Pathologic Conditions
- Definition: A group of syndromes characterized by the inability to metabolize carbohydrates.
- Pathophysiology: There is usually inadequate insulin production (by the beta cells of the pancreas) and/or tissue resistance to insulin, which results in the inability of glucose to enter and nourish body cells. Absence of glucose in the cells results in cellular starvation and in fluid and electrolyte imbalances. The body responds to cellular starvation by breaking down fat and protein, which results in muscle wasting and ketone and lactic acid buildup.
- Etiology: Cause unknown. Most cases appear to be genetic; others may result from a deficiency of beta cells caused by inflammation, malignancies of the pancreas, or surgery. Onset sometimes follows an apparently unrelated infection. Temporary or permanent gestational diabetes may occur during pregnancy.
- Manifestations: Hyperglycemia (elevated blood sugar), glycosuria (sugar in urine), polyuria (excessive urination), polydipsia (excessive thirst), polyphagia (excessive food intake), itching, weight loss, urine SG above 1.020, ketones in urine.
- Med Tx: Diet control, exercise, medications, and glucose monitoring.
- Nsg Dx: Alteration in elimination, alteration in nutrition, potential fluid volume deficit, potential for infection, knowledge deficit, numerous psychosocial diagnoses.
- Nsg Care: Assess frequently for S&S of hyperglycemia, hypoglycemia, dehydration, and acidosis. Provide patient and significant others with extensive education, including specific written information on diet, insulin, exercise, and complications. Provide frequent encouragement and emotional support.
- Prognosis: Varies with age of onset, compliance, and complicating factors, but consistent symptom management usually results in an acceptable quality of life for many years.