Hypo & Hyper glycemia ,Hypo & hyper natremia presented bye muhamma saeed anesthesia technologist

2. Presentedby: MUHAMMADSAEED
Anesthesia Department AHS 6th
presented to sir irshad awan & ahs 1
BASHIR INSTITUTE OF MEDICAL SCIENCE
ISLAMABAD

3. Hypoglycemia and
Hyperglycemia
Hyponatremia &
Hypernatremia

4. HYPOGLYCEMIA:
◉Hypoglycemia is “deficiency of
glucose in the bloodstream”
◉Hypoglycemia is a condition caused
by a very low level of blood sugar
(glucose)
◉Most people feel symptoms of
hypoglycemia when their blood sugar
is 70mg/dL or lower

5. CAUSES OF HYPOGLYCEMIA
◉Hypoglycemia is often related to the treatment of diabetes
◉Taking too much insulin or diabetes medication
◉Not eating enough (Starvation)
◉Increasing exercise or physical activity without eating more
◉Drinking alcohol
◉Pituitary insufficiency
◉Liver failure

6. SIGN & SYMPTOMS
 Confusion * Dizziness
 Feeling shaky * Hunger
 Headaches * Irritability
 Tachycardia * Pale skin
 Sweating * Weakness
 Anxiety * Comma
 Seizures * Death

7. TREAMENT OF HYPOGLYCEMIA
◉ There are many ways to receive glucose, including:
 Injecting glucose (50% glucose (each milliliter of 50% glucose will raise the .
. blood glucose of a 70-kg patient by approximately 2 mg/dL)
 Drinking fruit juice
 Eating carbohydrates

9. “Hyperglycemia” also known as high blood sugar, is a condition in which an
excessive amount of glucose circulates in the blood plasma
If fasting blood glucose level is >130mg/dL, a common diabetes
complication
If postprandial (1-2 hours after eating) blood glucose level is >180mg/dL
HYPERGLYCEMIA

10. .
CAUSES OF HYPERGLYCEMIA
◉Diabetes Mellitus (Low insulin or Insulin resistance)
◉Certain medications increase the risk of hyperglycemia (corticosteroids, beta
blockers, epinephrine, thiazide diuretics, statins)
◉Dysfunction of the thyroid, adrenal, and pituitary glands
◉Hormones such as the growth hormone, glucagon, cortisol and catecholamines, can
cause hyperglycemia when they are present in the body in excess amounts

11. SIGN AND SYMPTOMS
.
 Polyphagia – frequent hunger
◉Polydipsia – frequent thirst
◉Polyuria – increased volume of urination
◉Blurred vision
◉Fatigue
◉Restlessness
◉Weight loss
◉Poor wound healing
◉Dry mouth
◉Dry or itchy skin
◉Tingling in feet or heels
◉Coma
◉Seizures

12. ..
TREATMENT OF HYPERGLYCEMIA
◉Treatment of hyperglycemia requires elimination of the underlying cause
◉Incase of diabetes mellitus
Acute hyperglycemia – Insulin Administration
Fluid replacement
Electrolyte replacement
Severe hyperglycemia can be treated with oral hypoglycemic therapy and
lifestyle modification

13. Hyponatremia is decrease in serum sodium concentration <136 mEq/L
Hypovolemic Hyponatremia: Drainage of water from body with sodium ions
(Na+) e.g. due to diarrhea, vomiting, sweating, diuretics, trauma, sepsis
Euvolemic Hyponatremia: Concentration of Na+ Remains same with increase
in body fluid volume e.g. due to Fluid overload, massive blood transfusion
.

14. SIGN AND SYMPTOMS
Nausea
Vomiting
Lethargy
Fatigue
Muscle weakness
Spasms or cramps
Irritability
Headache
Short-term memory loss
Confusion
Seizures
Decreased consciousness or coma

15. TREATMENT:
◉Understanding of CNS condition e.g. seizure, confusion, comma
◉Alteration of osmolarity by introduction of
0.5 mEq/L Na+ ions in one hour
◉Don’t increase Na+ ions more than 10 mEq/L in 24 hour or 18
mEq/L in 48 hours
◉Treat Underlying etiology and manage symptoms

16. ◉Hypernatremia is a common electrolyte problem that is defined as a rise in
serum sodium concentration to a value exceeding 145 mmol/L
◉Types of Hypernatremia
1.Hypervolemic Hyponatremia (Hypervolemic Hyponatremia is caused by
excessive intake of Na+ due to Hypertonic IV fluids)
2.Euvolemic Hypernatremia (Euvolemic Hypernatremia is caused by diabetes
insipidus (excessive urine loss) is called Euvolemic Hypernatremia as Na+ in
body is as per body demand

17. ◉Inadequate intake of water e.g. in elderly or disabled patients
◉Excessive loss of water e.g. Glycosuria, Osmotic diuretics,
sweating, diarrhea
◉Diabetes insipidus (Excessive urine formation)
◉Intake of Hypertonic fluid

18. SIGN AND SYMPTOMS
◉The major symptom is thirst
◉The most important signs result from brain cell shrinkage
and include
◉Confusion
◉Muscle twitching or Spasms.
◉With severe elevations, seizures and comas may occur

19. TREATMENT
◉Treat the underlying cause
◉Stop administration of hypertonic fluids
◉Treat Diabetes insipidus
◉Hypervolemic
◉i) Dextrose 5%
◉ii) Loop Diuretics (furosemide)
◉Euvolemic
◉i) Treatment of Diabetes Insipidus
◉iii)Dextrose 5%