Diabetes, Thyroid, Antibotic Lecture Notes Flashcards
Hypoglycemia
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
If someone is agitated, stumbly, shaking, tachy, confused what is the first thing you should do?
Obtain blood sugar to rule out hypoglycemia. Then could look into ETOH and TBI
Type 1 Diabetes
Chronic insulin dependent condition, normally onset as a child or adolescent
Type 2 Diabetes
Chronic onset, different in every body, some controlled through diet, some through PO medications and some are insulin dependent
Drug does not play nice!!
Erythromycin, stop and look up medication interactions, inform doc
How do you know an antibotic is working in a patient
They are feeling better, have an appetite, more energy, fever goes down
Hot and Dry
Cold and Clammy
Hot and dry - Sugar High
Cold and Clammy - Need Candy
What will always increase the blood sugar levels
Steroids and Cortisol
How do you prepare NPH insulin
Cloudy, needs to be rolled before drawn, DO NOT SHAKE
Mother calls and states her child was put on amoxicillin for strep a few days ago and now has a rash
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.
Bacteriostatic
Stop the spread of bacteria, and bacterial growth
Hyperglycemia Signs
High blood sugar, not as life threatening, long term could have stroke/clots
Lots of drinking, lots of peeing, lots of eating
Fruity breath
Peaks and Troughs
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
Onset vs Peak vs Duration
Onset: when does the insulin start working
Peak: when will most of it be working
Duration: how long the insulin stays in the body
Cretinism
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
Hypothyroidism
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
A1C vs Blood Glucose
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
Empiric theory
What is known to work for that specific disease at a particular time
Antimicrobial
Any type of drug with the ability to kill or suppress
Prophylactic therapy
Preventative
Selective Toxicity
Targeted cell destruction
Resistance
Bacteria talk to each other and share DNA with new ways to protect themselves from antibiotics
Nosocomial Infection
Hospital acquired infection, 1/25 of patients
Bacteriocidal
Kills the cell “suicidal”
Would you recommend cephalosporin for a patient that get hives from amoxycillin?
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.
What should you ask patients before they start a new antibotic?
Ask them about previous and family antibiotic reactions
Myxedema
Low T3 and T4 in adults.
Hypothyroidism: lower temperature and heart rate, expressionless, and can be treated
Signs and Symptoms of Steven-Johnson Syndrome
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
If T3 and T4 are elevated
TSH will decrease, Hyperthyroidsm
If TSH is elevated
T3 and T4 will decrease, Hypothyrodism
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?
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
A1C and their corresponding average BG
4 - 68
5 - 97
6 - 126
7 - 152
add roughly 29
A1C Classification
Diabetic 6.5% or higher
Prediabetic 5.7-6.4%
Normal below 5.7%
Hyperthyroidism
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
Ototoxicity
Toxic to the ears common with gent
Nephrotoxicity
Medication toxic to the kidney, signs can be elevated creatine and BUN levels
What medication do you never give if expired?
-cyclines
