ENDOCRINE Flashcards
Identify 3 endocrine emergencies and describe the signs/symptoms of each
- Diabetic Ketoacidosis (DKA)
condition characterised by a life threatening metabolic state in which there is high BGL’s, ketones and acidosis
S & S: dehydration, flushed cheeks, weight loss, hyperventilation, acetone smell on breath, abdominal pain, disorientation
- Thyroid Storm
too many thyroid hormones in the system = organ dysfunction
S & S: fever, diaphoretic, LOC, tachycardia, tachypnea, pain - Acute Adrenal Crisis
lack of cortisol in the body as the adrenal gland is damaged
S & S: dizziness, weakness, sweating, abdominal pain, LOC
Describe the pathophysiology of DKA
In DKA –> Inadequate production of insulin by beta-2 pancreatic cells coupled with insulin resistance impairs the facilitation passage of glucose into the cell.
- Carbs are broken down into glucose by insulin (used to fuel source for brain) – without insulin, the body thinks its starving of its major source of energy - thus hyperglycaemia
Insulin deficiency –> hyperglycaemia for a period of time
Prolonged hyperglycaemia –> activates a cascade of events:
- Cellular starvation = release of counter regulatory hormones
- ^ production of glucose
- Hyperglycaemia due to body’s inability to use glucose
- When BGLs exceed kidneys ability to reabsorb –> High glucose in urine = polyuria, polydipsia
- Counter-regulatory hormones activate lipolysis
- Ketone production (as brain is starving for energy) = metabolic acidosis (hyperventilation – to lower CO2 as its acidic) – leads to respiratory alkalosis
What are the nursing responsibilities in caring for the patient in an endocrine emergency?
→ Get Ketone and glucose readings frequently
→ Constantly monitoring A-G
→ urinalysis test → investigate potential glucose in urine
→ Monitor urine output - ?IDC - strict fluid input/output
→ if insulin is administered, monitor potassium levels as insulin can cause hypokalemia
→ Blood samples
→ administer of IV fluids
