endocrine med surg Flashcards
what causes diabetic ketoacidosis
no insulin so cells breakdown protein/fat and produce ketones
respiratory signs of DKA
kussmaul respirations
what type of diabetes causes DKA
type 1 (no insulin)
rapid deep breathing at a consistent pace is called
kussmaul respirations
hyperglycemia over 600+ is what disease
hyperglycemic hyperosmolar nonketotic syndrome (HHNS)
what to give IV to unconcious pt w hyperglycemia
50% dextrose (d50)
graves disease is caused by what thyroid issue
hyperthyroidism
hashimotos disease is caused by what thyroid issue
hypothyroidism
myxedema coma is caused by what thyroid issue
hypothyroidism
what hormone controls calcium lvls in blood
parathyroid hormone
causes of hyperparathryroidism
-tumor on parathyroid
-chronic kidney failure
the increase of calcium in blood can cause what with hyperparathyroidism
kidney stones
how hyperparathyroidism affects the joints
-bone pain
-pathological fractures
how hyperparathyroidism affects the GI system
-abd pain
-N/V
-weight loss/loss of appetite
-constipation
how hyperparathyroidism affects the neuro system
-irritability
-confusion
how hyperparathyroidism is treated
parathyroidectomy
medications for hyperparathyroidism
phosphates
calcitonin
IV/oral biphosphonates
diet for hyperparathyroidism pt
increase fiber
moderate calcium
mneumonic for hyperparathyroidism s/s
stones, bones, moans and groans
relationship between calcium and phosphorus
inverse
calcium lvls in hypoparathyroidism
low
radiation can cause what parathyroidism
hypo
magnesium depletion can cause what parathyroidism
hypo
how does hypoparathyroidism affect the neuro system
-numbness/tingling
-anxiety
-irriability
-depression
how does hypoparathyroidism affect the muskuloskeletal system
-muscle cramps
-tetany
how does hypoparathyroidism affect the cardiovascular system
hypotension
how to test for hypoparathyroidism (same as hypocalcemia)
-trousseau
-chvostek sign
results of chvostek and trousseau in hypoparathyroidism
positive
how to treat hypoparathyroidism
IV calcium
phosphorus binding drugs
hypoparathyroidism diet
increase calcium
decrease phosphorus
what do adrenal cortex hormones do to sodium and water
retain them
what do adrenal cortex hormones do to potassium
decrease
what kind of hormone are glucocorticoids
adrenal cortex hormones
what kind of hormones are mineralocorticoids
adrenal cortex hormones
what kind of hormones are sex. hormones
adrenal cortex hormones
what causes cushings disease
too many adrenal cortex hormones (females, too much cortisol meds, adrenal gland tumor)
cushings disease affect on glucose lvls
increased
cushings disease affect on sodium
increased
cushings disease effect on cardiovascular system
-htn (that cush will raise ur BP)
cushings disease effect on weight
weight gain
cushings disease affect on sex hormones
hirtuism (that cush will turn u into a man)
cushings s/s
moon face
buffalo hump
truncal obesity
supraclavicular fat pads
how long will cushings disease pts need clucocorticoid replacement after adrenalectomy
forever
how is cushings disease treated
adrenalectomy
what is Glycosylated hemoglobin levels
hbA1c
what is Somogyi
hypoglycemia when sleeping that turns into hyperglycemia in the morning
causes of addison’s disease
-adrenal gland removal
-adrenal gland infection
-TB
-cytomegalovirus
-bacterial infection
constitutional sxs of addisons disease
-fatigue
GI sx’s of addisons disease
-N/V/D
-anorexia
endocrine sxs of addisons disease
hypoglycemia
electrolyte signs of addisons disease
-decreased Na
-decreased H2O
-increased potassium
integumentary sxs of addisons
-hyperpigmentation
-vitiligo
neuro sxs of addisons disease
-confusion
where are the adrenal glands
on top of the kidneys
constitutional sx’s of addisonian crisis
-profound fatigue
electrolyte sxs of addisonian crisis
-dehydration
-shock
-hyponatremia
-hyperkalemia
cardio sxs of addisonian crisis
-hypotension
-hypovolemia
-vascular collapse
renal sxs of addisonian crisis
-renal failure
treatment for addisonian crisis
-fluid resuscitation
-high dose hydrocortisone
how to treat addisons disease
-glucocorticoid
-mineralcorticoid
addisons pt diet education
increase protein and carbs
what does ADH control
amount of water in blood
where is ADH found
the pituitary gland
what are the 2 ADH pituitary gland disorders
Syndrome of inappropriate antidiuretic hormone (SIADH)
simple pathology of SIADH
too much ADH
causes of SIADH
-pulmonary diseases
-CNS disorders
-HIV
-meds
what pulmonary diseases cause SIADH
-TB
-severe pneumonia
what CNS disorders cause SIADH
-head injury
-brain surgery
-tumor
what meds cause SIADH
-vincristine
-phenothiazines
-antidepressants
-thiazide diuretics
-anticonvulsants
-diabetes drugs
-nicotine
s/s of SIADH
-oliguria
-fluid volume overload
-weight gain w/o edema
-hyponatremia
-N/V
-tachycardia
-HTN
meds for SIADH
-loop diuretics
-vasopressin antagonists
what precautions should SIADH pts be put on
seizure
should SIADH pts be put on fluid restrictions
yes
simple pathology of diabetes insipidus
not enough ADH
neuro causes of diabetes insipidus
-head trauma
-brain tumor
-CNS infection
-pituitary gland surge
renal causes of diabetes insipidus
renal tubles cant respond to ADH
urine sx’s of diabetes insipidus
-polyuria
-large amounts of dilated urine
-low urine specific gravity
endocrine sx’s of diabetes insipidus
-polydipsia
-polyuria
-large amounts of filated urine
-low urine specific gravity
integumentary sxs of diabetes insipidus
-decreased skin turgor
ENT sx’s of diabetes insipidus
-dry mucous membranes
-dehydration
cardio sx’s of diabetes insipidus
-postural hypotension
-tachycardia
neuro sx’s of diabetes insipidus
-headache
muskuloskeletal sx’s of diabetes insipidus
-muscle pain
-muscle weakness
sxs of diabetes insipidus
neuro:
-headaches
ENT:
-dry mucous membranes
-dehydration
cardio:
-tachycardia
-postural hypotension
endocrine:
-polyuria
-polydipsia
-low urine specific gravity
-lots of diluted urine
integumentary:
-decreased skin turgor (dry skin)
muskuloskeletal:
-muscle pain
-muscle weakness
what kind of saline should u give diabetes insipidus pt
IV hypotonic saline
what do vasopressin and desmopressin do
replace ADH
what meds would you treat diabetes insipidus with
vasopressin
desmopressin
what should u monitor in diabetes insipidus pt
-I&O
-weight
what hormones are made in the adrenal glands
epinephrine and norepinephrine
what is an adrenal gland tumor called
pheochromocytoma
what does pheochromocytoma do
causes adrenal glands to secrete excessive amounts of epinephrine and norepinephrine
what causes pheochromocytoma
family history of adrenal gland tumors