Endocrine Flashcards

Question

HYPOparathyroidism Treatment

Answer 1

IV calcium phosphorus binding drugs

Answer 2

epinephrine / norepinephrine

Answer 3

benign tumors that secrete epi and norepi in boluses familial don't do things to increase stress (smoking)

Answer 4

``` increased BP Increased HR palpitations flushed / extremely diaphroetic headache ``` Triad of Symptoms: **pounding headache, tachycardia, profuse sweating

Answer 5

Catecholamine levels (VMA - vanillylmandelic acid test) Metanephine (MN) test ** these tell if epi or norepi levels are elevated A CT scan and MRI can be done to detect tumor treatment is surgery = to remove tumor

Answer 6

test catecholamine levels (epi / norepi) Foods that alter VMA - vanilla, vit B, fruit juices, bananas Foods that alter MN - caffeine *24 hr urine specimen (throw away first and keep last)

Answer 7

epi and norepi

Answer 8

palpating the abdomen = can cause sudden release of catecholamines and severe HTN

Answer 9

glucocorticoids mineralocorticoids sex hormones * all of above are steroids

Answer 10

Change mood (depressed, psychotic, euphoric, insomnia) alter defense mechanisms (immunosuppressed) - don't put someone on steroids next to person w active infection Breakdown fats and proteins inhibit insulin (Hyperglycemia common / monitor glucose)

Answer 11

aldosterone make you retain sodium and water makes you lose potassium

Answer 12

testosterone, estrogen, and progesterone Too many sex hormones: irregular menstrual cycle, acne, hirsutism (female facial hair) Not enough sex hormones: decreased axillary / pubic hair, decreased libido

Answer 13

made in pituitary stimulate cortisol to be made

Answer 14

too many steroids too much ACTH and cortisol

Answer 15

not enough steroids shock hyperkalemia hypoglycemia Addison's Dz Cushing's Dz

Answer 16

adrenocoritcal insufficiency (not enough steroids) decreased glucocorrticoids, mineralocorticoids, and sex hormones

Answer 17

extreme fatigue N/V/D anorexia / wt loss hypotension confusion decreased sodium / increased potassium / hypoglycemia hyperpigmentation-bronzing color of the skin and mucous membranes white patchy area of depigmented skin (vitiligo)

Answer 18

combat shock (losing sodium and water) increase sodium in their diet ** processed fruit juice / broth have tons of sodium I&O / daily wt decreased BP losing wt fluid volume deficit MEDICATIONS: - corticosteroids - given BID - 2/3 of dose in morning and 1/3 of dose in evening - fludrocortisone acetate is synthetic aldosterone - dose is always changing (BP and daily wts must be monitored)

Answer 19

prednison hydrocortisone cortisone

Answer 20

severe HYPOtension and vascular collapse can occur with infections, emotional distress, physical exertion or stopping steroids abruptly

Answer 21

steroids inhibit insulin = increased glucose addison's = no steroids = decreased glucose

Answer 22

too many steroids

Answer 23

Glucocorticoids: - Growth arrest - thin extermities / skin (lipolysis) - increased risk of infection - hyperglycemia - psychosis to depression - moon faced (fat redistribution or fluid retention) - truncal obesity (fat redistribution / lipogenesis) - buffalo hump (fat redistribution) Sex hormones: - oily skin / acne - women with male traits Mineralocorticoids (aldosterone): - high BP - CHF - Wt gain - fluid volume excess ** since client has too much mineralocorticoid (aldosterone), potassium will be LOW (bc too much sodium) ** 24 hr urine would show very high cortisol levels

Answer 24

adrenalectomy (unilateral or bilateral) - if both are removed = lifetime replacement quiet environment - can't handle stress diet pre-treatment should be high potassium, decreased sodium, increased protein, and increased calcium (steroids decrease calcium by excreting it through GI tract) (steroids breakdown fats and protein) **avoid exposure to infections

Answer 25

osteoporosis

Answer 26

genetic / auto-immune appears abruptly first sign may be DKA (metabolic acidosis = Kussmaul respirations = increased RR) Polyuria, Polydipsia, Polyphagia *Polyuria = shock treatment = insulin ONLY

Answer 27

not abrupt / signs are wounds that won't heal, repeated vaginal infections, etc. evaluate for metabolic syndrome (Syndrome X) - increased waist circumference - tiglycerides > 150 mg/dL - HDL < 40 mg/dL - BP >130/85 Tx: start w diet and exercise and then add oral agents (some need insulin)

Answer 28

resembles type II mom needs 2-3x more insulin than normal If mom has risk factors screen at first prenatal and retest at 24-28 weeks Screen all moms at 24-28 weeks Complications to baby: increased birth wt and hypoglycemia

Answer 29

requires 2 abnormal tests A1C 6.5% or above Fasting plasma glucose 126 or above oral glucose tolerance test 200 or above Prediabetes A1C 5.7 to 6.4 Fasting plasma glucose 100 to 125 oral glucose tolerance test 140 to 199 Normal A1C about 5 Fasting plasma glucose 99 or below oral glucose tolerance test 139 or below

Answer 30

vascular damage

Answer 31

carbs like fruit, veg, whole grains, and low fat dairy high fiber (slows down glucose absorption) MyPlate - 1/2 w non-starchy veg - 1/4 w carbs - 1/4 w protein

Answer 32

regular, consistent exercise wait until blood sugar normalizes to begin exercise eat before hand and exercise when sugar is at its highest exercise same amount and same time daily

Answer 33

oral antidiabetic reduces glucose production and enhances how glucose enters the cell don't see hypoglycemia with this drug Hypoglycemia destroys vessels ** discontinue before contrast dye surgeries. Can continue after 48 hrs if kidney functin and creatinine levels are normal

Answer 34

another antidiabetic used in conjunction with metformin if it is not effective on its own

Answer 35

dulaglutide / semaglutide / pramlintide ** taken once a day, once every two days, or once a week ** wt loss

Answer 36

long acting (Lantus)

Answer 37

less than 7%

Answer 38

blood test gives average of what pts blood sugar has been over past 3-4 months

Answer 39

Hypoglycemia is 70 mg/dL or less ``` cold/clammy confusion shaky headache nervous nausea taachycardia hunger ```

Answer 40

+15 grams of carbs (4-6oz of soda / 8-10 lifesavers) glucose absorption is slowed in foods with lots of fat 15-15-15 rule - 15 g - wait 15 min - 15 more gram if still low once blood sugar is up, they need to eat a complex carb and protein snack (peanut butter crackers) * *D50W * * injectable glucagon (subQ, IM, IV) To prevent, teach client to eat, take insulin regularly, know s/sx, and check blood glucose regularly.

Answer 41

causes: illness, infection, skipping insulin Type 1 Polyuria, polydipsia, polyphagia --> fat breakdown (acidosis) --> Kussmaul respirations (trying to blow off CO2) --> decreased LOC

Answer 42

Treat cause (infection) hourly blood sugar and potassium levels IV insulin (insulin decreases glucose and potassium) ECG hourly outputs ABGs IVFs - polyuria causes shock / start w NS then when blood sugar gets down to 250-300, switch to D5W to prevent hypoglycemia potassium will most likley be put into IVF eventually

Answer 43

Type II looks like DKA, but no acidosis or ketones making just enough insulin to avoid breaking down fats no kussmaul respirations or fruity breath

Answer 44

diabetic retinopathy | nephropathy (may need dialysis)

Answer 45

sexual problems (impotence / decreased sensation) foot/leg probs (pain / paresthesia / numbness) Neurogenic bladder (incontinence / retention) Gastroparesis (aspiration risk due to delayed stomach emptying) Risk for Infection

Answer 46

``` cut toenails straight across dry in b/w toes always wear well-fitting shoes inspect feet daily no chemicals no lotions ```