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NCLEX > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

What does calcitonin do?

A

Opposite of PTH
- decreases serum calcium levels by taking calcium out of the blood and putting it back into the bone
(for osteoporosis)

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2
Q

Graves disease…is it HYPER- or HYPOthyroid

A

Hyperthyroid

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3
Q

With hyperthyroidism, would thyroxine (T4) and TSH be increased or decreased?

A

Thyroxine (T4) –> increased

TSH –> decreased

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4
Q

Client must d/c any iodine containing meds ___ week prior to a thyroid scan and must wait ___ weeks to restart meds.

A

1 week

6 weeks

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5
Q

Anti-thyroid meds are used to ___ the thyroid; stops the thyroid from making ___.
Name them…

A

stun
hormones
methimazole and propylthiouracil (PTU)

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6
Q

Iodine compound med ___ the size and vacularity of the thyroid.
What should we remember about this administration?
Name it…

A

decreases
Give in milk or juice with a straw…stains teeth
potassium iodine

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7
Q

Beta blockers such as ___ (___) provide supportive therapy. What 4 things do they do?

A

propanolol (Inderal)

1) decreases myocardial contractility
2) could decrease CO
3) decreases HR, BP
4) decreases anxiety

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8
Q

Who should NOT receive beta blockers? Why not?

A

Asthmatics - cause bronchial constriction

Diabetics - masks symptoms of hypoglycemia

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9
Q

Myxedema is longterm ___. What are 4 visible signs of this?

A

hypothyroidsim

1) general puffiness
2) facial edema
3) dull, mask-like expression
4) tongue protusion

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10
Q

With hypothyroidism, what will happen to thyroxine (T4)

and TSH?

A

Thyroxine (T4) will decrease

TSH will increase

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11
Q

What do we remember with levothyroxine admin?

A
  • take on EMPTY stomach

- start with low dose and work up

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12
Q

Adrenals help you handle ___

A

stress

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13
Q

Adrenal medulla secretes…

Adrenal cortex secretes…

A

Medulla –> epi and norepi

Cortex –> glucocorticoids, mineralocorticoids, sex hormones

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14
Q

What tests are used to measure catacholamine levels?

What foods should be avoided prior to these tests?

A

VMA (vanillylmandelic acid) test
Metanephrine (MN) test

(Avoid several days to a week prior: vanilla foods, caffeine, vit B, fruit juices, banana)

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15
Q

What is an example of a glucocorticoid?

What does it do?

A

Cortisol

  • changes mood
  • alters defense mechanisms/immunosuppression
  • Breakdown fats and protein
  • Inhibit insulin (serum glucose can go up)
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16
Q

Example of mineralocorticoid;

What does it do?

A

Aldosterone (remember this??)

  • makes you retain Na and water
  • makes you lose K (b/c Na and K have inverse r’ship)
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17
Q

Too much aldosterone:

  • Fluid volume ___
  • Serum K ___

Not enough aldosterone

  • Fluid volume ___
  • Serum K ___
A

Too much

  • fluid volume EXCESS
  • K DECREASED

Not enough

  • fluid volume DEFICIT
  • K INCREASED
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18
Q

Too many steroids = ___

A

hypercortisolism

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19
Q

Addison’s disease is caused by (too much or not enough) steroids?

A

Not enough

It’s an adrenocortical insufficiency

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20
Q

Addison’s disease leads to hyperkalemia…why?

A

K and Na are inversely related

If not enough aldosterone secreted, leads to low Na and water, leads to high K

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21
Q

What 2 things occur during an Addisonian crisis?

A
  • severe hypotension

- vascular collapse

22
Q

Cushing’s Disease is the opposite of Addison’s, so ___ ___ steroids

A

too many

23
Q

Pts must have 3 of these characteristics to be labeled “metabolic syndrome”

A

Waist circumference:

  • Men >40 in
  • Women >35 in

Triglycerides: >150

HDL:

  • Men <40
  • Women <50

BP: >130/85

FBS: >100

24
Q

Pregnant women need ___-___ x more insulin than normal. Why?

A

2 - 3
placenta has an anti-insulin-like effect
If not, there’s a possibility that the placenta is not working correctly and there could be a problem with the baby.

25
Q

Diet recommendations for DM (Type 1 and 2)

A 
Majority of calories from complex carbs (45%)...
then fats (30-40%)...
lastly protein (15-20%)

Extreme blood sugar = vascular damage –> BAD

High fiber slows down glucose absorption in the intestines, eliminating the sharp rise/fall in blood sugar

26
Q

Diabetics should wait until blood sugar ___ before exercising.
Pt should ___ pre-exercise to prevent hypoglycemia.
Exercise when blood sugar is at its ___.
Exercise same ___ and ___ daily.

A

normalizes
eat
highest
time and amount

27
Q

What is the most widely used anti-diabetic med? How does it work?

A

metformin (Glucophage)

  • Reduces glucose production
  • Enhances how glucose enters the cell
  • Does not stimulate the release of more insulin, so no hypogycemic response –> good!
28
Q

Pts on metformin should d/c before surgery or procedure where dye is used. Can resume ___ hours after if ___ ___ is normal. Why?

A

48 hours
kidney function
The dye and metformin compete for kidney excretion. Metformin wins so the dye will stay in the blood…BAD!

29
Q

What is the avg adult dose of insulin?

A

0.4 - 1 unit/kg/day

30
Q

What color insulin?
Regular ___
NPH ___
Draw up in what order?

A

Regular –> Clear
NPH –> Cloudy

Put in your air, then draw up CLEAR before CLOUDY

31
Q

Why is NPH so cloudy?

A

It is is packed with particles (time release)

32
Q

The most common method of daily dosing insulin is ___/___ dosing.

A

basal / bolus

33
Q

The total daily dose of insulin with the basal / bolus method is a combination of a ___ insulin and a ___ insulin.

A

long-acting

rapid-acting

34
Q

Long-acting insulin is given ___ x day.
When does it peak?
Name a long-acting insulin:

A

1
Doesn’t peak
glargine / Lantus

35
Q

The rapid-acting insulin is given ___ the day ___ meals in ___ doses. It covers the food eaten at meals.
Name a rapid-acting insulin:

A

throughout
before
divided
aspart / Novolog (the log rolls down the hill rapidly)

36
Q

Always have food right there when giving ___ insulin!!!

A

rapid-acting

37
Q

Clients should eat when insulin is at its ___; this is when blood sugar is at its ___.
Always monitor a client on insulin for ___.

A

peak
lowest
hypoglycemia

38
Q

HbA1c goal for diabetics is ___%

A

= 7%

39
Q

Insulin admin: rotate ___ an area first

A

within

40
Q

What type of insulin is used in an insulin pump?

What type of dosing does the pump provide?

A

Only RAPID-acting
Both continuous (BASAL) dosing of RAPID-acting insulin and on-demand (BOLUS) dosing.
(Remember “Basal / Bolus”)

41
Q

8 signs of hypoglycemia

A

1) cold and clammy
2) confusion
3) shaky
4) HA
5) nervous
6) tachycardia
7) nausea
8) hunger

42
Q

If hypoglycemic, the client should consume ___ ___.
Snacks should be ___ g of carbs.
Glucose absorption is ___ in foods with lots of ___.

A

simple carbs
15g
delayed, fat

43
Q

What is the 15 - 15 - 15 rule?

A

15g of simple carbs
Wait 15 min…check blood sugar again
Give 15g of more simple carbs if still low

44
Q

What is the first line of defense for someone in a hypoglycemic crisis?
If no IV access, can use ___.

A

D50W

glucagon (IM…or sometimes subq)

45
Q

What to remember with D50W admin?

A

Very hard to push b/c so thick

Choose a large bore IV if possible

46
Q

Treatment for DKA

A 
Hourly blood sugar &amp; K checks
ECG (watch for K-induced arrythmias)
Hourly output
ABGs
Isotonic fluids to raise BP (b/c polyuria)
47
Q

What to remember with DKA IVF regimen:

A
  • Start with NS (isotonic) and IV regular insulin
  • When blood sugar gets down to 250-300, switch to D5W to prevent hypoglycemia
  • Anticipate MD adding K to IV solution at some point
48
Q

Diabetics can develop poor ___ everywhere due to vessel damage from elevated ___ over time.
(Sugar ___ the vessel lining; accumulation of sugar will ___ the size of the vessel lumen, therefore ___ blood flow.)

A 
circulation
sugar
irritates
decrease
decreasing
49
Q

What are 2 VASCULAR complications that can occur over time with poorly managed DM?

A

diabetic retinopathy

nephropathy (dialysis needed)

50
Q

What are 4 NEUROPATHIC complications that can occur over time with poorly managed DM? (Why?)

A
  • Sexual problems: impotence/decreased sensation
  • Foot/leg problems: pain/paresthesia/numbness
  • Neurogenic bladder: does not empty properly
  • Gastroparesis: delayed stomach emptying, risk for aspiration
51
Q

Teach pt about foot care:

A
  • cut toenails straight across
  • dry in between toes
  • always wear shoes
  • wear comfy shoes
  • inspect feet daily
  • avoid harsh chemicals

NCLEX (13 decks)

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