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Nursing Pharmacology > C9-Endocrine System Pt1 > Flashcards

C9-Endocrine System Pt1 Flashcards

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1
Q

Endocrine system

A

Pancreas
Thyroid
Adrenal gland
Pituitary gland

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2
Q

Pancreas Produces:

A

Insulin
Glucagon

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3
Q

Thyroid gland produces

A

Thyroid hormones
T3
T4

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4
Q

Adrenal Gland produces:

A

Corticosteroids
from the cortex

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5
Q

Pituitary Gland Produces:

A

Anterior pituitary
TSH
ACTH

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6
Q

Pancreas Alpha cells create:

A

Glucagon (hyperglycemia)

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7
Q

Pancreas Beta Cells produce:

A

Insulin
(hypoglycemia)

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8
Q

Diabetes Mellitus (DM) is deficient in

A

Carbohydrate metabolism
(can’t metabolize)

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9
Q

What are the 3 POLYS discussed with DM?

A

Polyuria (excessive urine)
Polydipsia (extreme thirst)
Polyphagia (excessive hunger)

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10
Q

Type 1 Diabetes

A

Destruction of pancreatic beta cells
Juvenile onset
Produce no insulin

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11
Q

Type 2 diabetes

A

Non insulin dependent
Mature onset diabetes of the young (MODY)
Adult onset
Insulin resistant

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12
Q

Gestational diabetes

A

Increased hormone levels during pregnancy can inhibit insulin usage

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13
Q

Secondary Diabetes

A

Result of other medications
steroids
diuretics

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14
Q

Insulin administration

A

Given subcutaneous or IV
not effective orally

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15
Q

Insulin Naturally occurring from the

A

Pancreas (beta cells)

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16
Q

Insulin absorption rates vary, what is the fastest absorption site?

A

Abdominal

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17
Q

Insulin absorption rates vary, what is the slowest absorption site?

A

Thigh

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18
Q

Insulin absorption varies according to what?

A

Injection site
Blood supply
Degree of tissue hypertrophy at injection site

Exercise increases absorption

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19
Q

Insulin therapeutics (what does it help?)

A

Diabetes
Type 1 or (2 not common unless necessary)
Hyperkalemia
increased influx of K+
Emergency
DKA
diabetic ketoacidosis

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20
Q

Insulin Action

A

Moves glucose into ell
used for Krebs cycle
changes ADP into ATP
Lowers blood glucose
glucose can be stored as glycogen
can be converted into fat for storage
Lowers level of K+

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21
Q

Insulin is classified by concentration, what are the different dosages? Which is most common?

A

U100 (most common) 100 units/mL
U200
U500
*USE APPROPRIATE SYRINGE!
(different colors for different doses)

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22
Q

Rapid Acting Insulin Name:

A

Aspart Lispro (Humulog Novolog)

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23
Q

Short Acting insulin name

A

Regular (Humulin R)

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24
Q

Intermediate acting insulin name

A

NPH= Isophane
(Humulin N)

** CLOUDY **

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25
Q

Constant acting Insulin name

A

Lantus (glargine)

Detemir

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26
Q

Rapid acting insulin ONSET

A

15 mins

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27
Q

Rapid acting insulin PEAK

A

1-3 HOURS

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28
Q

Rapid acting insulin DURATION

A

3-5 HOURS

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29
Q

Short acting insulin ONSET

A

0.5-1 HOUR

30
Q

Short acting insulin PEAK

A

2-4 HOURS

31
Q

Short acting insulin DURATION

A

6-8 HOURS

32
Q

Intermediate acting Insulin ONSET

A

1-2 hours

33
Q

Intermediate acting Insulin PEAK

A

6-12 HOURS

34
Q

Intermediate acting Insulin DURATION

A

18-24 HOURS

35
Q

Constant insulin ONSET

A

Irrelevant because constant overlaps

36
Q

Constant insulin PEAK

A

NONE

37
Q

Constant insulin DURATION

A

> 24 HOURS

38
Q

When mixing insulin, what is the rhyme to help you know which order to draw up first?

A

Draw up the CLEAR (fast-acting)

Before the CLOUDY (long-acting)

39
Q

Adjust client’s dosage of insulin on a sliding scale, increase it with:

A

Increased calories
Infection
Stress
Growth spurts
2nd and 3rd trimester

40
Q

Adjust client’s dosage of insulin on a sliding scale, decrease it with:

A

NPO/ fasting
Exercise
1st trimester

41
Q

Give mixed insulin within ___ mins of mixing:

A

15 mins

42
Q

Before administering insulin check the clients ______________

A

Blood glucose

43
Q

Insulin complications: Hypoglycemia results from (list situations)

A

Reduced intake of food
Vomiting/diarrhea
Intensive exercise
Childbirth

44
Q

Insulin complications: Lipodystrophy results from

A

Lipoatrophy
Lipohypertrophy

ROTATE INJECTION SITES

45
Q

Insulin complications- Hypokalemia causes

A

Arrhythmias

46
Q

Drug interactions: Hypoglycemic agents

A

Sulfonylureas
Glinides
Beta Blockers
hide signs & symptoms of low blood sugars
Alcohol

47
Q

Drug interactions (insulin): Hyperglycemic agents

A

Thiazide/Loop diuretics
Glucocorticoids
(inc. Blood glucose)
Sypathomimetic drugs

48
Q

Hypoglycemia definition:

A

Insulin shock
Very low blood glucose

49
Q

Hypoglycemia treatment: (conscious)

A

15:15 rule
15g oral sugar (fast acting)
Recheck glucose in 15 mins
Repeat as needed

50
Q

Hypoglycemia treatment: (unconscious)

A

Dextrose
Glucose IV 10%-50%
Glucagon

51
Q

Hyperglycemia: (DKA)

A

Diabetic ketoacidosis
more common in type 1
300-500 blood glucose level

52
Q

Hyperglycemia: HHNC

A

Hyperosmolar hyperglycemic nonketotic coma
(more common in type 2)
800-1000 blood glucose level

53
Q

Bicarbonate reverses ________

A

Acidosis

54
Q

Hypoglycemia: Signs and symptoms

A

Sweating (Diaphoreis)
Trembling/shaking
Anxiety
Tachycardia
Hunger/ overactive abdominal sounds
Nause/vomiting
Dizziness
Confusion
Headache

55
Q

Hyperglycemia: Signs and symptoms

A

Warm/dry skin
Dehydration
Acetone breath (DKA)
Confusion
Comatose
Polyuria

56
Q

Blood Sugar rhyme: (15:15 Rule)

A

Hot & Dry = Sugar High

Cold & Clammy = Need some candy

57
Q

Hypoglycemic Treatment : (2) drugs

A

Glucagon
Dextrose in water

58
Q

Glucagon comes from

A

Pancreatic alpha cells

59
Q

Glucagon increases blood sugar by

A

Stimulating glycogen breakdown

60
Q

Glucagon Routes of administration

A

Sub Q
IM
IV

61
Q

Dextrose in water different concentrations

A

5%
10%
50%

62
Q

Oral anti-diabetics treat which type?

A

Type 2 only

63
Q

Oral Anti-Diabetics: action

A

Increase insulin release
Or
Reduce insulin resistance

64
Q

Oral Anti-Diabetics therapeutic goal

A

Lower blood sugar
moderate rise after meals

65
Q

Oral Anti-Diabetics medications

A

Metformin
Glipizide/glyburide
Acarbose
Sitagliptn

66
Q

Oral Anti-Diabetics: Sulfonylureas (medication)

A

Glipizide
Glyburide

67
Q

Oral Anti-Diabetics: Sulfonylureas (nursing)

A

Give daily with first meal

Use caution with sulfa allergies

68
Q

Oral Anti-Diabetics: Sulfonylureas (action)

A

Stimulate pancreas to release insulin
Increases sensitivity of insulin receptors

69
Q

Oral Anti-Diabetics: Sulfonylureas (side effects)

A

Hypoglycemia
Pregnancy cat. C/lactation

70
Q

Oral Anti-Diabetics: Sulfonylureas (interactions)

A

Sulfonamides
Insulin
Thiazide/loop diuretics
Alcohol

71
Q

Mixed insulin

A

Humulin 70/30

Nursing Pharmacology (11 decks)

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