ENDOCRINE #2 Flashcards by Maren Bond

Addisons clinical manifestations

muscle weakness
wt loss
fatigue
hypotension
anorexia
dry skin
low Na
High P+

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Myxedema coma interventions

Give O2
fluids
patent airway
thyroid hormone, levothyroxine IV

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Lispro given at 1630, watch for hypoglycemia at…

1830

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Intervention of A1C

prevent hyperglycemia

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what test measures BGL for 8-10 weeks

HgB A1C

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pt is NPO with BGL of 52. what to do?

Call HCP

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Diabetes insipidus clinical manifestations

polyuria

polydipsia

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SIADH resolving will show specific gravity?

above 1.005

SATA anything above 1.005

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will buffalo hump w cushings resolve?

yes slowly with treatment

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Graves disease interventions

high cal diet
monitor VS
keep room quiet

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insulin drawn up

Nph to reg
Reg to nph

Nph cloudy

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Why calcium after thyroidectomy

treat hypocalcemia with tetany

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pt has hoarseness after thyroidectomy

temporary d/t swelling

rest voice

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NPH given at 0830 when will pt experience hypoglycemia?

6-14 hours

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Lispro onset?

15 minutes

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DM foot care

use mild soap
warm water
apply lotion, not between toes

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GOITER clinical manifestations?

hoarseness
dysphagia
enlarged thyroid

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acromegaly manifestations

sleep apnea
large hand/feet
joint pain

ANDRE THE GIANT

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DM has dehydration what check first

BGL

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How do sulfonylureas act?

stimulate insulin production
decrease glucose production in the liver
decrease insulin metabolism in the liver
increase insulin sensitivity to target cells
stimulates pancreas to produce greater amounts of insulin

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DM pt has nonhealing foot wound what to do?

Wound care consult

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Post adrenalectomy what to teach pt

diet
activity
DB/C
incentive spirometer
s/s infection
prevent incision infection

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D/C instructions for Cushing’s

increase k+
decrease Na
check ankles for swelling
no contact sports

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Spironolactone does?

decrease BP
increase sodium excretion
increase potassium secretion

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lab that shows DM1 might have complication if

Ketonuria | (DKA=ketonuria+BGL > 250

will increase insulin for DM1 if

ketonuria pt is ill taking steroids BGL not controlled

LIpodystrophy

when insilin injected into same site over and over again

New DM diet teaching

healthy snacks diet drinks with no sugar balanced meals fruits for sweets

why abd for insulin injections

Fastest absorption

Hypoglycemia s/s

``` irritable personality changes tremors shakiness tachy palpitations diaphoretic pallor ```

Remember DM pts

need more insulin when ill need to check BGL not urine Never just stop insulin check BGL before giving insulin

in order to function properly the parathyroid needs

Vitamin D

Levothyroxine teaching

take in morning on empty stomach in morning to prevent sleeplessness in morning to increase absorption

Diabenese (chlorpamide) is effective oral hypoglycemic because?

decrease polyuria taken orally decrease polyphagia keeps BGL under 120

When is Lantus given

at bedtime | QHS Qday

why myxedema feels like hangover

sensitivity to thyroid hormone given IV

PT DM2 does not understand teaching when states?

I can take insulin orally i can eat more because I take pills to decrease BGL I can eat more because insulin to cover what I eat I wont take any pills when I'm sick

Post DKA pt teaching

Check BGL regularly | test for ketonuria

Cushings diet

high K+ low Na Drink fluids

best canidate for radioactive iodine vs thyroidectomy

not good surgical canidate cancer+heart disease RA and Chron's

DM1 ask when exercise if taking NPH in morning

May exercise in morning May exercise in early afternoon NOT in late afternoon as NPH peaks 6-14 hrs after taking

medications for hyperthyroidism

Propylthiouracil

hyperparathyroidism does

increase calcium | can cause polyuria

post parathyroidectomy taught to take calcium

after meals

when pt taking corticosteroids pt should

watch s/s infection | check BGL

Hypocalcemia s/s

``` tremors shakiness pallor diaphoretic personality changes irritability tachy palpatations ```

tremors in sign of what in DM

Hypoglycemia

for IDDM taking steroids needs

more insulin

hat factors lead to hypoglycemia in DM1

Illness exercise- less insulin NPO - less insulin pt needs to understand insulin they take and peaks to avoid heavy exercise

Addisons treatment

Mineral corticosteroids glucocorticosteroids hydro cortisone has both properties

pt on syntroid still have symptoms of hypothyroidism

does needs to be increased

giving NPH at 10 watch for hypoglycemia at

4 pm

foods high in potassium

ham apples bananas potatoes

DKA s/s

``` kussmal breathing fruity breath thirst drowsiness confusion polyuria ```

DI is caused by

Decreased ADH

Glyburide for DM2 because

increases insulin in pancreas increases insulin sensitivity of target cells helps prevent insulin resistance

hyperparathyroidism means that serum calcium is

increased

hypoparathyroidism means that serum calcium is

decreased

cushings s/s include

``` facial hair thin skin moon face large trunk extremety swelling tachy high BP ```

DI treatment is effective when

urine output decreases | fluid intake remains 2500mL/day

Vassopresson for DI because

it decreases urine output

hypothyroidism diet

low cal to slow wt gain

adverse reaction to synthroid

Tachycardia

Thyroid glad produces

T3 T4 Calcitonin

HHNS need fluid intake of

IV fluids | intake of 2-3 L in 2-3 HRs

Hypovalemia in Addisons disease cases decreased BP by

low sodium | low K+

Treatment for SIADH is effective when

wt decreases lungs clear increases urine output decreased serum osmolality

what does pheochromocytoma do?

increases the release of catecholamines (epinephrine and norepinephrine.)

what controls the release of hormones in body?

NEGATIVE FEEDBACK

nurse priority for pre-op adrenalectomy

monitor VS

Pheochromocytoma diet is?

high cal high vitamins and minerals graham crackers and milk

thyroid storm and vasodilation occurs what happens

BP drop

teach about salt restricted diet

Salt substitutes are high in K+

What might thyroid crisis lead to

CHF

Nursing DX for acromegaly

risk for falls trauma injury

laryngeal spasms are possible with hypoparathyroidism

what contributes to cushings depression

moon face facial hair wt gain

Chvostek and Trousseau sign of

Hypocalicemia