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NURS 428: Evolution > Endocrine System > Flashcards

Endocrine System Flashcards

Exam 4 (Final)

1
Q

The Endocrine system:

What does it do?

A

Secretes hormones

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2
Q

The Endocrine system:

What does it control? What does it take part in?

A

Controls metabolism,

transports substances across cell membrane,

fluid and electrolyte balance,

growth and development, adaptation,

and reproduction

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3
Q

The Endocrine system:

How is hormone production maintained? What does it involve?

A

Hormone production is maintained by a negative or positive feedback loop involving the hypothalamic–pituitary axis.

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4
Q

Endocrine Dysfunction:

What occurs?

A

Subnormal hormone production as a result of gland destruction or malformation

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5
Q

Endocrine Dysfunction:

What else can occur?

A

Hormone excess

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6
Q

Endocrine Dysfunction:

How does production of abnormal hormone occur?

A

Production of abnormal hormone resulting from gene mutation

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7
Q

Endocrine Dysfunction:

How do hormone receptor disorders result?

A

Hormone receptor disorders resulting from autoimmune processes

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8
Q

Endocrine Dysfunction:

Disorders of hormone transport or metabolism result in what?

A

Disorders of hormone transport or metabolism, resulting in increased levels of “free” hormones in the blood

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9
Q

The Hypothalamus and Pituitary Gland

What do they share?

A

They share two connecting pathways:

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10
Q

The Hypothalamus and Pituitary Gland

They share two connecting pathways: what are they?

A
  1. a rich vascular network that connects hypothalamus to anterior pituitary,
  2. and nerve fibers that link the hypothalamus with the posterior pituitary.
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11
Q

The Hypothalamus and Pituitary Gland:

What do they control?

A

They control the

thyroid gland,

adrenal glands,

gonads, and

exert control over growth and metabolism.

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12
Q

The Hypothalamus and Pituitary Gland:

What is referred to as the master gland?

A

Pituitary is referred to as the master gland.

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13
Q

The Hypothalamus and Pituitary Gland:

What is hypothalamus?

A

Hypothalamus is the coordinating center of the brain.

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14
Q

The Thyroid and Parathyroid Glands

What does the thyroid gland do?

A

Thyroid gland- Produces, stores, and secretes thyroid hormones T3 and T4

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15
Q

The Thyroid and Parathyroid Glands

Each lobe of the thyroid contains what?

A

Each lobe of the thyroid gland contains two parathyroid glands.

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16
Q

The Thyroid and Parathyroid Glands

What synthesizes T3 and T4?

A

Tyrosine (amino acid) and iodide synthesize T3 and T4, stored in the colloid of the follicular cell until needed.

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17
Q

The Thyroid and Parathyroid Glands

What helps transport T3 and T4? Where are they manufactured?

A

Plasma proteins help to transport T3 and T4 , and are manufactured in the liver.

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18
Q

The Thyroid and Parathyroid Glands

What kind of condition can damage to liver produce?

A

Damage to liver can produce a condition that resembles hyperthyroidism.

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19
Q

Thyroid and Parathyroid hormones

Thyroid hormones: What are they and what produces them?

A

The follicular cells of the thyroid glands produce thyroid hormones thyroxine (T4) and triiodothryronine (T3).

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20
Q

Thyroid and Parathyroid hormones

Thyroid hormones: What do T3 and T4 do? What does this lead to?

A

Both T3 and T4 increase metabolism, which causes an increase in oxygen use and heat production in all tissues.

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21
Q

Thyroid and Parathyroid hormones

Thyroid hormones: What produces calcitonin?

A

The parafollicular cells produce Calcitonin

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22
Q

Thyroid and Parathyroid hormones

The parafollicular cells produce Calcitonin:

What does calcitonin inhibit?

A

Inhibits calcium reabsorption in the GI tract

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23
Q

Thyroid and Parathyroid hormones

The parafollicular cells produce Calcitonin:

What does calcitonin increase?

A

Increases calcium excretion from kidney

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24
Q

Thyroid and Parathyroid hormones

Parathyroid hormone: What is produced by?

A

Produced by the parathyroid glands

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25
Q

Thyroid and Parathyroid hormones

Parathyroid hormone: What does it promote?

A

Promotes bone resorption

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26
Q

Thyroid and Parathyroid hormones

Parathyroid hormone: What does it increase?

A

Increases calcium reabsorption

Increases calcium blood levels

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27
Q

Thyroid and Parathyroid hormones

What does vitamin D do?

A

Vitamin D acts on intracellular enzymes in intestinal mucosa to increase calcium absorption.

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28
Q

The Pancreas:

Has what kind of functions?

A

Endocrine functions

Exocrine functions

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29
Q

The Pancreas:

Endocrine functions: What occurs?

A

The Islets of Langerhans secrete hormones into the blood. They are composed of cell types:

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30
Q

The Pancreas:

Endocrine functions: The Islets of Langerhans secrete hormones into the blood. They are composed of cell types: What are they?

A

Alpha cells

Beta cells

Delta cells

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31
Q

The Pancreas:

Endocrine functions: The Islets of Langerhans secrete hormones into the blood. They are composed of cell types:

Alpha cells?

A

Alpha cells which secrete glucagon

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32
Q

The Pancreas:

Endocrine functions: The Islets of Langerhans secrete hormones into the blood. They are composed of cell types:

Beta cells?

A

Beta cells which secrete insulin.

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33
Q

The Pancreas:

Endocrine functions: The Islets of Langerhans secrete hormones into the blood. They are composed of cell types:

Delta cells?

A

Delta cells which secrete somatostatin

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34
Q

The Pancreas:

Exocrine functions: What does it involve?

A

Involves the secretion of digestive enzymes into the duodenum.

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35
Q

The Pancreas:

What do C-peptide levels measure?

A

C-peptide levels measure the degree of beta-cell activity and can assist in dx of types 1 and 2 diabetes.

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36
Q

The Pancreas:

What do low C-peptide levels indicate? What does this lead to?

A

Low C-peptide = autodestruction of beta cells; no insulin production = type 1 diabetes

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37
Q

Insulin:

What is it?

A

Insulin is an anabolic hormone

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38
Q

Insulin:

What is it responsible for?

A

responsible for blood glucose concentrations and storage of carbohydrates, proteins, and fat

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39
Q

Insulin:

What does it facilitate:

A

Facilitates use of glucose for energy

Facilitates cellular transport of glucose, amino acids, and fatty acids across cell membranes

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40
Q

Insulin:

What increases the production of insulin?

A

Elevated plasma levels of glucose increase the secretion of insulin.

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41
Q

Insulin:

What decreases the production of insulin?

A

Lower levels of glucose decrease insulin output.

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42
Q

Insulin:

Insulin resistance: What is it a characteristic of?

A

It is a characteristic of type 2 diabetes mellitus.

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43
Q

Insulin:

Insulin resistance: What is it?

A

It is a physiologic condition in which a person needs more insulin to lower serum glucose effectively than would normally be required.

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44
Q

Insulin:

Insulin resistance: What does this eventually lead to?

A

Beta cell exhaustion results when the pancreas must keep up with the higher demands for insulin.

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45
Q

Glucose Regulation:

What is involved?

A

Glucagon

Somatostatin

Pancreatic polypeptide

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46
Q

Glucose Regulation:

Glucagon: What does it do?

A

Elevates blood glucose levels to enable entry and use by cells of the body by stimulating the secretion of insulin

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47
Q

Glucose Regulation:

Somatostatin: What does it do?

A

Inhibits the release of insulin and glucagon from the pancreas

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48
Q

Glucose Regulation:

Pancreatic polypeptide:

A

Has a role in smooth muscle relaxation of the gallbladder

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49
Q

The Adrenal Glands:

What are the two parts?

A

Adrenal gland cortex

Medulla

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50
Q

The Adrenal Glands:

Adrenal gland cortex: What are the hormones produced by it?

A
  1. Mineralocorticoids
  2. Glucocorticoids
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51
Q

The Adrenal Glands:

Adrenal gland cortex:

Mineralocorticoids- What do they do?

A

Reabsorption of sodium

Elimination of potassium

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52
Q

The Adrenal Glands:

Adrenal gland cortex:

Glucocorticoids- What do they do?

A

Responds to stress

Decreases inflammation

Alters metabolism of protein and fat

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53
Q

The Adrenal Glands:

Medulla- produces what hormones?

A

Epinephrine

Norepinephrine

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54
Q

The Adrenal Glands:

Medulla-

Epinephrine- What does it do?

A

Stimulates sympathetic system

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55
Q

The Adrenal Glands:

Medulla-

Norepinephrine- What does it do?

A

Increases peripheral resistance

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56
Q

Endocrine Disorders:

Effect what parts of the body?

A

Affect all body systems

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57
Q

Endocrine Disorders:

What are they caused by?

A

Caused by an overproduction or an underproduction of hormones

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58
Q

Endocrine Disorders:

What are signs and symptoms?

A

Vital signs

Energy level

Fluid and electrolyte imbalances

Heat and cold intolerance

Weight changes

Altered sleep patterns

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59
Q

Thyroid Dysfunction:

What are the most common ones?

A

The most common are

hyperthyroidism,

hypothyroidism, and

thyroid nodules.

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60
Q

Thyroid Dysfunction:

Hyperthyroidism: its severe form?

A

Thyrotoxicosis (Thyrotoxic crisis)

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61
Q

Thyroid Dysfunction:

Hypothyroidism: its severe form?

A

Myxedema coma

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62
Q

Thyroid Dysfunction

What are causes of thyroid dysfunction?

A

Causes of thyroid dysfunction:

Graves’ disease,

Hashimoto’s disease,

thyroiditis.

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63
Q

Signs and Symptoms of Hypothyroidism:

Lower body:

A

Pretibial edema

Muscle weakness/cramps

Loss of body hair, dry patchy skin, cold intolerance

Menstrual irregularities

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64
Q

Signs and Symptoms of Hypothyroidism:

Middle body:

A

Constipation

Slower heart beat,

elevated cholesterol

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65
Q

Signs and Symptoms of Hypothyroidism:

Neck:

A

Swelling (goiter)

Hoarseness/deepening voice

Dry/sore throat

Difficulty swallowing

66
Q

Signs and Symptoms of Hypothyroidism:

Head:

A

Thinning hair/hair loss

Puffy eyes

67
Q

Signs and Symptoms of Hypothyroidism:

Mind:

A

Depression

Forgetfulness/slower thinking

Irritability

Inability to concentrate

Tiredness

68
Q

Signs and Symptoms of Hyperthyroidism:

Lower body:

A

Osteoporosis

Infertility

Menstrual irregularities/light period

Excessive vomiting in pregnancy

First trimester miscarriage

69
Q

Signs and Symptoms of Hyperthyroidism:

Middle body:

A

Warm moist palms

Fine tremors

Frequent bm

Weight loss

70
Q

Signs and Symptoms of Hyperthyroidism:

Neck:

A

Hoarseness/deepening voice

Swelling (goiter)

Persistent dry or sore throat

Difficulty swallowing

Weight loss

71
Q

Signs and Symptoms of Hyperthyroidism:

Head:

A

Heat intolerance

Increased sweating

Bulging eyes

Unblinking stare

Lid lag

72
Q

Signs and Symptoms of Hyperthyroidism:

Mind:

A

Nervousness

Irritability

Difficulty sleeping

73
Q

Normal Total T4 values

A

4-12 mcg/dL

74
Q

Normal Free T4 values

A

0.8-2.7 ng/mL

75
Q

Normal Free T4 index

A

4.6-12 ng/mL

76
Q

Normal Free T3 index

A

260-480 pg/dL

77
Q

Normal TSH values

A

260-480 pg/dL

78
Q

Normal Total T4 values: 4-12 mcg/mL

What does a high T4 level indicate?
What does a low T4 level indicate?

A

High = hyperthyroidism

Low = hypothyroidism

79
Q

Normal Free T4 values: 0.8-2.7 ng/mL

What does a high T4 level indicate?
What does a low T4 level indicate?

A

High in hyperthyroidism

Low in hyperthyroidism

80
Q

Normal Free T3 values: 260-480 pg/dL

What does a high T3 level indicate?
What does a low T3 level indicate?

A

Low in hypothyroidism

81
Q

Normal TSH values: 260-480 pg/dL

What does a high TSH level indicate?
What does a low TSH level indicate?

A

High in hypothyroidism

Low in hyperthyroidism

82
Q

Thyrotoxic crisis (Thyroid storm)—

What is it?

A

Thyrotoxic crisis is a severe form of hyperthyroidism often associated with physiologic or psychological stress.

83
Q

Thyrotoxic crisis (Thyroid storm)—

History and physical examination:

What are precipitating factors?

A

Precipitating factors such as infection, trauma, stress

84
Q

Thyrotoxic crisis (Thyroid storm)—

History and physical examination:

What are meds are precipitating factors? Why?

A

Medications such as contrast material for radiographic procedures or amiodarone (an antiarrhythmic drug), may precipitate the thyrotoxic state because of their high iodine content.

85
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

What are signs and symptoms?

A

S & S:

Sweating,

heat intolerance,

nervousness/anxiety,

tremors,

palpitations,

tachycardia,

hyperkinesis (restlessness),

increased bowel sounds,

hyperthermia,

decreased LOC

86
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Labs: How are T3, T4 and TSH levels?

A

Elevated total T4, free T3, and free T4,

extremely low TSH

87
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Labs: How are electrolytes and more?

A

Hypercalcemia,

hyperglycemia,

abnormal LFTs,

high or low WBC

88
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Management: What should be treated?

A

Treat the precipitating factor.

89
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Management: What should be controlled?

A

Control excessive thyroid hormone release with Iodine solution

90
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Management: What should be inhibited? how?

A

Inhibit thyroid hormone biosynthesis with antithyroid medications

91
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Management: What else should be treated? What else should be given?

A

Treat the peripheral effects—nutritional support, manage hyperthermia

Medications

92
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Management:

Medications: What is the preferred med during pregnancy? How is it given?

A

Antithyroid medication such as Propylthiouracil (PTU) is the preferred agent during pregnancy.

Only be given orally.

93
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Management:

Medications: What other med can be given?

A

Iodine solutions or Lugol’s solution blocks release of thyroid hormone.

94
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Management:

Medications: What is given for iodine sensitive patients?

A

Lithium for iodine sensitive patients.

95
Q

Thyrotoxic crisis (Thyroid storm)—Assessment and management

Management: What is done for emergency removal of excess circulating hormone replacement?

A

Plasmapheresis, dialysis, or hemoperfusion adsorption for emergency removal of excess circulating hormone replacement.

96
Q

Myxedema Coma;

What is it?

A

Rare, life-threatening emergency, extreme hypothyroidism

97
Q

Myxedema Coma;

What is it precipitated by?

A

Precipitated by stress, extreme cold temperature, trauma

98
Q

Myxedema Coma

Pathophysiology: Two types?

A

Primary

Secondary

99
Q

Myxedema Coma

Pathophysiology

Primary:

A

loss of thyroid tissue, defective hormone synthesis, antithyroid drugs, iodine deficiency

100
Q

Myxedema Coma

Pathophysiology

Secondary:

A

peripheral resistance to thyroid hormone, pituitary infarction, hypothalamic disorders

101
Q

Myxedema Coma

Pathophysiology

Signs and symptoms

A

Fatigue, weakness, decreased bowel sounds, decreased appetite, weight gain, ECG changes

Altered mental status, hypothermia (no shivering), hypoventilation, hypoxemia, hyponatremia, hypoglycemia, hyporeflexia, hypotension, bradycardia

102
Q

Myxedema Coma

Labs: T4? Na and K? TSH? ABGs?

A

Decrease T4 and free T4,

low sodium,

high potassium,

high TSH,

ABGs show severe hypercapnia with decreased arterial oxygen tension (PaO2) and increased arterial carbon dioxide tension (PaCO2).

103
Q

Myxedema Coma—Management

A

Mechanical ventilation

IVF

Vasopressors

Thyroid hormone and corticosteroids

Rewarming

Monitor cardiovascular and respiratory function

Treat bowel symptoms

Patient education

104
Q

Adrenal Gland Dysfunction—Adrenal Crisis

What is it also known as? How common is it?

A

Adrenal insufficiency is also known as Hypoadrenalism or hypocorticism

Rare but life threatening

105
Q

Adrenal Gland Dysfunction—Adrenal Crisis

Primary adrenal insufficiency is called?

A

Addison’s disease

106
Q

Adrenal Gland Dysfunction—Adrenal Crisis

H and P: What does Adrenal crisis effect?

A

Affects glucose metabolism, fluid and electrolyte balance, cognitive state, and cardiopulmonary status

107
Q

Adrenal Gland Dysfunction—Adrenal Crisis

H and P: What are symptoms?

A

Weakness, fatigue, anorexia, nausea, vomiting, diarrhea, abdominal pain,
tachycardia, orthostatic hypotension, headache, dehydration, lethargy,
irritability

108
Q

Adrenal Gland Dysfunction—Adrenal Crisis

Diagnostic studies: electrolytes?

A

Low sodium, high potassium, low serum bicarbonate, high BUN,
metabolic acidosis, hypoglycemia

109
Q

Adrenal Gland Dysfunction—Adrenal Crisis

What confirms diagnosis?

A

Serum cortisol levels and cortisol stimulation confirm diagnosis.

110
Q

Adrenal Crisis—Management

A

Hormone therapy

IVF (normal saline and 5% dextrose solutions)

Electrolyte balance

Prevent complications.

Monitor cardiovascular and respiratory status.

Monitor neuromuscular signs.

Emotional support

Patient education

111
Q

Pheochromocytoma:

What is it?

A

Rare catecholamine-secreting tumor that arises from chromaffin cells (that produce and release epinephrine and norepinephrine) in the adrenal glands

112
Q

Pheochromocytoma:

What occurs with it?

A

Life-threatening hypertension, cardiac dysrhythmia

113
Q

Pheochromocytoma:

What is the triad?

A

Sudden and severe hypertension,

palpations,

sweating

114
Q

Pheochromocytoma:

How is the diagnosis made?

A

Dx: measurement of fractionated plasma metanephrines and normetanephrines (blood test) and urine metanephrines and normetanephrines (urine test).

115
Q

Pheochromocytoma:

How is the diagnosis confirmed?

A

Diagnosis is confirmed with MRI or CT

116
Q

Pheochromocytoma:

How to treat?

A

Surgical resection of tumor, control hypertension

117
Q

Antidiuretic Hormone Dysfunction:

What are the two types?

A

SIADH

Diabetes Insipidus (DI)

118
Q

Antidiuretic Hormone Dysfunction:

SIADH: What is it?

A

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an excess of ADH.

119
Q

Antidiuretic Hormone Dysfunction:

DI: What is it?

A

Diabetes insipidus (DI) involves a deficiency of ADH.

120
Q

Antidiuretic Hormone Dysfunction:

SIADH and ADH: What can they both cause?

A

Both disorders can produce severe fluid and electrolyte imbalances and adverse neurologic changes.

121
Q

Antidiuretic Hormone Dysfunction:

Pathophysiology SIADH: What is there an increase of?

A

Increased secretion or increased production of antidiuretic hormone (ADH)

122
Q

Antidiuretic Hormone Dysfunction:

Pathophysiology SIADH: Increase of ADH causes what?

A

Increased ADH causes total increase in body water.

123
Q

Antidiuretic Hormone Dysfunction:

Pathophysiology DI:

A

Water imbalance from inadequate or resistance to ADH

124
Q

Antidiuretic Hormone Dysfunction:

Pathophysiology DI:

What happens normally (absence of DI)?

A

Normally as osmolality increases, hypothalamus releases ADH from the posterior pituitary, causing water and sodium absorption in the kidneys

125
Q

Antidiuretic Hormone Dysfunction:

Pathophysiology DI:

Normally as osmolality increases, hypothalamus releases ADH from the posterior pituitary, causing water and sodium absorption in the kidneys. What happens in DI?

A

Normally as osmolality increases, hypothalamus releases ADH from the posterior pituitary, causing water and sodium absorption in the kidneys

Disruption in this process causes large volumes of dilute urine to be excreted.

126
Q

SIADH—Assessment

What are possible causes of SIADH?

A

Possible causes of SIADH include pituitary tumor,

pancreatic carcinoma,

head injuries;

pulmonary diseases, such as pneumonia and lung abscesses;

CNS infections (meningitis) or tumor

127
Q

SIADH—Assessment

History and physical examination

How are S and S?

A

S & S are neurologic and gastrointestinal

128
Q

SIADH—Assessment

History and physical examination

What are signs and symptoms?

A

Headache, decreased mentation, lethargy, confusion, seizures, and coma
abdominal cramps, nausea, vomiting, diarrhea, anorexia

129
Q

SIADH—Assessment

What are diagnostic studies showing?

A

Hyponatremia and hypo-osmolality,

high urine specific gravity,

low urine output,

low BUN and creatinine,

low calcium,

low potassium

130
Q

SIADH—Management

What should be treated?

A

Treat underlying cause.

131
Q

SIADH—Management

What should be alleviated?

A

Alleviate excessive water retention.

132
Q

SIADH—Management

Alleviate excessive water retention.- How?

A

Fluid restriction,

3% hypertonic normal saline solution and

furosemide

133
Q

SIADH—Management

What should be provided?

A

Provide comprehensive care needed for the patient with depressed LOC.

134
Q

SIADH—Management

Provide comprehensive care needed for the patient with depressed LOC.

What should be monitored?

A

Monitor I & Os,

electrolytes,

neuro status.

135
Q

Diabetes Insipidus—Assessment and MANAGEMENT

What is DI characterized by?

A

Diabetes insipidus is a disease characterized by water imbalance resulting from inadequate ADH or resistance to ADH, leading to water diuresis and dehydration.

136
Q

Diabetes Insipidus—Assessment and MANAGEMENT

What are hallmarks of DI?

A

Polyuria, polydipsia, and dehydration are the hallmarks of diabetes insipidus.

137
Q

Diabetes Insipidus—Assessment and MANAGEMENT

What are S and S of DI?

A

S & S of dehydration, tachycardia, hypotension, low central venous pressure (CVP), rise in body temperature, weight loss

138
Q

Diabetes Insipidus—Assessment and MANAGEMENT

Management: What is given?

A

Hypotonic IVF

Desmopressin,

Pitressin,

permanent hormone replacement

139
Q

Diabetes Insipidus—Assessment and MANAGEMENT

Management: What should be monitored?

A

Monitor fluid and electrolyte balance.

140
Q

Diabetes Insipidus—Assessment and MANAGEMENT

What are complications?

A

Complications: cardiovascular collapse and tissue hypoxia

141
Q

Laboratory Values for SIADH and Diabetes Insipidus

How is serum ADH in SIADH and DI?

A

SIADH: increased

DI: decreased

142
Q

Laboratory Values for SIADH and Diabetes Insipidus

How is serum osmolality in SIADH and DI?

A

SIADH: <285

DI: >300

143
Q

Laboratory Values for SIADH and Diabetes Insipidus

How is serum sodium in SIADH and DI?

A

SIADH: <33

DI: >145

144
Q

Laboratory Values for SIADH and Diabetes Insipidus

How is urine osmolality in SIADH and DI?

A

SIADH: >300

DI: <300

145
Q

Laboratory Values for SIADH and Diabetes Insipidus

How is urine output in SIADH and DI?

A

SIADH: below normal

DI: 30-40 L/24H

146
Q

Laboratory Values for SIADH and Diabetes Insipidus

How is fluid intake in SIADH and DI?

A

SIADH: goal <600-800 mL/24h (restricted fluid intake)

DI: > 50L/24h

147
Q

Diabetic Ketoacidosis

Pathophysiology

A

Severe insulin deficiency that leads to disordered metabolism of proteins, carbohydrates, and fats

148
Q

Diabetic Ketoacidosis

Pathophysiology: What is there an elevation in?

A

Elevation in GH, cortisol, epinephrine, and glucagon exacerbates the condition.

149
Q

Diabetic Ketoacidosis

What occurs in this?

A

Ketosis and acidosis

Volume depletion

149
Q

Diabetic Ketoacidosis

Who does it occur in mostly?

A

Mostly occurs in type I diabetics

150
Q

Diabetic Ketoacidosis

What are causes of this?

A

Causes: infection,

inadequate insulin therapy,

severe illness,

stroke,

MI,

pancreatitis,

alcohol abuse,

trauma,

drugs

151
Q

Diabetic Ketoacidosis—Assessment

History and physical examination:

What should be collected?

A

Detailed history,

focus on diabetic regimen and compliance,

recent changes in health,

appetite, weight,

abdominal bloating,

bowel function,

urinary frequency and amount.

152
Q

Diabetic Ketoacidosis—Assessment

History and physical examination:

What VS should be assessed?

A

Blood pressure,

heart and respiratory rate,

breathing pattern,

breath sounds, LOC

153
Q

Diabetic Ketoacidosis—Assessment

History and physical examination: What is seen?

A

Findings:

hyperventilation,

Kussmaul’s respiration,

fruity breath,

dehydration,

abdominal distention,

dry mucous membranes,

poor skin turgor,

decreased LOC

154
Q

Diabetic Ketoacidosis—Assessment & MANAGEMENT

Laboratory studies: What kind of labs are collected?

A

Glucose,

electrolytes,

osmolality,

anion gap,

pH,

ABGs,

urine acetone,

155
Q

Diabetic Ketoacidosis—Assessment & MANAGEMENT

Laboratory studies: How are glucose ranges?

A

Serum glucose ranges from 250 mg/dL to 800 mg/dL or higher.

156
Q

Diabetic Ketoacidosis—Assessment & MANAGEMENT

Laboratory studies: What is a key diagnostic feature?

A

Serum ketones is key diagnostic feature.

157
Q

Diabetic Ketoacidosis—Assessment & MANAGEMENT

Diagnostic studies:

A

Urine test, blood glucose.

Throat, blood, and urine cultures may be done to rule out infection

158
Q

Diabetic Ketoacidosis—Assessment & MANAGEMENT

What is included in management?

A

Fluid replacement

Insulin therapy

Potassium and phosphate replacement

Bicarbonate replacement

Reestablishing metabolic function

Patient education

159
Q

if you have time- slides 29-32

A

NURS 428: Evolution (17 decks)

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