Diabetes and Altered Mental Status
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What is the primary action of oral glucose in a diabetic emergency?

  • Decreases blood sugar levels
  • Prevents seizures
  • Stabilizes insulin production
  • Increases blood sugar levels (correct)

    • Which of the following steps should be taken before administering oral glucose?

  • Remove any existing insulin from the patient
  • Ensure the patient is unconscious
  • Administer high-flow oxygen
  • Confirm that the patient can swallow (correct)

    • What is a major side effect of improperly administered oral glucose?

  • Increased heart rate
  • Nausea and vomiting
  • Aspiration without a gag reflex (correct)
  • Hypotension

    • When assisting a patient experiencing a seizure, what is the most important initial action?

    <p>Protect the patient from environmental hazards (C)</p> Signup and view all the answers

    What should be done if a patient with altered mental status loses consciousness after receiving oral glucose?

    <p>Remove the tongue depressor from the mouth (D)</p> Signup and view all the answers

    Which symptom is typically associated with hypoglycemia?

    <p>Altered mental status (C)</p> Signup and view all the answers

    What should be maintained for a patient experiencing a stroke?

    <p>Position of comfort and airway protection (B)</p> Signup and view all the answers

    Which of the following is NOT considered a potential cause of altered mental status?

    <p>Chronic hypertension (B)</p> Signup and view all the answers

    In the context of diabetic emergencies, what is a recognized reassessment strategy?

    <p>Perform ongoing assessment (D)</p> Signup and view all the answers

    What type of oxygen administration is recommended during a seizure event?

    <p>High-flow oxygen (D)</p> Signup and view all the answers

    What is the primary action to take for a patient with altered mental status?

    <p>Maintain and reassess the airway (A)</p> Signup and view all the answers

    When should oral glucose be administered to a patient?

    <p>When a patient is responsive and able to swallow (B)</p> Signup and view all the answers

    Which of the following is a contraindication for administering oral glucose?

    <p>Patient is unable to swallow (D)</p> Signup and view all the answers

    Which of the following symptoms may indicate hypoglycemia?

    <p>Confusion and irritability (D)</p> Signup and view all the answers

    What type of glucose product is commonly used in emergencies?

    <p>Glutose or Insta-Glucose (D)</p> Signup and view all the answers

    What should be performed if a patient with altered mental status is experiencing airway obstruction?

    <p>Suction the airway (A)</p> Signup and view all the answers

    In diabetic emergencies, what is the significance of administering high-flow oxygen?

    <p>To improve oxygen delivery to tissues (C)</p> Signup and view all the answers

    What should be done before transporting a patient with altered mental status?

    <p>Ensure airway maintenance (A)</p> Signup and view all the answers

    How often should the patient’s airway be reassessed in cases of altered mental status?

    <p>Continuously until stable (C)</p> Signup and view all the answers

    Which insulin type is typically used for immediate control in diabetic emergencies?

    <p>Rapid-acting insulin (A)</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with hypoglycemia?

    <p>Severe headache (B)</p> Signup and view all the answers

    What is the primary cause of hyperglycemia in diabetic emergencies?

    <p>Insufficient insulin production (D)</p> Signup and view all the answers

    In assessing a patient's mental status, what does the 'P' in AVPU stand for?

    <p>Painful stimuli response (D)</p> Signup and view all the answers

    Which type of insulin is used when the pancreas no longer produces any insulin?

    <p>Insulin-dependent insulin (C)</p> Signup and view all the answers

    Which of the following statements about diabetic medications is true?

    <p>Micronase is an insulin medication. (C)</p> Signup and view all the answers

    Which is a correct approach to manage a patient experiencing seizures?

    <p>Placing a pillow under the patient's head. (A)</p> Signup and view all the answers

    What is the most common cause of altered mental status in diabetes patients?

    <p>Hypoglycemia (C)</p> Signup and view all the answers

    What is a potential consequence of untreated hyperglycemia?

    <p>Diabetic ketoacidosis (B)</p> Signup and view all the answers

    Which factor is NOT typically associated with an increased risk of stroke?

    <p>Regular exercise (D)</p> Signup and view all the answers

    What defines insulin-dependent diabetes mellitus?

    <p>The pancreas produces no insulin. (A)</p> Signup and view all the answers

    What is a common assessment tool used to evaluate potential strokes?

    <p>Cincinnati Prehospital Stroke Scale (A)</p> Signup and view all the answers

    Which symptom is NOT typically associated with a stroke?

    <p>Nausea (D)</p> Signup and view all the answers

    In the Cincinnati Prehospital Stroke Scale, what does a positive test for speech involve?

    <p>Patient slurs the sentence (C)</p> Signup and view all the answers

    What should be done for a patient you suspect may be having a stroke?

    <p>Give oxygen and transport to the hospital (D)</p> Signup and view all the answers

    Which of the following is NOT a typical cause of altered mental status?

    <p>Nutritional deficiency (D)</p> Signup and view all the answers

    What initial action is recommended for diabetic emergencies?

    <p>Assessment and airway management (C)</p> Signup and view all the answers

    When assessing a patient for hypoglycemia, which symptom is most indicative?

    <p>Sudden confusion or irritability (D)</p> Signup and view all the answers

    What is the best course of action to manage a seizure for a patient in an emergency?

    <p>Ensure the patient is in a safe environment (A)</p> Signup and view all the answers

    What does the sample acronym stand for in patient assessment?

    <p>Symptoms, Medication, Past history, Last meal, Events leading up (A)</p> Signup and view all the answers

    Which of the following insulin types has the fastest onset of action?

    <p>Rapid-acting insulin (B)</p> Signup and view all the answers

    Flashcards

    Oral Glucose administration technique

    Administering glucose between the cheek and gum or on the tongue depressor, ensuring patient consciousness and swallowing ability.

    Oral Glucose mechanism of action

    Increases blood sugar levels.

    Oral Glucose side effects

    Generally safe when administered properly, but if the patient does not have a gag reflex, it may be aspirated.

    Seizure care

    Protect the patient from harm, ensure an open airway, administer high-flow oxygen, and transport to a hospital.

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    Stroke care

    Maintain a comfortable position, protect the airway, administer high-flow oxygen, and transport to a hospital.

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    Altered mental status causes

    Conditions such as diabetic emergencies, seizures, strokes, and other potential causes.

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    Diabetic Emergency

    A medical emergency related to diabetes, often requiring oral glucose.

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    Reassessment strategies (oral glucose)

    If the patient loses consciousness or has a seizure, remove the tongue depressor.

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    Emergency care assessment

    Evaluating the patient's condition and needs during an emergency.

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    Airway management procedures

    Ensure the airway remains open and clear to facilitate breathing during an emergency.

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    Altered Mental Status

    A change in a person's usual state of awareness, alertness, and ability to think clearly.

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    Hypoglycemia

    Low blood sugar leading to symptoms.

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    Hyperglycemia

    High blood sugar in the body.

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    Diabetes Mellitus

    A disease where the body doesn't produce enough or use insulin properly.

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    Insulin

    A hormone which helps regulate blood glucose.

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    Diabetes Types

    Insulin-dependent (no insulin produced) and non-insulin-dependent (some insulin produced).

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    AVPU

    A way to assess responsiveness based on responses to stimuli (Alert, Verbal, Pain, Unresponsive).

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    Stroke

    Blocked or broken blood vessels in the brain.

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    Seizure

    Sudden, uncontrolled electrical activity in the brain.

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    Hypoxia

    Decreased oxygen levels in the body.

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    Stroke signs

    Sudden weakness/numbness (often one side), confusion, trouble speaking/seeing, headache, difficulty walking.

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    Cincinnati Prehospital Stroke Scale

    A test evaluating speech, facial droop, and arm drift to assess potential stroke.

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    Stroke Speech Assessment

    Ask patient to repeat "The sky is clear in Cincinnati."; slurred speech is positive.

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    Facial Droop (Stroke)

    One side of face/mouth droops during a smile; asymmetry a positive sign.

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    Arm Drift (Stroke)

    One arm drifts down or away when arms are extended and eyes closed; positive sign.

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    Stroke Suspicion Criteria

    Two or three positive from Cincinnati Prehospital Stroke Scale strongly suggest stroke.

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    Stroke Treatment

    Provide oxygen; transport immediately to hospital for rapid treatment.

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    Mental Status Alteration Causes

    Poisoning, intoxication, infection, head trauma, decreased oxygen, or extreme temperatures.

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    Diabetic Emergency Assessment

    Includes scene size-up, initial assessment, focused history (SAMPLE) and physical exam (OPQRST).

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    Oral Glucose Administration

    Giving oral glucose to patients with altered mental status and known diabetes.

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    Unresponsive Patient

    A patient who is not showing any response to stimuli.

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    Unable to Swallow

    A patient who cannot take oral medication or substances by mouth safely.

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    Airway Management

    The process of ensuring an airway is clear and open for breathing.

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    High-flow Oxygen

    A method of delivering oxygen at high concentrations.

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    Oral Glucose

    A quick method of raising blood glucose in patients with diabetes.

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    Assist Ventilations

    Helping a patient breathe when they can't breathe properly.

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    Generic Name of Oral Glucose

    Oral glucose is the generic name.

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    Study Notes

    Diabetes and Altered Mental Status

    • Diabetes and altered mental status is a chapter topic.
    • The overview of the topic includes causes of altered mental status, diabetic emergencies, seizures, stroke, and other possible causes.
    • Emergency care of patients with altered mental status includes assessment, airway management, and treatment for diabetic emergencies.

    AVPU

    • AVPU stands for Alert-oriented, Alert and disoriented, Verbal response, Painful response, and Unconscious.
    • These are used to assess levels of consciousness.

    Causes of Altered Mental Status

    • Hypoglycemia is a cause.
    • Poisoning is a cause.
    • Intoxication is a cause.
    • Hypothermia is a cause.
    • Hyperthermia is a cause.
    • Head trauma is a cause.
    • Infection is a cause.
    • Decreasing oxygen levels (also known as hypoxia) is a cause.

    Diabetic Emergencies

    • Insulin is a hormone that breaks down glucose into usable energy.
    • Insipidus and Mellitus are types of diabetes related to anti-diuretic hormone from the pituitary and blood glucose levels, respectively.
    • Glucose is a basic sugar found in many foods.
    • Diabetes mellitus is a disease where the pancreas fails to produce enough insulin.
    • Two forms of diabetes include insulin-dependent (pancreas produces no insulin) and non-insulin-dependent (pancreas still produces some insulin).
    • Common diabetic medications include Insulin, Humulin, Diabinese, Orinase, and Micronase.

    Blood Sugar Levels

    • Hypoglycemia is a symptomatic decrease in blood sugar concentration.
    • Hyperglycemia is a symptomatic increase in blood sugar concentration.

    Signs and Symptoms of Hypoglycemia

    • Rapid onset of altered mental status.
    • Intoxicated appearance.
    • Elevated heart rate.
    • Cold, clammy skin.
    • Anxiety.
    • Hunger.
    • Seizures.

    Seizures

    • A convulsive body movement or impaired mental state caused by random brain electrical impulses.
    • Common seizure causes include fever, infection, poisoning, overdose, and intoxication.
    • Other causes include hypoglycemia, head trauma, hypoxia, epilepsy, brain tumor, and unknown.

    Stroke

    • Strokes occur when brain arteries are blocked or break.
    • Most strokes (about 85%) are ischemic, caused by blood clots blocking the arteries.
    • Hemorrhagic strokes (about 15%) result from bleeding inside the brain.
    • Stroke signs and symptoms include sudden weakness or numbness (often on one side), confusion, trouble speaking or seeing, headache, difficulty walking.
    • The Cincinnati Prehospital Stroke Scale evaluates speech, facial droop, and arm drift.
      • To assess speech, have the patient repeat "The sky is clear in Cincinnati."
      • Examine facial droop or asymmetry when smiling.
      • Assess arm drift by having the patient close their eyes and hold their arms out straight.
    • Any patient suspected of having a stroke should receive oxygen and be transported immediately to the hospital.

    Emergency Care of Patients with Altered Mental Status

    • Diabetic emergencies: assessment, airway management, oral glucose administration.
    • Scene size-up, initial assessment, focused history and physical exam (SAMPLE, OPQRST).
    • Airway management (positioning, suction).
    • Maintaining and reassessing the patient's airway is crucial.
    • General treatment includes airway maintenance, high-flow oxygen, assisting ventilations as needed, and oral glucose administration.
    • Transport the patient after all necessary actions done.

    Oral Glucose

    • Generic name: Oral glucose
    • Trade names: Glutose, Insta-Glucose
    • Indications: Patients with altered mental status and a known history of diabetes controlled by medication.
    • Contraindications: Unresponsive patients, patients unable to swallow.
    • Administration technique: Order from medical direction, ensure consciousness and swallowing ability, place between cheek and gum, or tongue.
    • Mechanism of action: Increases blood sugar.
    • Side effects: None when given properly, may be aspirated if patient doesn't have a gag reflex.
    • Reassessment strategies: If patient loses consciousness or has a seizure, remove the glucose device from the mouth.

    Seizure Management

    • Protect the patient from the environment.
    • Maintain an open airway.
    • Administer high-flow oxygen.
    • Transport the patient.

    Stroke Management

    • Maintain a comfortable position.
    • Maintain and protect the airway.
    • Administer high-flow oxygen.
    • Transport the patient.

    Summary

    • Overview of causes and emergency care of altered mental status.
    • Specific details on diabetic emergencies, seizures, and stroke, along with related assessments.

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    Related Documents

    Chapter 20: Diabetes and Altered Mental Status PDF

    Description

    Explore the relationship between diabetes and altered mental status through key concepts and emergency care strategies. This quiz covers causes of altered mental status, including diabetic emergencies, and assessment techniques like AVPU. Prepare yourself to effectively manage patients with neurological concerns related to diabetes.

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