cause of diaphoresis

[Ms.RN]

hello everyone

i have a question about one of my patient i had the other day. this patient is a brittle diabetic patient. when i took care of her, she was diaphoretic and her gown was wet. i checked her blood sugar and it was over 400 and i gave her coverage with short acting. i rechecked her blood sugar and it went down. to 120. but she was still very diaphoretic. her face was wet with sweat, her gown was also wet. i checked her vitals, her blood pressure was little elevated to 150/80. pulse 80, and temp was normal, 98.7, pulse ox 97% in ra. she just complained that she is not feeling well. so waht do you think is causing this?

[rnmi2004]

It could be something minor, like she had a fever that broke. Or it could be more serious, like an acute MI or PE. The patients I have seen that have been coded or near codes have been very diaphoretic and couldn't really verbalize a specific feeling, just "not feeling well." It is something that warrants further investigation!

[EricJRN, MSN, RN]

Had it happened to her before? What other meds does she take?

[jnrsmommy]

How long after you gave the insulin did you recheck bs? I would imagine the diaphoresis was due to hyperglycemia, but then afterwards might've been due to the rapid drop if was pretty soon afterwards. Might also be the reason for not feeling good. Again, this is all assuming that there was a rapid drop in bs.

[RNcDreams]

Was the patient having chest pain?

Shortness of breath?

Shakiness?

Belly or back pains?

Did they have too many blankets on?

Was the room hot?

(Those last two might sound silly, but there are a few rooms in my department that are STIFLING.... and a patient with a fever feels the chills, so we tend to cover them up without thinking.. and then when the fever breaks, POOF they sweat.. under all 5 blankets.)

[jlcole45]

Was she taking narcotics? Like Percocet? I've noticed that many patients who are taking narcotics say post op, develop sweats afterwards.

[aeauooo]

There are neurological reasons for diaphoresis (e.g. diffuse axonal injury, autonomic dysreflexia), but nothing that you described would fit those categories.

Oh, and my favorite: the sweating stage of a malarial paroxysm!

[Ms.RN]

oh, and my favorite: the sweating stage of a malarial paroxysm!

huh???? what is malarial paroxysm????????????:thnkg:

[aeauooo]

what is malarial paroxysm?

if you've ever had one (i have), it's something you will never forget.

the stages are:

1. shivering - pulling as many blankets over you as you possibly can find, but still feeling like you're freezing

2. the hot stage - you throw all of those blankets off because now you are burning up

3. the sweating stage. the first time i had malaria i woke up the morning after my paroxysm and felt fine, but the matress i had been sleeping on was drenched with sweat.

if you don't treat it, you'll feel fine until you have another paroxysm 48 or 72 hours later - depending on species.

of course, that's a classic paroxysm. p. falciparum often does not cause paroxysms - sometimes it's just feeling kind of crummy until you go into a coma and die - and yes, i have had falciparum malaria.

[leslie :-D]

i automatically suspected mi, knowing that women do not present classically.

either way, she said she wasn't feeling well, combined w/the diaphoresis, i would have pursued this with the doc...

at least get a strip running.

leslie

[Zookeeper3]

diabetics can have silent deadly MI's. Diabetics do not present with classic signs and symptoms. Diaphoresis makes me worry, you can't fake it. Did the patient have a temp, low or high?

interesting,,,

[Ms.RN]

diabetics can have silent deadly mi's. diabetics do not present with classic signs and symptoms. diaphoresis makes me worry, you can't fake it. did the patient have a temp, low or high?

interesting,,,

found out this patient had infection in her stool and in her wound. but when i assessed her, she did not have a fever.