Endocrine Case Study Flashcards
Creatinine 2.5
Numbness extremities
T2DM
WBC 20,000
Temp 102
HR 115
Infection
The client is at risk for developing —-1—-, due to —-2—-.
Hypoglycemia
Lispro
Prednisone is contraindicated in acute infections because it blocks the immune response Prednisone also raises the blood glucose level interfering with glucose control and would healing. Other medications can be used to control the arthritic pain.
Why would the healthcare provider discontinue the prednisone?
TSH, T3, T4
What lab(s) should the healthcare provider order to check the client’s thyroid level?
Medication should be given at the same time each day on an empty stomach
What is important with administration of Levothyroxine to maintain the correct therapeutic level?
MOA: increases insulin sensitivity; decreases hepatic glucose production and GI glucose absorption
AE: C - N/V/D, abd discomfort, anorexia (first 2 weeks);
Rare - lactic acidosis (life-threatening)
What is the mechanism of action of metformin (Glucophage)? What are the most common adverse effects associated with this drug?
Risk of acute kidney injury
Why did the healthcare provider order the metformin to be held 2 days before and 2 days after receiving IV contrast?
Creatinine 2.5, BUN, 40 are indicative of kidney damage probable diabetic nephropathy; WBC 20,000 indications infection; Glucose 320 is elevated – poor glucose control by client and may be exacerbated by infection
Regarding the above scenario, why are the labs taken in the ER concerning?
Onset: 5-15 min
Peak: 30-60 min
Duration: 3-4 hrs
What is the onset, peak and duration for Lispro insulin?
Onset: gradual
Peak: none
Duration: 24 hrs
What is the onset, peak and duration for Glargine insulin?
Lispro 5 units scheduled + 10 units = 15 units
The nurse is preparing to pass medications. The unlicensed assistive personnel (UAP) takes the client’s blood glucose at 11:45 am (before lunch) and reports it to be 290 mg/dL. Using the MODERATE DOSE Sliding Scale Insulin Order Set (above) how many units of insulin should the nurse administer?
30-60 minutes
The client decides to eat only 25% of their lunch stating, “Nothing on this tray was very good.” When is the client most at risk for developing hypoglycemia?
Mild <70 mg/dl
15/15 Rule:
Give the client 15 g carbohydrate (Ex: 4 Glucose tablets; 4 oz regular soda pop; ½ c juice; 1 c (8 oz) milk)
Wait 15 minutes and retest blood glucose
If remains below 60 mg/dL, repeat carb, recheck BG (15 min)
Once stable- Check BG 1 hour
An hour after administering the appropriate dose of insulin, the client complains of nausea, diaphoresis, and shaking. The client is alert and oriented. The nurse checks the BG and finds it is 62. What is the nurse’s next action?
