ABSTRACT
Acute complications of diabetes are like a runaway roller coaster. Diabetes or its treatment can rocket your patient's blood glucose level to dizzying heights or plunge it to life-threatening lows. Hypoglycemia, the most common endocrine emergency, typically occurs in a known diabetic patient whose therapy with insulin or oral diabetes agents goes awry. At the opposite extreme, soaring blood glucose levels mark the acute conditions diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic nonketotic state (HHNS). These complications may send the patient to the emergency department (ED) before he even knows he has diabetes. In this article, I'll explain how these problems develop and spell out nursing measures to get your patient back on track.
Subject(s)
Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/complications , Diabetic Ketoacidosis/nursing , Hyperglycemic Hyperosmolar Nonketotic Coma/nursing , Hypoglycemia/nursing , Aged , Blood Glucose/analysis , Diabetic Ketoacidosis/blood , Diabetic Ketoacidosis/etiology , Emergencies , Female , Humans , Hyperglycemic Hyperosmolar Nonketotic Coma/blood , Hyperglycemic Hyperosmolar Nonketotic Coma/etiology , Hypoglycemia/blood , Hypoglycemia/etiology , Nursing Assessment/methodsABSTRACT
Older adults with heart failure have extensive and complex care needs. This article presents a framework for assessment and intervention with this fragile patient group. Comprehensive assessment of elders with heart failure includes gathering information about care, advocacy, and knowledge needs. Nursing interventions are focused on providing direct care, counseling, teaching, and advocacy. The unique role of the advanced practice nurse in discharge planning and home follow-up of elders with heart failure is emphasized.
