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Med Surg II - Exam 3 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

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

KNOW THIS!!!

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?

KNOW THESE HALLMARK SYMPTOMS!!!!!

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

KNOW THIS!!!!

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?

KNOW THIS!!!!

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)

KNOW THIS!!!!!!

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?

KNOW THIS!!!!!

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
Q

What is the onset, peak, & duration of Novolog / Insulin Apart?

KNOW THIS!!!!

A
  • Onset: 5-15 minutes
  • Peak: 1-2 hours
  • Duration: 4-6 hours
26
Q

What is the onset, peak, & duration of NPH (insulin)?

KNOW THIS!!!!

A
  • Onset: 2-4 hours
  • Peak: 4-10 hours
  • Duration: 10-16 hours
27
Q

What is the onset, peak, & duration of Lantus?

KNOW THIS!!!!

A
  • Onset: 2-4 hours
  • Peak: FLAT
  • Duration: 20-26 hours
28
Q

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

A

b.) Have the patient drink 8 oz juice

Med Surg II - Exam 3 (9 decks)

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