PATHOPHYSIOLOGY

Ingestion of Food.

Food enters the

GI tract and
gets digested.

Carbohydrates Broken down by

are broken down enzymes: Amylase
into glucose. and Maltase.

Glucose enters

NORMAL
the blood stream
(Absorption)

The hypothalamus
senses high glucose
levels in the blood

Signals the Pancreatic

b-cells and trigger
insulin release.

Insulin the blood Insulin acts as

attaches to insulin “Keys” to the
receptors in the organ tissues’
organ tissues. insulin receptors.

This allows glucose

to enter the tissues,
reducing glucose
levels in the blood.

Continuous intake
of high
Carb/Starchy food.
 Increased release of
insulin in the blood.

Continuous release
of insulin wears out
the insulin receptors PRECIPITATING FACTORS
in the tissues. Age
Family History
The tissue organs will
POLYPHAGIA INSULIN RESISTANCE
ask for more glucose.

PREDISPOSING FACTORS
The tissue cells won’t
Lifestyle
respond to the insulin
Obesity
and will stop
receiving glucose.

The pancreas will

still continue
insulin production
to compensate.
The increase production of
insulin forces the receptors
to minimally open and HYPERINSULINEMIA
receive some glucose.

Overworked b-cells Pancreatic b-cells

will dysfunction, will lose its ability
overtime. to produce/release
insulin.

Insulin levels in the The liver will release

blood will decrease, glucose to compensate
while glucose levels to the loss of glucose
continue to rise. in the tissues.
 BLOOD CHEMISTRY FBS Glucose will only stay
in the blood because BLOOD CHEMISTRY
Hemoglobin A1C 10-13-2022, 5 am HYPERGLYCEMIA the tissues can no
High, >15 (4.2-6.2%) longer receive it. Creatinine
The amount of glucose attached to hemoglobin = 189mg/dL (61.88-123.76mmol/L)
High, 383.50 (October 9, 2022)
High, 248.40 (October 10, 2022)
Increased creatinine may be a sign of poor Kidney
MEDICATION Function.
GOOD MICROSCOPY
Insulin 70/30 DIABETESMELLITUS II Unclassified Cast
PROGNOSIS 20units AM High 2 (0-1/LPF)
10 units PM High Casts are a sign of many types of Kidney
Diseases

BLOOD CHEMISTRY

Creatinine
(61.88-123.76mmol/L)
High, 383.50 (October 9, 2022)
High, 248.40 (October 10, 2022)
Increased creatinine may be a
sign of poor Kidney Function.
MICROSCOPY
Unclassified Cast
High 2 (0-1/LPF)
High Casts are a sign of many
types of Kidney Diseases
MEDICATION
Allopurinol
10mg/tab q12H
Kidneys fail to Low Glucose levels in High glucose levels in Glucose in the blood
secrete uric acid. the tissue organs. the blood causes low will travel to the
immunity through kidneys for secretion.
different mechanisms.
Poor blood circulation
Uric acid
due to viscous blood. GLUCOSURIA
accumulation.
Hyperglycemia promotes
the production of Glucose will drag
destruction molecules in
Inadequate oxygen Osmotic Diuresis water with it
the body (Free Radials). because it is a
HYPERURICEMIA and glucose in the
tissue organs. solute.

POLYURIA
FATIGUE This interferes with the
BLOOD CHEMISTRY body’s natural defense
mechanism and hobbles its
Blood Uric Acid ability to fight infection.
Fatigue Related to hyperglycemia as evidenced
High, 633.10 (214.2-458.15mmol/L)
by High HbA1c level and FBS Result.
Too much uric acid in the blood can
• Monitor Vital Signs The impaired defense
cause joint pain or gout and form
• Assess levels of activity and behavior of mechanism makes way
kidney stones.
patient by asking the watcher. for bacterial and viral
• Promote overall health measures such as infections in the body.
nutrition, adequate fluid and intake of
food.
• Monitor Blood Sugar levels.
 PRECIPITATING FACTORS PREDISPOSING FACTORS

Socio Economic Status Poor Sanitation

Poor Hygiene
Ingestion of Raw food.

Transmission:

Person-Person
Direct and Indirect
Fecal Oral

Etiologic Agent:
Patient’s Etiologic Agent Rota Virus
Fecal Analysis: Norovirus
None Found Enteric Adenovirus

MEDICATIONS
The pathogen invades
Ciprofloxacin Hydrochloride 200mg IV q12 the Gastrointestinal
Omeprazole 40mg IV OD wall.
Metronidazole 500mg IV infusion q8H

WBC will try to destroy the The pathogen will attack the
Irritation if Release of internal pathogens attacking the cells, epithelial cells in the GI wall,
Hypothalamus pyrogens. making a debris and blocking the killing and destroying the cells.
absorption of fluid.

Alteration of
thermoregulation. This stops the absorption of fluids,
increasing the amounts of fluid
retained in the GI tract.
FEVER

Water/Fluid remains
unabsorbed.

The body needs to

remove all the retained
fluid.
 ACUTE GASTROINTERITIS ABDOMINAL PAIN DIARRHEA

HEMATOLOGY
Hgb Low 12.5 (14.0-17.0gms%) Deficient Fluid Volume related to
-Low Hgb can be signs of Anemia Fluid Loss secondary to Diarrhea Fluid Loss
Hematocrit Low 38.62 (42-52%) • Encourage patient to increase
-Low Hematocrit are signs of Anemia
RBC Low 4.27 (4.7-6.1x10^12/L) fluid intake.
-Low RBC are signs of Anemia • Monitor INO and IV Dehydration
WBC High 15.3 (5-10x10^9/L) • Provide health teaching on
-High WBC are signs of infection or inflammation. avoidance of Dehydration.
Neutrophils High 80.3 (40-73%)
-High Neutrophils are signs of infection. Left Untreated
Lymphocytes Low 11.1 (15-45.5%)
-Low lymphocytes are signs of infection. Poor Skin turgor
Eosinophils Low 0.393 (0.50-7.0 Thirst
-Low eosinophils can be the result from alcohol or excessive Dry Mucus Membrane Low fluid in the body triggers
production of cortisol. Severe Dehydration the intestines to remove extra Constipation
Skin is Dry
FECALYSIS water from the stool
Color Brown, Consistency Soft, Parasite or Ova None Seen

Loss of Plasma
BLOOD CHEMISTRY
Blood Urea Nitrogen High 9.02 MEDICATIONS
Arterial Low Venous Reduction of ELECTROLYTE (1.01-3.49mmol/L)
HYPOVOLEMIA Sodium
Hypotension Return Circulatory Blood IMBALANCE Elevated BUN can be cause by
Dehydration. Bicarbonate
Sodium Low 134.19 400mg/tab TID
Reduced Perfusion (135-155mmol/L)
Hyponatremia occurs when
concentration of Sodium in your blood
is low, drinking too much water cab
Anaerobic
cause low sodium by overwhelming
Metabolism
the kidney’s ability to excrete water.

Produce Acidosis Accumulation of

Lactic Acid

Low oxygen equals

heart muscle fatigue.
MEDICATIONS

Norepinephrine
Myocardial
16mg+PNSS 250cc @
Dysfunction
10cc/hr; titrate to attain
BP >90/60
 Ineffective Tissue Perfusion related to Diminished
Low Cardiac Output
Venous Return as evidenced by delayed Capillary
Refill, Cold Clammy Skin, Pale Color and Clubbing
of Fingers.
• Assess VS, Capillary and ECG Cold Clammy Skin
• Assess Skin Color and Temperature. HYPOVOLEMIC SHOCK Clubbing of Fingers
• Assess for rapid changes or continuous shifts Pale Color Skin
in mental status.
• Record BP readings for orthostatic changes.
• Monitor Hemoglobin
• Determine Pulse Equality and Intensity,
POOR
Compare Bilaterally.
PROGNOSIS
• Advice to avoid strenuous activities.

Precipitate Multi
Organ Failure

Kidney
Liver Dysfunction Spleen Damage
Dysfunction

DEATH