D 64. If diabetes goes untreated for a long time, what disease can develop? HINT:patients must be hospitalized for successful treatment of this condition A. hypoglycemia B. diabeticketoacidosis C. ketosis D. hyperglycemia E. ketourina Ans: B 65. What are the three most COMMON symptoms of diabetes? A. headaches vomiting constant illness B. intolerable thirst constant urination weight loss C. double vision infections constant urination D. tingling of the feet slow healing wounds weight loss E. intolerable thirst vomiting heart burn Ans: B 66. What is one cause of diabetes? MORE THAN ONE RIGHT ANSWER A. virus (Missed. B. antibody mistake (Missed. C. too much sweets D. genetics (Missed. E. bacteria Ans: C,E 67. Name both types of diabetes SCIENTIFICLY A. Type 1 and Type 2 B. Old Diabetes and Young Diabetes C. Juvenile Diabetes and Adult-Onset Diabetes D. Brittle Diabetes and Insulin Dependant Diabetes Ans: C 68. Can diabetes kill you? A. Yes B. No C. Only if you're a certain race Ans: A 69. An insulin pump's site must be changed...... A. once a week B. never C. every three days D. every day E. every five days Ans: C 70. Aspart insulin is also referred to as...... A. long acting insulin B. short acting insulin C. intermediate acting insulin Ans: B 71. Why does a Long-Acting-Insulin shot hurt more than a Short-Acting-Insulin shot A. Because it is a bigger shot B. Because Long-Acting-Insulin has preservatives in it to keep it working the full 20 to 24 hours C. Because you use a different needle to deliver Long-Acting-Insulin Ans: B 72. If a person does not like the insulin needle or pump, they want might to try the...... A. syringe B. moniter C. pen D. inhaler Ans: C 73. About how many Americans have diabetes A. 5 million B. 47 million C. 21 million D. 16 million E. 33 million Ans: C 74. What food can make you have a high blood sugar? A. nuts B. water C. yogurt D. pizza E. bread Ans: D 75. A urine test in an undiagnosed diabetic may show........ A. glucose and ketones in the urine B. glucose and high amounts of bilirubin in the urine C. ketones in the urine D. ketones and adrenaline in the urine Ans: A 76. A slice of bread has about how many carbohydrates? A. 5 carbs B. 30 carbs C. 15 carbs D. no carbs E. 25 carbs Ans: C 77. Which is not true about Diabetes? A. the blood sugar may go out of control B. the person may be hospitalized if they are not treating the diabetes C. Diabetes can be completely cured D. diabetes can be associated with nausea Ans: C 78. When you are sick, the blood sugar may....... A. be normal B. very low C. higher than usual D. lower than usual Ans: C 79. In a newly-diagnosed patient who is in the hospital, their first major goal is to..... A. have their blood sugars go back to normal B. clear their ketones C. get an insulin pump Ans: B 80. Ketones are produced by......... A. not having insulin B. a high blood sugar C. fat breakdown D. passing urine with sugar in it Ans: C 81. What are the 3 main factors to success with diabetes? A. food exercise insulin B. food insulin ketones C. exercise ketones insulin Ans: A 82. People with diabetes can lead normal lives? A. Yes B. No C. Only some Ans: A 83. Diabetes is a world wide disease A. True B. False Ans: A 84. Which of the following is a symptom of diabetes? A. Pregnancy B. Mood Swings C. Blurred Vision D. Loss of Hearing Ans: C 85. What is the medicine that is injected into your body by a needle? A. Insulin B. Sugar C. Glucose D. Diabetic Solution Ans: A 86. What is a test you can get at the doctor to see if you have diabetes? A. Blood Test B. X-ray C. MRI D. Diabetes test Ans: A 87. How many different types of diabetes are there? A. 1 B. 2 C. 3 D. 5 Ans: B 88. 1. Secretory product associated with pancreatic alpha cells: A. A. insulin B. B. proglucagon C. C. somatostatin D. D. pancreatic polypeptide E. E. insulin and somatostatin Ans: B 89. 1. Major manisfestations of diabetes mellitus: A. A. inappropriate hyperglycemia B. B. disordered metabolism C. C. both D. D. neither Ans: C 90. 1. Type I diabetes: A. A. most often presents in adults B. B. anabolic metabolic disorder C. C. circulating insulin is virtually absent D. D. glucagon levels are low E. E. ketoacidosis is rarely seen Ans: C 91. 1. Extrinsic factors which may affect pancreatic B cell function: A. A. mumps virus B. B. toxic chemicals C. C. coxsackievirus D. D. mumps virus and toxic chemicals E. E. mumps virus, toxic chemicals and coxsakievirus Ans: E 92. What is prediabetes? A. When blood glucose levels are higher than normal but not high enough for diagnosis. (Correct Answer. B. When your diabetes is in submission until you turn forty Ans: A 93. Type 1 diabetes was previously known as what? A. Endrino diabetes B. Juvenile diabetes Ans: B 94. What is the most common type of diabetes? A. Type 1 diabetes B. Type 2 diabetes C. Pre-diabetes Ans: B 95. There is always symptoms when you have diabetes. A. True B. False Ans: B 96. Type I diabetes is characterized by: A. resistance to insulin B. autoantibodies C. complicated by HHS Ans: B DIABETES Interview Questions and Answers pdf Download Read the full article

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