3 Diabetic Emergencies Free Online FlashCards

What blood glucose level generally defines hypoglycemia?

Hypoglycemia is generally a blood glucose below $70\text{ mg/dL}$ \(3.9\text{ mmol/L}).

What can trigger hypoglycemia?

Common causes include too much insulin or glucose-lowering medication, delayed or missed food, unexpected activity, and illness.

How should an alert patient who can swallow safely be treated for hypoglycemia?

Give $15\text{ g}$ of fast-acting carbohydrate, then recheck glucose after $15\text{ minutes}$. Repeat if it remains below $70\text{ mg/dL}$.

What is the priority when a patient with hypoglycemia cannot swallow safely?

Give nothing by mouth. Call for emergency assistance and administer prescribed glucagon or IV dextrose according to the care setting’s protocol.

What causes ketone production and acidosis in DKA?

Inadequate insulin leads to fat breakdown, ketone production, and metabolic acidosis.

What pattern distinguishes HHS from DKA?

HHS typically involves profound hyperglycemia, dehydration, and increased serum osmolality, with little or no significant ketosis or acidosis.

What laboratory pattern supports a diagnosis of adult DKA?

In adults, the pattern is glucose $\geq 200\text{ mg/dL}$ or known diabetes, significant ketones, and acidosis: pH $<7.3$ and/or bicarbonate $<18\text{ mmol/L}$.

What laboratory pattern supports a diagnosis of HHS?

HHS criteria include glucose $\geq 600\text{ mg/dL}$ and effective osmolality $>300\text{ mOsm/kg}$ or total osmolality $>320\text{ mOsm/kg}$, without substantial ketonemia or acidosis.

Why is insulin generally delayed when potassium is below $3.5\text{ mmol/L}$?

If potassium is below $3.5\text{ mmol/L}$, insulin is generally delayed while potassium is replaced, because insulin can lower potassium further and cause dangerous complications.

Why may dextrose be added to fluids during DKA treatment?

When glucose falls below $250\text{ mg/dL}$, prescribed fluids are generally adjusted to include dextrose so insulin can continue until ketoacidosis resolves.

What initial fluid rate is described for adults without cardiac or renal compromise?

For adults without cardiac or renal compromise, initial isotonic saline or balanced crystalloid is generally $500\text{–}1{,}000\text{ mL/hour}$ for the first $2\text{–}4\text{ hours}$; treatment must be individualized.

How often should bedside glucose generally be checked during crisis treatment?

Adult consensus guidance recommends bedside glucose checks every $1\text{–}2\text{ hours}$ during crisis treatment.