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Endocrine - Coggle Diagram

- - - - patients showing signs of inadequete breathing, a pulse aximetry levels less than or equal to 94%, or altered mental status should receive high-low oxygen (12 to 15 L/min via nonrebreathing mask)
      - hyperglycemic patients may have kussmack respiration anbd sweet, fruity breath
      - hypoglycemic patients will have normal or shallow to rapid respiration
    - - dry, warm skin: hyperglycemia
      - moist, pale skin: hypoglycemia
      - rapid, weak pulse: symptomatic hypoglycemia
    - - provide prompt transport for patients with altered mental status and inability to swallow
      - further evaluate conscious patients capable of swallowing and able to maintain airway
  - - - obtain history of present illness from responsive patient, family, or bystanders
      - if patient has eaten but did not take insulin, hyperglycemia is most likely to expect
      - if patient has taken insulin, but not eaten, hypoglycemia is more likely
    - - "Do you take insulin or pills to lower blood sugar?"
      - "Do you wear an insulin pump? Is it working properly?"
      - "Have you taken your insulin dose or medication today?"
      - "Have you eaten normally today?"
      - "Have you had any illness, unusual amount of activity, or stress?"
  - - - assess unresponsive patient head-to-toe
      - when you suspect a diabetes- related problem, focus on mental status, ability to swallow, and ability to protect airway
    - - Use a glucometer, if available and protocols allow
      - Hypoglycemia: respirations are normal to rapid, pulse weak and rapid, and skin is typically pale and clammy with a low blood pressure
      - Hyperglycemia: respirations may be deep and rapid; pulse may be rapid, weak, and thready; and skin may be warm and dry with normal blood pressure
    - - study the operator's manual for proper use in field
      - know the upper and lower ranges at which your glucometer functions
      - normal nonfasting adult and child blood glucose level range: 80 to 120 mg/dL; nonates should be above 70 mg/dL
  - - - Hypoglycemic, conscious, can swallow:
        
        encourage patients to take glucose tablets or drink juice with sugar
        
        administer highly concentrated sugar gel
        
        provide rapid transport
      - Hypoglycemic, unconscious, risk of aspiration:
        
        patient needs intravenous (I glucose or intramuscular (IM) or (IN) glucagon
        
        When in doubt, consult medical control
- - - - Can occur with diabetes mellitus type 1 and 2
  - - - Polyuria
      - Polydipsia
      - Polyphagia
      - weight loss
      - Fatigue
    - - this produce ketones, which is acid waste
      - When the ketone levels go up in the blood, they spill into the urine
      - kidneys are not able to maintain acid-base balance
      - Causes the patient to develop kussmaul respiration, which is when they breathe faster and deeper.
  - - - obesity predisposes patients to the type 2 diabetes
      - Pancreas produces more insulin
    - - recurrent infection
      - change in vision
      - change in
      - numbness in the feet.
    - - Leads to a nonketonic hypersomolar state of dehydration.
- - - - Patients who inject insulin needs to check their glucose level about 6 times or more a day.
      - Will not be able to survive without insulin.
      - Patient must obtain insulin
      - Usually is provided with an implanted insulin pump.
    - - A patient should be checking their blood sugar regularly, multiple times a day