Diabetes, Thyroid, Antibotic Lecture Notes

Question 1

Hypoglycemia

Answer 1

Low blood sugar, agitated, shaky, stumbly, unresponsive, can be confused with drunk or head injury
>20 dangerous
PUSH SUGAR drink juice, pure sugar packets, honey

Question 2

If someone is agitated, stumbly, shaking, tachy, confused what is the first thing you should do?

Answer 2

Obtain blood sugar to rule out hypoglycemia. Then could look into ETOH and TBI

Question 3

Type 1 Diabetes

Answer 3

Chronic insulin dependent condition, normally onset as a child or adolescent

Question 4

Type 2 Diabetes

Answer 4

Chronic onset, different in every body, some controlled through diet, some through PO medications and some are insulin dependent

Question 5

Drug does not play nice!!

Answer 5

Erythromycin, stop and look up medication interactions, inform doc

Question 6

How do you know an antibotic is working in a patient

Answer 6

They are feeling better, have an appetite, more energy, fever goes down

Question 7

Hot and Dry
Cold and Clammy

Answer 7

Hot and dry - Sugar High
Cold and Clammy - Need Candy

Question 8

What will always increase the blood sugar levels

Answer 8

Steroids and Cortisol

Question 9

How do you prepare NPH insulin

Answer 9

Cloudy, needs to be rolled before drawn, DO NOT SHAKE

Question 10

Mother calls and states her child was put on amoxicillin for strep a few days ago and now has a rash

Answer 10

DOCUMENT
Educate that patient needs to be seen. Could be an indication for Steven Johnson Syndrome.
Any child with a rash needs to be seen.

Question 11

Bacteriostatic

Answer 11

Stop the spread of bacteria, and bacterial growth

Question 12

Hyperglycemia Signs

Answer 12

High blood sugar, not as life threatening, long term could have stroke/clots
Lots of drinking, lots of peeing, lots of eating
Fruity breath

Question 13

Peaks and Troughs

Answer 13

Lab values drawn to make sure patient is in therapeutic range. Peaks drawn 30 minutes after infusion and troughs 30 minutes before next infusion is due. Commonly ordered for Gentamicin

Question 14

Onset vs Peak vs Duration

Answer 14

Onset: when does the insulin start working
Peak: when will most of it be working
Duration: how long the insulin stays in the body

Question 15

Cretinism

Answer 15

Condition where fetus was not exposed to enough T3 and T4 in utero. Chronic, untreatable condition, mentally not there, “look” different, do not develop properly, have no sense for personal safety

Question 16

Hypothyroidism

Answer 16

T3 and T4 levels are low TSH levels are high
thermostat turned down
pale, puffy, expressionless face, cold and dry skin, brittle hair/hair loss, low heart rate and temp

Question 17

A1C vs Blood Glucose

Answer 17

A1C measures the average blood sugar in a red blood cell (over a three month period, lifespan of a RBC)
BG is the current sugar levels in the body at that time should be in range 80-120

Question 18

Empiric theory

Answer 18

What is known to work for that specific disease at a particular time

Question 19

Antimicrobial

Answer 19

Any type of drug with the ability to kill or suppress

Question 20

Prophylactic therapy

Answer 20

Preventative

Question 21

Selective Toxicity

Answer 21

Targeted cell destruction

Question 22

Resistance

Answer 22

Bacteria talk to each other and share DNA with new ways to protect themselves from antibiotics

Question 23

Nosocomial Infection

Answer 23

Hospital acquired infection, 1/25 of patients

Question 24

Bacteriocidal

Answer 24

Kills the cell “suicidal”

Question 25

Would you recommend cephalosporin for a patient that get hives from amoxycillin?

Answer 25

Ceph is a cousin of penicillin, there’s an 18% chance of having an allergic reaction to cephs as well. Since it is a mild reaction it is okay.

Question 26

What should you ask patients before they start a new antibotic?

Answer 26

Ask them about previous and family antibiotic reactions

Question 27

Myxedema

Answer 27

Low T3 and T4 in adults.
Hypothyroidism: lower temperature and heart rate, expressionless, and can be treated

Question 28

Signs and Symptoms of Steven-Johnson Syndrome

Answer 28

Cue: penicillin’s or sulpha meds
- Upper respiratory symptoms when the infection didn’t originate there
- Painful red/purple skin lesions
- Blisters on skin, mouth, nose and genitals
- Red, painful, watery eyes

Question 29

If T3 and T4 are elevated

Answer 29

TSH will decrease, Hyperthyroidsm

Question 30

If TSH is elevated

Answer 30

T3 and T4 will decrease, Hypothyrodism

Question 31

You are an ER nurse and a patient comes into the hospital with an oozing wound that you suspect is an infection. What should you do?

Answer 31

Obtain a pure culture and multiple (2-3) Once broad spectrum antibiotics are started it could kill some of the microbes
Educate patient that culture takes time to grow, and explain broad vs narrow treatment

Question 32

A1C and their corresponding average BG

Answer 32

4 - 68
5 - 97
6 - 126
7 - 152
add roughly 29

Question 33

A1C Classification

Answer 33

Diabetic 6.5% or higher
Prediabetic 5.7-6.4%
Normal below 5.7%

Question 34

Hyperthyroidism

Answer 34

When your body is producing too much T3 and T4. Graves and Plummer’s disease. Treatment is surgical removal or other destruction of the tissue

Question 35

Ototoxicity

Answer 35

Toxic to the ears common with gent

Question 36

Nephrotoxicity

Answer 36

Medication toxic to the kidney, signs can be elevated creatine and BUN levels

Question 37

What medication do you never give if expired?

Answer 37

-cyclines