Endocrine Nursing assessment PPT Flashcards
a 28 year old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
A) the patient always carries hard candies when engaging in exercise
B) The patient goes for a vigorous walk when his glucose is 200 mg/dl
C) The patient has a peanut butter sandwich before going for a bicycle ride.
D) The Patient increases daily exercise when ketones are present in the urine
D. Ketones are bad…. they are just not cool
A Patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient? A) Urine dipstick for glucose B) Oral glucose tolerance test C) Fasting blood glucose level D) Glycosylated hemoglobin level
D. Glycosylated Hemoglobin Level- A1C
A 32 year old patient with Diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage? A) Lispro (Humalog) B) Glargine (Lantus) C) Detemir (Levemir) D) NPH (Humulin N)
A) Lispro (Humalog)
Need fast acting insulin for meal time coverage like Humulin R or Humalog
When a patient who takes metformin (Glucophage) to manage type 2 diabetes developed an allergic rash from an unknown cause, the health care provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may
A) need a diet higher in calories while receiving prednisone
B) develop acute hypoglycemia while taking prednisone
C) require administration of insulin while taking prednisone
D) have rashes caused by metformin-prednisone interactions
C. require administration of insulin while taking prednisone
*corticosteroids raises blood sugar
A 26 year old patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to administer the morning insulin? A) Thigh B) Buttock C) Abdomen D) Upper Arm
D) Upper Arm
*dont want to inject in any muscles that are working because it will cause insulin to be absorbed faster.
What is the sick day management for DKA
Check blood glucose q4h
notify HC provider of illness
Test urine for ketones
Continue with diabetic medications
If unable to eat solids then drink carbohydrate content of meal
CALL PROVIDER WHEN * persistent N/V, moderate to large ketones or fever
what are all those endocrine glands?
For class we are focusing on : Pancreas, Adrenals, and pituitary
theres also: hypothalamus, thyroid, parathyroid, ovaries, testes, pineal gland
What different about endocrine glands
Hormones secreted in very small amounts and regulated by a feedback system. They also bind to specific receptors in the body.
What are the two classifications of endocrine hormones
Lipid soluble
Water Soluble
About Lipid soluble endocrine hormones
bind to plasma proteins fro transport
released when needed
EX: thyroid hormones and steroids
About Water soluble endocrine hormones
circulate freely in blood to target tissues
EX: Insulin, growth hormone, prolactin
The endocrine system is regulated by________
This system can………
Simple feedback which includes Positive and negative feedback.
This system can stimulate or inhibit hormone secretion.
tell me about Negative feedback
- relies on blood level of hormone or other chemical compound (glucose).
- most common feedback
- comparable to thermostat - control system
Tell me about positive feedback
- regulates hormone synthesis and release
- rising hormone levels cause another gland to release a hormone that stimulates further release of the first hormone.
- mechanism for turning off the first hormone is needed or it will continue to be released
- female ovarian system is operated by this method
How does Nervous system regulate hormonal secretion of endocrine system
pain, emotion, sexual excitement and stress can stimulate NS to modulate hormone secretion.
-initiated by CNS but implemented by sympathetic nervous system
Circadian Rhythm
24 hour rhythm of the body. sleep/wake cycle.
Ultradian rhythm
occurs over a period of time greater than 24 hours
EX: Menstral cycle
Hypothalamus have two types of hormones that control pituitary recreations. what are those bad boys???
Releasing hormones
Inhibiting hormones
List of hypothalamus releasing hormones just in case you want to know them
Corticotropin-releasing hormone (CRH) Thyrotropin-releasing hormone (TRH) Growth Hormone-releasing hormone (GHRH) Somatotropin-releasing hormone Gonadotropin-releasing hormone (GnRH) Prolatin-releasing factor (PRF)
List of the hypothalamus inhibiting hormones just in case you want to know them
Somatostatin (inhibits growth hormone release)
Prolactin-inhibiting factor (PIF)
The pituitary is regulated by its boss the______
hypothalamus
The pituitary produces all these crazy hormones
TSH- tells thyroid to secrete thyroid hormones
ACTH- andrenocortiotropic hormone- tells adrenal to secrete corticosteroids
FSH- secretion of estrogen
LH- ovaries
growth hormone-
Prolactin-breast development/lactation
These are produced in the hypothalamus but released by its awesome friend the pituitary
antidiuretic hormone- regulation of fluid volume
oxyctocin- stimulate milk in mammary ducts, uterus contractions, sperm motility
ADH secretion is stimulated by increased __1___ and _2____. This causes __3___ release from the pituitary. Renal tubules reabsorb water which increases __4____ ______ and decreases __5____ ______.
- plasma osmolality
- hypovolemia
- ADH
- Plasma volume
- Plasma osmolality
