Ch.20 Endocrine and Hematologic Emergencies

Question 1

Insulin and Glucagon

Answer 1

Insulin: helps glucose enter cells
Glucagon: Hunger stimulates liver to release glycogen to convert to glucose for fuel

Question 2

Diabetes mellitus

Answer 2

-Impaired ability to get glucose into cells
Impaired insulin production or not enough receptors for insulin to bind to

Glucose can’t enter cell, blood glucose remains high + rises

Question 3

Hyperglycemia

Answer 3

Onset: gradual
SKin: warm and dry
Infection: common
GI:
Thirst: intense
Hunger: present and increasing
Vomiting/abdominal pain: common
Respiratory:
Breathing: DKA -kussmaul
Odor: sweet/fruity
Cardio:
BP: normal or low
Pulse: weak and thready
Nervous:
Consciousness: restlessness, coma, slurred speech, unsteady gait
Treatment:
response: gradual 6-12 hours

Question 4

Hypoglycemia

Answer 4

Onset: rapid
Skin: pale, cool, moist
Infection: uncommon
GI:
Thirst: absent
Hunger: absent
Vomit/pain: uncommon
Respiratory:
Breathing: normal, shallow to ineffective
Odor: normal
Cardio:
BP: normal to low
Pulse: rapid, weak
NErvous:
Consciousness: irritability, confusion, seizure, coma, unsteady gait
Treatment response: immediate after glucose administration

Question 5

Diabetes mellitus type 1

Answer 5

Antibodies against pancreatic beta cells= less insulin
Glucose can’t enter cells
Symptoms:
polyuria: frequent urination
polydipsia: increased thirst
polyphagia: severe hunger

Question 6

Diabeticketoacidosis (DKA)

Answer 6

fat metabolism and ketone production
Abdominal pain, body aches, nausea, vomit, altered LOC

Question 7

Diabetes mellitus type 2

Answer 7

Resistance to effects of insulin at cellular level
Fewer insulin receptors
Obesity
Body makes more insulin to make up for increased blood glucose. Becomes inefficient and blood glucose doesn’t respond to insulin =insulin resistance

Question 8

Type 2 medications

Answer 8

Glipizide
Glyburide
Metformin
Pioglitazone
Exenatide
Sitagliptin

Question 9

Hyperosmolar hyperglycemic nonketotic syndrome (HHNS)

Answer 9

Type 2
hyperglycemia leads to dehydration, fluids discharged out of body through kidneys, kidneys overwhelmed and blood becomes more concentrated

Signs/Symptoms: hyperglycemia, altered LOC, dehydration, visual/sensory deficits, partial paralysis, seizures

Question 10

Long term hyperglycemia

Answer 10

Don’t heal
numbness in hands and feet
renal failure
gastric motility problems

Question 11

hypersmolarity

Answer 11

concentrated blood due to dehydration

Question 12

Hypoglycemia reasons

Answer 12

-Insulin w/o food
-more insulin than needed
-insulin and acute illness
-insulin and routine change-exercise more, late meal

Question 13

AEIOU-TIPS
Altered mental status

Answer 13

Alcohol
Epilepsy, endocrine, electrolytes
Insulin
Opiates and drugs
Uremia (kidney failure)

Trauma, temperature
Infection
Poisoning, psychogenic
Shock, stroke, seizure

Question 14

Sickle cell disease

Answer 14

Hemoglobin S disease
Affects red blood cells
Sharp and misshaped cells means oxygen binding and unintentional clot formation (vasoocclusive crisis)
Short life span of RBCs
Anemia, gallstones, jaundice, vascular occlusion with ischemia

Question 15

Hemophilia

Answer 15

Males inherit from mother carrier
Females from mother carrier and dad has disease
Decreased ability to clot

Question 16

Thrombophilia

Answer 16

Disorder in body’s ability to maintain viscosity and smooth flow of blood
Clogging and blockage issues
Easy clotting

Question 17

Deep Vein Thrombosis (DVT)

Answer 17

Blood clots
Common after Joint replacement
LEg swelling