I think you have correctly identified the diagnosis for this patient in having HHS with the symptoms that where present in the scenario. The main difference between DKA and HHS is that the urine contain no ketones. The patient urine is negative for ketones which is a clinical symptom of HHS. “The difference between DKA and HHS is that ketosis and acidosis generally don't occur in HHS, partly because of the different insulin levels"(Hinkle & Cheever, 2014, p.1445). "HHS the insulin level is too low to prevent hyperglycemia and subsequent osmotic diuresis but is high enough to prevent fat breakdown"(Hinkle & Cheever, 2014, p. 1445)."In DKA, no insulin is present and this promotes the breakdown of stored glucose, protein, and fat, which lead to
During the late 1950’s the space race began. This was a race to see who could achieve the most space firsts, between the USA and Russia. Sonny, O’Dell, Sherman, Roy Lee and Quentin live in Coalwood, West Virginia.The space race inspired these boys, who decide to call themselves the Rocket Boys, to make their own rockets. The BCMA (Big Creek Missile Agency) was born when Sonny called a meeting with his friends in his room and discussed how he wanted to build rockets. With the help from the a man at the town’s machine shop, Mr.Bykovski, the BCMA built its first rocket, called Auk I. The rocket was named after an extinct bird that was unable to fly. Auk I was equipped with a wooden bullet shaped nose cone, an aluminum tubing body, fins, and a soldered washer at the bottom. The boys mixed together black powder and postage stamp glue to act as fuel for their rocket. The rocket flew up 6ft, and then fell back down. The rocket boys later found out that the reason their rocket stopped flying was because the solder melted. The BCMA was happy with the result from the rocket, because it was their first ever rocket to fly.
She had a two week history of feeling generally unwell, complaining of tiredness and lethargy. She had no other significant symptoms. Her past history includes well controlled asthma and anxiety. She was a smoker of 20 cigarettes per day. She was taking amitriptyline, Symbicort (budesonide and formoterol inhaler). She had no significant family history of medical illness and had no clinical findings on examination. Blood tests showed corrected calcium of 4.22mmol/L (NR 2.20 -2.60) with suppressed paired PTH of 1.45pmol/L (NR1.60- 6.9). Her renal function was initially impaired, but normalized with rehydration. Her liver function tests, full blood count, vitamin D, myeloma screen and serum ACE levels were all within normal limits. Ultra sound scan (USS) of kidneys, USS of parathyroid and computerized tomography (CT) of thorax, abdomen and pelvis were all reported as normal with no cause found for her
The poem “Extended Development” by Sarah Kay explores the ways in which the art of photography has changed throughout time, yet still remains a highly important and influential hobby. More specifically, how photography is an important aspect in each member of the speaker’s family. By using allusions, characterization, and imagery, Kay explores how the art of photography has changed throughout time.
HCAHPS is a survey instrument and data collection methodology for measuring patients' perceptions of their hospital experience. The HCAHPS survey can be used as a method of communication to involve the patients in promoting this change by giving insight on their experience. To improve patient experiences of the quality of care, nurses need to know what factors within the nursing work environment are of influence. This will provide a way for nurses to respond to concerns. There is evidence that performing change of shift nursing report at a patient’s bedside helps patients to be more informed and engaged, and may lead to an improvement in patient satisfaction (Sherman & Sand-Jecklin, 2013).
Diabetes mellitus, habitually referred to as diabetes is caused by a decline in insulin secretion by the cells of the pancreatic islet resulting into a surge in blood glucose concentration, a condition known as hyperglycemia. Diabetes insipidus is a disorder defined by the secretion of huge quantities of highly diluted urine, this is regardless if a reduction in fluid intake. This is as a result of a deficit of anti-diuretic hormone (ADH) also known as vasopressin produced by the posterior pituitary gland. The disorder diabetes mellitus is associated by extreme reduction in weight, a higher urge for urination, also known as polyuria, higher levels of thirst (polydipsia) and an extreme craving to eat known as polyphagia. This disorder has been categorized as Type 1 or insulin dependent diabetes and Type 2 or non-insulin dependent diabetes another type is the Gestational diabetes. The Type 1 diabetes mellitus is portrayed by a deficiency of the insulin-secreting beta cells of the islets of Langerhans found in the pancreas, this leads to a shortage of insulin. The principal cause for this deficiency of beta cells is a T-cell mediated autoimmune onslaught. In children, Type1 diabetes is known as juvenile diabetes. The Type 2 diabetes mellitus is as a result of insulin resistance or diminished insulin sensitivity coupled to a reduction in insulin production.
If you believe women suffer systemic wage discrimination, read the new American Association of University Women (AAUW) study Graduating to a Pay Gap. Bypass the verbal sleights of hand and take a hard look at the numbers. Women are close to achieving the goal of equal pay for equal work. They may be there already.
Aid to Families with Dependent Children (AFDC) no longer exists. A new era has arrived and the nation has moved in a completely different direction. In 1996, new legislation, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, was passed. Under this new Act, " The state and local governments wide –ranging autonomy, discretion and responsibility for serving poor women and children were returned to them. It does this by repealing AFDC, the nation’s welfare employment program (the Job Opportunity and Basic Skills Training Program), and the AFDC emergency assistance program. In its place, Congress and the president have authorized an unprecedented amount of block grant funding to states through Temporary Assistance for Needy Families (TANF)".
This occurs when the systemic arterial blood is above 26mEq/liter and the blood pH is above 7.45 (Tortora, 2014). The cause of metabolic alkalosis is too much bicarbonate in the blood, prolonged vomiting, and extreme lack of potassium. When the regular compensatory mechanisms are not working, respiratory compensation through hypoventilation help bring back pH level to normal leaving HCO3- high. Lung assist in compensatory mechanism. Treating metabolic alkalosis consist of correcting Cl-, K+, and other electrolyte deficiencies by providing fluid solutions. Older age compromises the acid-base balance in metabolic alkalosis due to inadequate fluid intake of more water than Na+ which occur through vomiting, feces, or urine. These changes are associated with the kidney.
officials spend $ 200,000 a year, and a $ 100,000 insurance policy in one year adds
Diabetes Insipidus is the less known form of diabetes. It is often accompanied by excess urine outflow, intake of fluid, and an increased thirst. Bedwetting due to lack of control and frequency, and an unusual concentration of urine is included. There are four types of DI, and each are completely different in treatment and causes. Most commonly, the cause is the lack of vasopressin, which concentrates urine to reduce its output. It is called pituitary DI because it is usually caused by the destruction of the back of the pituitary gland. It cannot be cured, but drugs can help with symptoms. Gestational DI is caused by pregnancy and usually disappears a few weeks after delivery. The placenta uses the vasopressin too fast and causes it. The symptoms are repressed the same way as pituitary DI. The third type of DI is caused by the kidneys inability to respond to the effects of vasopressin, called nephrogenic DI. It is resulted from drugs against kidney diseases, and could (or could not) be cured only by eliminating the drug or disease. Drugs can be prescribed to alleviate some of the symptoms. The fourth, primary polydipsia, is caused by excessive intake of fluids and has two subcategories. Dipsogenic DI is most common and usually associated with an abnormality in the brain that regulates thirst. Psychogenic polydipsia is caused by psychosomatic issues. Neither one can be completely treated.
The root cause of all of these symptoms is probably the same (Sizer and Whitney 113). Late symptoms include hypotension, oliguria (secretion of a diminished amount of urine in relation to fluid intake) or anuria (the complete suppression of urinary secretion by the kidneys) (American Diabetes Association).... ... middle of paper ...
body a person has low blood pressure, low blood sugar, high potassium, low sodium, and a rapid
Diabetes mellitus(DM) is the most common form of diabetes. DM is a disturbance in metabolism and malfunction in the beta cells of the pancreas that causes a disruption in the use of glucose. Beta cells are responsible for making insulin, and because the insulin is used to metabolize carbohydrates, proteins, and fats, diabetes mellitus can cause a disruption in anyone of these. Diabetes mellitus is not solely tired to just the disruption of glucose, even though this disruption is the underlying issue regardless of the type of diabetes. The discrepancy in insulin, and the body's failure to metabolize sugar and starch, sugar starts to accumulate in the blood and urine. The by-products of the alternative fat metabolism disturbs the acid-base balance of
Some of the symptoms associated with type II diabetes include polyuria, polyphagia, and polydipsia. At diagnosis, 33 percent of patients have ketonuria, and 5 to 25 percent have ketoacidosis, both of which can be tested for by simple urinalysis (American Diabetes Assoc. 2000). Most patients of T2DM are obese with little to no weight loss, which allows doctors to distinguish them from type I diabetics. The total lack of insulin among type I diabetics, or insulin dependent diabetics, will result in problems in the storage of fat and mu...
The diagnosis of both EDS and LDS is a bit of a dilemma as it involves taking into account the signs and symptoms that can be elicited after testing a patient with oral glucose, hydrogen breath tests, which are quite sensitive, and endoscopy or barium swallow studies to discern the anatomy of the gastrointestinal (GI) tract. Laboratory studies are rarely, if ever, helpful in being able to establish the diagnosis of DS. However, possible laboratory findings can be obtained from biochemical panels and anemia and decrease albumin levels may be discovered in patients that are malnourished.