Endocrine Flashcards
DM, DI, SIADH, DKA, Hyperthyroidism, Hypothyroidism, Insulin, Addison's, Cushing's
S+S of Diabetes Insipidus
Polyuria (dilute and pale urine)
Dehydration (tachycardia, hypotension, diminished peripheral pulses, dry mucous membranes)
Insomnia
Lab values of DI
Increased sodium and osmolality
Decreased urine specific gravity
Nursing interventions of DI
Administer desmopressin
Administer hypotonic fluids (0.45% NaCl)
S+S of Diabetes mellitus
Polyuria
Polydipsia
Polyphagia
Ketoacidosis
Blurred vision
Nocturnal enuresis
Vaginal candidiasis
How much carbs during exercise (with DM)?
10-15 carbs for every 30-45 min
Hypoglycemia
BG < 70
S+S of hypoglycemia
Diaphoresis
Pallor
Trembling
Tx of hypoglycemia (alert/unconscious)
Oral quick-acting glucose if alert
IM glucagon if unconscious
Patho of Diabetic Ketoacidosis
Lack of insulin -> intracellular starvation -> body breaks down fat for energy -> high levels of acidic ketones (metabolic acidosis) -> potential hypovolemic shock
S+S of DKA
Polyuria
Polydipsia
N+V
Fruity odor on breath
Kussmaul respirations
Lethargy
Dry skin
Hypotension and tachycardia
Dizziness
Lab studies of DKA
Elevated BG
Elevated ketones
Metabolic acidosis
Hyperkalemia
Nursing interventions of DKA
Administer 0.9% sodium chloride
IV regular insulin
Monitor for rebound hypokalemia after IV insulin replacement
Hypoparathyroidism labs
Decreased PTH
Decreased calcium
Increased phosphate
S+S of hypoparathyroidism
Tingling, numbness
Trousseau sign
Chvostek sign
Muscle cramps
Prolonged QT interval
Severe tetany
Nursing interventions for hypoparathyroidism
Seizure precautions
Monitor for dysrhythmias
High calcium and vitamin D, low phosphorus diet
Patho of SIADH
Excessive renal water reabsorption resulting in:
Water retention
Increased total body water
Dilutional hyponatremia
S+S of SIADH
Low urine output
Weight gain
HTN
Hyponatremia (changes in mental status)
Labs of SIADH
Low urine volume
Increased urine specific gravity
Hyponatremia
Nursing interventions of SIADH
Seizure precautions
Neuro checks
Fluid restriction
Diuretics
Oral salt tablets/hypertonic saline (3% NaCl)
Vasopressin antagonists
Hyperthyroidism S+S
Tachycardia
Exphthalmos
Heat intolerance
Fine hand tremor
Hypothyroidism S+S
Weight gain
Constipation
Cold intolerance
Labs of hypothyroidism and hyperthyroidism
Hypo: Increased TSH and decreased T3/T4
Hyper: Decreased TSH and increased T3/T4
Tx for hyperthyroidism
Radioactive iodine
PTU
Thyroidectomy
Radioactive iodine tx for hyperthyroidism education
Avoid sharing utensils
Wash clothes separately
Sleep in separate rooms
Delay pregnancy attempts for 4-6 months
Use separate bathroom and flush 3x each use
PTU
Slows thyroid down
Used for hyperthyroidism
Is an immunosuppressant
Thyroidectomy (partial vs. total)
Partial: at risk for thyroid storm
Total: need life-long hormone replacement; at risk for hypocalcemia; check Trosseau and Chvostek
Interventions for thyroid storm
Best: cooling blanket
First: ice packs
O2 per mask at 10 L
Postop risks for thyroidectomy
Airway first
Then hemorrhage
12-48 hrs: Total=tetany; Sub-total=thyroid storm
After: infx
Rundown of DI
Polyuria, polydipsia -> dehydration
High urine output
Rundown of SIADH
Oliguria and no thirst
Decreased urine output
Increased urine specific gravity (due to decreased urine volume)
Types of insulin
Regular
NPH
Lispro
Glargine
Regular insulin is
Clear
NPH is
Cloudy
What insulins can be mixed? With what?
NPH (intermediate) can be safely mixed w/ short-acting (regular) and rapid-acting (lispro) in one syringe
Hypoglycemia looks like
Drunk and in shock
Drunk: staggered, slurred, slow
Shock: tachycardia, tachypnea, low BP, cold/clammy, mottled skin
HHNS - think of
Dehydration
HHNS S+S
Skin is dry, flushed, decreased turgor, increased HR
Relationship b/w amt of urine and specific gravity
OPPOSITES
More urine out, lower specific gravity
S+S of Addison’s
Hyperpigmented
Doesn’t adapt well to stress
Tx of Addison’s
Glucocorticoids
S+S of Cushing’s
Moon face
High glucose
Bruises
Hypernatremia
Stretch marks
DM 1:
DM 2:
DM 1: autoimmune destruction of pancreatic beta cells
DM 2: impaired tissue response to insulin
Metformin is a tx of what?
DM 2
Hold 48 hrs before surgery
Tx of exophtalmos
Using artificial tears
Taping eyelids shut during sleep
Maintaining HOB in raised position
Administering corticosteroids
Using dark glasses to prevent irritation
Priority tx of DKA
NS bolus: fluid resuscitation to prevent hypovolemic shock and normalize electrolyte and glucose levels