• Reduce the disease and economic burden of the disease
• Improve the quality of life for people that have or are at risk for Diabetes.

• insulin secreted when blood glucose is high to lower it
• Glucogon is secreted when blood glucose is low to retain glucose

• Absence of insulin
• Beta cell destruction
• occurs in childhood
• believed to be genetic

Type 2 diabetes

• most often after 45 yrs of age
• most common type (90-95%)
• slow progressive disease resulting from insulin resistence
• Risk factors of overweight, stress Hyperglycemia, inactivity, age and family history

• associated with Hypertenstion, Low HDL, obesity and impaired glucose levels

• Risk factors that raise your risk for heart disease, diabetes and stroke.
• Obesity, hypertenstion,age, hyperglycemia.

Hyperglycemia that develops during pregnancy

Risk factors

• Age
• obesity
• certain ethnicities
• family history

• Polyuria - urination
• polydipsia - thirst
• polyphagia - hunger

the body's process that balances heat loss and gain to maintain the body temp.

core temp is constant and surface can change based off the enviroment.

• stress 
• hormones
• metabolic rate
• Infection

less subcutaneous fat and blood vessels are closer to the skin

Children are more effected by the enviroment until puberty

• Glucose 70-110 mg/dl
• Creatinine .5 - 1.2 mg/dl
• Blood urea nitrogen 7-20 mg/dl
• Sodium 135-145 mEq/l
• Potassium 3.5-5.3 mEq/l
• chloride 95-105 mEq/l

• Pancreas changes in ability to metabolize glucose and ability to produce/sensitivity to insulin
• Thyroid changes - lower metabolic rate, hyperthyroidism and able to feel nodules
• Adrenal medulla can cause hypertension
• Pituitary  - reduced production of hormones like estrogen and and progesterone.

Hematocrit

Lab levels

Ratio of red blood cells to total volume of blood

HGB

M: 13.8-18 g/dl

F: 12-16 g/dl

Both go down with blood loss

Hct 

m:37-49%

F: 36-46%

up with dehydration and down with overhydration.

Life threatening levels of fluid loss

infant 70-80%

adult 50-60

elderly 45-55

the hypothalamus

and sensitivity to thirst decreases in elderly

no tears

delay in skin turgor

capillary refill greater than 3 seconds

unresponsive or lethargic

weightloss

orthostatichypotension

rapid weak pulse

decreased skin turgor

altered LOC

increased temp

Fluid replacement oral or iv

vital signs 

daily weight

I and O

assess and monitor labs

assess skin turgor in the forehead and sternum because of slower refill in extremities

Check I and O, daily weight and interactions with medications.

Increased fluid intake

increased sodium intake

heart failure

renal failure

cirrosis of the liver.

weight gain

jugular distention

tachycardia

s3 heart sound

increase in pulse

abnormal lung sounds

decreased Hct

confusion

early detection

daily weights

strict i&o

monitor labs

assess lung sounds

assess adema

Sodium

and lab levels

90% of ECF fluid

kidneys are primary regulators

causes cognitive impairment

lab levels

135-145 mEq/L

Potassium

and lab levels

Primary for intracellular fluid

critical for cardiac muscle

mostly excreted by kidneys

3.8-5.3 mEq/L

too high or too low result in cardiac arhythmias

Calcium 

and lab levels

ca++ serum is 9-11 mEq/L

ionized is 4.25-5.25 mg/dl

necessary for bone, teeth and muscle contraction, blood coagulation and nerve impulses

Found in dry peas and beans, milk and milk products and green leafy vegetables.

Magneslium

and lab levels

1.5-2.5 mEq/L

used to prevent convulsions from preclampsia

and muscle cramps.

Phosphate

and lab levels

essential to form ATP

1.7-2.6 mEq/L

Chloride

and lab levels

95-105 mEq/L

Helps form hydrochloric acid in stomach