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NCLEX > Endocrine > Flashcards

Endocrine Flashcards

DM, DI, SIADH, DKA, Hyperthyroidism, Hypothyroidism, Insulin, Addison's, Cushing's

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1
Q

S+S of Diabetes Insipidus

A

Polyuria (dilute and pale urine)
Dehydration (tachycardia, hypotension, diminished peripheral pulses, dry mucous membranes)
Insomnia

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2
Q

Lab values of DI

A

Increased sodium and osmolality
Decreased urine specific gravity

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3
Q

Nursing interventions of DI

A

Administer desmopressin
Administer hypotonic fluids (0.45% NaCl)

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4
Q

S+S of Diabetes mellitus

A

Polyuria
Polydipsia
Polyphagia
Ketoacidosis
Blurred vision
Nocturnal enuresis
Vaginal candidiasis

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5
Q

How much carbs during exercise (with DM)?

A

10-15 carbs for every 30-45 min

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6
Q

Hypoglycemia

A

BG < 70

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7
Q

S+S of hypoglycemia

A

Diaphoresis
Pallor
Trembling

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8
Q

Tx of hypoglycemia (alert/unconscious)

A

Oral quick-acting glucose if alert
IM glucagon if unconscious

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9
Q

Patho of Diabetic Ketoacidosis

A

Lack of insulin -> intracellular starvation -> body breaks down fat for energy -> high levels of acidic ketones (metabolic acidosis) -> potential hypovolemic shock

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10
Q

S+S of DKA

A

Polyuria
Polydipsia
N+V
Fruity odor on breath
Kussmaul respirations
Lethargy
Dry skin
Hypotension and tachycardia
Dizziness

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11
Q

Lab studies of DKA

A

Elevated BG
Elevated ketones
Metabolic acidosis
Hyperkalemia

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12
Q

Nursing interventions of DKA

A

Administer 0.9% sodium chloride
IV regular insulin
Monitor for rebound hypokalemia after IV insulin replacement

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13
Q

Hypoparathyroidism labs

A

Decreased PTH
Decreased calcium
Increased phosphate

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14
Q

S+S of hypoparathyroidism

A

Tingling, numbness
Trousseau sign
Chvostek sign
Muscle cramps
Prolonged QT interval
Severe tetany

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15
Q

Nursing interventions for hypoparathyroidism

A

Seizure precautions
Monitor for dysrhythmias
High calcium and vitamin D, low phosphorus diet

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16
Q

Patho of SIADH

A

Excessive renal water reabsorption resulting in:
Water retention
Increased total body water
Dilutional hyponatremia

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17
Q

S+S of SIADH

A

Low urine output
Weight gain
HTN
Hyponatremia (changes in mental status)

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18
Q

Labs of SIADH

A

Low urine volume
Increased urine specific gravity
Hyponatremia

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19
Q

Nursing interventions of SIADH

A

Seizure precautions
Neuro checks
Fluid restriction
Diuretics
Oral salt tablets/hypertonic saline (3% NaCl)
Vasopressin antagonists

20
Q

Hyperthyroidism S+S

A

Tachycardia
Exphthalmos
Heat intolerance
Fine hand tremor

21
Q

Hypothyroidism S+S

A

Weight gain
Constipation
Cold intolerance

22
Q

Labs of hypothyroidism and hyperthyroidism

A

Hypo: Increased TSH and decreased T3/T4
Hyper: Decreased TSH and increased T3/T4

23
Q

Tx for hyperthyroidism

A

Radioactive iodine
PTU
Thyroidectomy

24
Q

Radioactive iodine tx for hyperthyroidism education

A

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

25
Q

PTU

A

Slows thyroid down
Used for hyperthyroidism
Is an immunosuppressant

26
Q

Thyroidectomy (partial vs. total)

A

Partial: at risk for thyroid storm

Total: need life-long hormone replacement; at risk for hypocalcemia; check Trosseau and Chvostek

27
Q

Interventions for thyroid storm

A

Best: cooling blanket
First: ice packs
O2 per mask at 10 L

28
Q

Postop risks for thyroidectomy

A

Airway first
Then hemorrhage
12-48 hrs: Total=tetany; Sub-total=thyroid storm
After: infx

29
Q

Rundown of DI

A

Polyuria, polydipsia -> dehydration
High urine output

30
Q

Rundown of SIADH

A

Oliguria and no thirst
Decreased urine output
Increased urine specific gravity (due to decreased urine volume)

31
Q

Types of insulin

A

Regular
NPH
Lispro
Glargine

32
Q

Regular insulin is

A

Clear

33
Q

NPH is

A

Cloudy

34
Q

What insulins can be mixed? With what?

A

NPH (intermediate) can be safely mixed w/ short-acting (regular) and rapid-acting (lispro) in one syringe

35
Q

Hypoglycemia looks like

A

Drunk and in shock
Drunk: staggered, slurred, slow
Shock: tachycardia, tachypnea, low BP, cold/clammy, mottled skin

36
Q

HHNS - think of

A

Dehydration

37
Q

HHNS S+S

A

Skin is dry, flushed, decreased turgor, increased HR

38
Q

Relationship b/w amt of urine and specific gravity

A

OPPOSITES
More urine out, lower specific gravity

39
Q

S+S of Addison’s

A

Hyperpigmented
Doesn’t adapt well to stress

40
Q

Tx of Addison’s

A

Glucocorticoids

41
Q

S+S of Cushing’s

A

Moon face
High glucose
Bruises
Hypernatremia
Stretch marks

42
Q

DM 1:
DM 2:

A

DM 1: autoimmune destruction of pancreatic beta cells

DM 2: impaired tissue response to insulin

43
Q

Metformin is a tx of what?

A

DM 2
Hold 48 hrs before surgery

44
Q

Tx of exophtalmos

A

Using artificial tears
Taping eyelids shut during sleep
Maintaining HOB in raised position
Administering corticosteroids
Using dark glasses to prevent irritation

45
Q

Priority tx of DKA

A

NS bolus: fluid resuscitation to prevent hypovolemic shock and normalize electrolyte and glucose levels

NCLEX (40 decks)

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