Endocrine Emergencies Flashcards
What is DKA?
Metabolic state characterised by increased BSL, ketosis, acidosis
Pathophysiology of DKA
insulin deficiency - cellular starvation - counter-reg hormones - more glucose - hyperglycaemia - kidney can’t absorb - urine, osmotic diuresis (polyuria, polydipsia, hyperK+) - counter-reg hormones - lipolysis - fats and proteins into glucose, beta oxidation (weight loss) - by product ketone - increase ketone - metabolic acidosis (weight loss, polyphagia, ketone breath) - buffer w bicarb - system overwhelmed - activate mechanisms - compensatory respiratory alkalosis (kussmaul breathing)
DKA symptoms
- N+V
- Abdominal pain
- Flushed cheeks
- Shock
- Disorientation
- Drowsiness
DKA treatment
- Investigations
- Symptoms management
- Fluids
DKA nursing responsibilites
- Symptom management
- Fluid input/output chart
- IDC
- Fluid replacement
- Meds/insulin
- Check ketone, K+
What is thyroid storm
Excessive thyroid hormone leading to multi organ failure
Thyroid storm symptoms
- Thermoregulatory: warm skin, fever, diaphoresis
- Cardiovascular: AF, tachycardia, hypertension
- Respiratory: tachypnoea
- Gastrointestinal: vomiting, nausea, diarrhoea, abdominal pain
- Neurologic: LOC, seizure, restlessness, psychosis, coma
Thyroid storm treatment
- PTU: propylthiouracil (stop thyroid release)
- Symptomatic management
- Fluid management
What is adrenal crisis
Insufficient release of cortisol hormone leading to increased BSL and decreased immune system
Adrenal crisis symptoms
- Abdominal, lower back, leg pain
- Diarrhoea, vomiting
- Slurred speech
- Lethargy
- Confusion
- Syncope, LOC
- Fever
- Hyponatremia
- Hypotension
- Hypoglycaemia
- Hyperkalaemia
Adrenal crisis treatment
- Hydrocortisone treatment
- Symptomatic treatment
- Fluid replacement
