Endocrine Flashcards

1
Q

What is another name for Glycosylated Hemoglobin and what is the normal value?

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A

HbA1C

Normal = 4% - 6%

  • Under 7% in patients with diabetes
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2
Q

What happens to the following hormones or responses in response to stress?
* glucose
* cortisol
* aldosterone
* potassium
* healing
* metabolic demands

A
  • ↑ glucose
  • ↑ cortisol
  • ↑ aldosterone
  • ↓ potassium
  • ↓ healing
  • ↓ metabolic demands

KNOW THE BOLD ITEMS

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3
Q

Explain the action of insulin!!!

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A
  • Promotes glucose uptake by target cells
  • Glucose storage as glycogen
  • Prevents fat & glycogen breakdown
  • Inhibits gluconeogenesis
  • Increases protein synthesis
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4
Q

What are the 5 actions of insulin?

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A

1.) Promotes glucose uptake (by target cells)
2.) Glucose is stored as glycogen
3.) Prevents fat & glycogen breakdown
4.) Inhibits gluconeogenesis
5.) Increases protein synthesis

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5
Q

What is the job of glucagon?

A

Glucagon maintains blood glucose by increasing the release of glucose from the liver into the blood

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6
Q

What are the 3 hallmark signs of diabetes mellitus?

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A
  • Polyuria (↑ urine)
  • Polydipsia (↑ thirst)
  • Polyphagia (↑ hunger)
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7
Q

What is the cause of type 1 diabetes mellitus?

A

Destruction & loss of beta cells

  • T1DM is technically an autoimmune disorder
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8
Q

Sick Day Rules for Diabetes

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A
  • Patients should NOT stop taking their insulin or oral agents
  • Check blood sugar every 3-4 hours
  • Modify diet to include & check ketones
  • Notify HCP if not tolerating diet & becomeing dehydrated
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9
Q

Causes of Diabetic Ketoacidosis (DKA)

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A
  • Infection, surgery, trauma
  • Inadeqaute insulin, malfuntioning insulin pump, management changes (diet/exercise)
  • Pregnancy & growth spirts
  • Emotional stress
  • Drugs: steroid therapy & epinephrine/norepinephrine
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10
Q

Signs & Symptoms of Diabetic Ketoacidosis (DKA)

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A
  • Ketones in urine
  • Hyperglycemia & metabolic acidosis
    * pH under 7.3
    * bicarbonate under 18
  • Kussmaul breathing
    * compensating with respiratory alkalosis – hyperventilating / blowing off CO2)
  • Glucose over 250 mg/dL
  • HIGH potassium
  • Dehydration (fluid volume deficit)
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11
Q

What medication class can mask the symptoms of hypoglycemia?

A

Beta-blockers

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12
Q

What is the cause of diabetes insipidus (DI)?

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A

Lack of antidiuretic hormone (ADH)

ADH/vasopressin regulates water in the body / kidneys

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13
Q

Symptoms of Diabetes Insipidus (DI)

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A
  • Increased urine output (polyuria)
  • Increased thirst (polydipsia)
  • Decreased urine specific gravity (diluted urine)
  • Decreased ADH
  • Hypernatremia (↑ Na+)
  • Clear urine
  • High serum osmolality (> 300) = dehydrated
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14
Q

What is the treatment for Diabetes Insipidus (DI)?

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A

Desmopressin (lifelong synthetic vasopressin)

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15
Q

What is Syndrome of Inappropriate Antiduretic Hormone Secretion (SIADH)?

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A

Too much ADH leading to hyponatremia (↓ Na+)

  • increased urine osmolality (concentrated urine)
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16
Q

Signs & Symptoms of SIADH

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A
  • High ADH
  • Concentrated urine
  • Hyponatremia (↓ Na+) (body is retaining too much water)
  • LOW (↓) serum osmolarity
  • slow onset
  • Confusion
17
Q

What is the treatment for SIADH?

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A
  • Fluid restrictions
  • Sodium replacement
    * 3% hypertonic saline
18
Q

KEY Clinical Symptoms of DKA

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P 29 (endocrine PPT)

A
  • Fruity breath (from volatile acids)
  • Hypotension (↓ BP)
  • Tachycardia (↑ HR)
  • Kussmaul breathing (↑ rate/depth / hyperventilation)
19
Q

What is the treatment for hypoglycemia in a patient who is unconscious?

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A

1 amp D50

  • = 50 mL of fluid with 25 g of dextrose

Once individual is conscious give them 1/2 cup of juice + carb + protein

20
Q

Clinical signs & symptoms of Hyperglycemic Hyperosmolar Syndrome (HHS)

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A
  • glucose > 600 mg/dL
  • pH > 7.3
  • Serum osmolality > 320 (extreme dehydration)

Associated with type 2 diabetes

21
Q

Which type of diabetes are HHS & DKA usually associated with?

A

HHS = Type 1

DKA = Type 2

22
Q

What is the treatment / management for HHS?

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A
  • Rapid rehydration
  • Insulin administration
  • Electrolyte replacement (potassium)
23
Q

What key hormone is secreted by the pituitary gland?

A

ADH

Antidiuretic hormone

24
Q

Diabetes Mellitus Drugs

Onset, Peak, & Duration:
* Novolog / Insulin Apart
* NPH
* Lantus

A

Novolog / Insulin Apart
* Onset: 5-15 minutes
* Peak: 1-2 hours
* Duration: 4-6 hours

NPH
* Onset: 2-4 hours
* Peak: 4-10 hours
* Duration: 10-16 hours

Lantus
* Onset: 2-4 hours
* Peak: flat
* Duration: 20-26 hours

25
**What is the onset, peak, & duration of Novolog / Insulin Apart?** | **KNOW THIS!!!!**
* *Onset:* 5-15 minutes * *Peak:* 1-2 hours * *Duration:* 4-6 hours
26
**What is the onset, peak, & duration of NPH (insulin)?** | **KNOW THIS!!!!**
* *Onset:* 2-4 hours * *Peak:* 4-10 hours * *Duration:* 10-16 hours
27
**What is the onset, peak, & duration of Lantus?** | **KNOW THIS!!!!**
* *Onset:* 2-4 hours * *Peak:* FLAT * *Duration:* 20-26 hours
28
**The nurse documents a capillary blood glucose level of 47 mg/dL for a patient who is diagnosed with type 2 diabetes mellitus (DM). The patient is alert, but clammy and has cool skin to the touch. Which is the nurse's first action?** **a.)** Give D50W by IV push immediately **b.)** Have the patient drink 8 oz juice **c.)** Quickly administer 1 mg glucagon 1 via IM injection **d.)** Draw blood from a different finger for comparison
**b.) Have the patient drink 8 oz juice**