Labs:
HgbA1c: 9.5
FSBS: 304
Total Cholesterol: 214
Triglycerides: 175
HDL: 24
LDL: 145
Creatinine: 1.0
BUN: 18
Na: 141
K: 4.3
ETOH use
Nicotine use
Decreased
adiponectin
Vasoconstriction
BP Increase
S/S: BP:
142/94
Insulin Resistance
Increase RAAS
and SNS
HTN
Decrease
Cardiac
Contractility
BV
damage
Ventricular
remodeling
BV
Narrowing
Systemic
Resistance
Increase
Cardiac
workload
Increase
afterload
Tachycardia
S/S: HR 105
Decreased
Cardiac
Output
Endothelial
Damage
•
Med hx: T2DM, HTN, HLD,
Social hx: Smokes ½ PPD for 40 years and drinks 1-2
mixed drinks once a month
Vitals: 142/94 Temp: 98.6.
Resp: 18.: O2: 94 F
Etiology
Mrs. Q has uncontrolled Diabetes. He has a
history of T2DM, HTN, and HLD. She
hasn’t visited the doctor in 3 years Due to
her health history and neglect, it will
eventually lead to T2DM.
Adrenergic
agonist
Mrs. Quenga a 57 y/o woman came into the ER with c/o
significant weight loss over three months. She has normal
appetite but has been eating more than usual. She also has
frequent urination throughout the night and decided to come
to the hospital due to feeling weak and tired.
Current Meds:
Metformin 1000mg
Januvia 50mg
Atorvastatin 80mg
Aspirin 81mg
Lisinopril 20mg
Uncontrolled T2DM
Insulin resistance and continuing decrease in insulin
secretion by pancreatic beta cells causing
hyperglycemia.
Diet
Increase sugar
and fat intake
Hyperglycemia
Increased
Insulin
Production
•
•
•
•
•
Nursing Dx: Risk Deficient Fluid
Volume
As evidenced by polyuria, nocturia,
and osmotic
Diuresis
Nursing Mgmt: 1. Assess vital signs 2.
Monitor I&O
3. Assess peripheral pulses, capillary
refill, and mucous
membranes
Decreased
Insulin
production
Decrease
Beta cell function
s/s: fatigue
Glomerular
Injury
•
•
•
•
•
•
s/s Polyuria and
Nocturia
Atherosclerosis
Microalbuminuria
Increased
Macrovascular
Damage
Peripheral
Vascular
Disease
Decreased Water
Reabsorption
Decreased O2
transportation
Ischemia
Decreased
Sensitivity
to pain and
Tissue damage
Neuropathy
Increased
Susceptibility
to injury
Increased
Bacterial
growth
Infection
Epidemiology
Diabetes currently affects more than 74 million
Indians, which is more than 8.3% of the adult
population. Among young and middle aged
adults, the prevalence of diabetes is 6.7% and
prediabetes is 5.6% according to the National
Family Health Survey-4. The average age on
onset is 42.5 years
Risk Factors
Family History
Race
Obesity
High Blood pressure
Low HDL cholesterol
Smoking
Prevention
Avoid smoking
Controlling high bp and diabetes
Physically active
Healthy food options
Managing stress
Nursing Dx: Impaired Skin Integrity
r/t skin
Injury, laceration, impaired
circulation, uncontrolled
Diabetes as evidenced by:
erythematous wound edges
and purulent drainage
Nursing Mgmt: 1. Apply wound
dressing as ordered 2. Assess for
any signs of further infection: color,
smell, bleeding 3. Administer pain
medications as ordered