Ketoacidosis, 5 Observation and 9 Care
Posted on November 18, 2009
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Ketoacidosis is an acute complication of diabetes is caused due to a serious shortage of insulin. When the patients with severe deficiency of insulin, glucose metabolism disorders increased sharply, when the body can not use glucose, had no choice but to use fat for energy, while the fat-burning is not complete, resulting in severe secondary disorder of fat metabolism.
In the event of coma in patients with diabetic ketoacidosis are generally a precursor to the former, and outstanding performance are: fatigue, marked anorexia, nausea, vomiting, extreme thirst, urine volume significantly more than usual; also often dizziness, headache, expression of indifference, lethargy, irritability, breathing deepened to speed up; some exhaled gases of patients with rotten apple. Further deterioration, then decreased urine output, dry skin, eye subsidence, rapid pulse slim and fragile and is not structured, blood pressure, cold limbs. Small number of patients, there may be abdominal pain, or even be misdiagnosed as acute abdomen.
Disease observation:
1. Ketoacidosis occurs in patients with progressive fatigue, weakness, extreme thirst, anorexia, nausea, and vomiting.
2. Tachypnea, expiratory time to time one flavor (smell like rotten apples).
3. With the increased water loss dehydration, decreased urine output, skin dry and inelastic, eye subsidence.
4. Severe shock can be expressed as heart rate, pulse small velocity, blood pressure, limb Jueleng so, the patient was tired to sleep and gradually into a coma.
5. Experimental checks, blood glucose increased significantly decreased blood carbon dioxide combining power, blood ketones increased, urine sugar strong positive, Ketone-positive white blood cell counts increased and so on.
Symptomatic care:
1. Diagnosed with ketoacidosis, the absolute bed rest, with life-saving treatment immediately.
2. Quickly establish intravenous access, correct water, electrolyte and acid-base balance disorders, to correct symptoms of ketosis.
3. The doctor’s advice to use regular insulin. Application of small doses of insulin pump doses to the right in order to reduce hypoglycemia, hypokalemia, cerebral edema.
4. Assist in handling-induced disease and complications, close observation of vital signs, consciousness and pupil (see coma care routine) to help make the determination of blood glucose and records.
5. Food Care fasting until after the change to alleviate diabetic coma or semi-liquid diet diabetes.
6. The prevention of infection must be prepared oral and skin care to keep the skin clean to prevent bed sores and secondary infections, female patients should be kept outside the perineum clean.
7. Vascular disease diabetes, general nursing care according to Chu, the under the different parts or organs of the vascular lesions in nursing.
8. Neuropathy care, control of diabetes, applied a lot of vitamin B, partial massage and physical therapy, lost feeling on the skin should be taken to avoid damage.
9. Good health guidance, so that patients or their families to grasp the knowledge of diabetes and establish the confidence of disease-fighting
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