Exam 2 Blueprint Endocrine Flashcards
what is diabetes insipidus?
Decreased in ADH or vasopressin, uncontrolled polyuria and polydipsia, multiple causes, frequent signs: sudden enuresis of potty-trained child
what is the diagnosis and TX for DI?
water deprivation test, MRI to rule out a secondary cause, and desmopressin (DDAVP).
what are the nursing considerations for DI?
strict I&O and monitoring of urine osmolality (urine concentration), monitor for dehydration, monitor for unsupervised fluid intake, monitor infants for signs of DI and dehydration during therapy, caregiver and patient education, patient should wear a medical alert bracelet, and encourage caregiver involvement in hospital care.
what is Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)?
too much ADH leads to kidneys reabsorbing fluid and recirculating it into the central circulation. Most common cause of hyponatremia in hospitalized kids.
What is the diagnosis and treatment of SIADH?
Diagnosis: Na <120 mEq/L, low serum osmolality, elevated urine osmolality.
Treatment: fluid restriction: ¼ to ½ maintenance intake, diuretics, Declomycin, and NA supplements.
what are the nursing considerations for SIADH?
accurate I&O, daily weights, monitor for FVO, seizure precautions and neuro checks, education: fluid restrictions, precautions, monitor I&O, weight, and med management/admin.
What is Graves’ disease?
Hyperthyroidism: excess of thyroid hormone, often hereditary, most common cause of hyperthyroidism in kids, thyrotoxic mom = probable positive neonate, and 5x more likely in girls than boys.
what is the diagnosis and treatment of Graves’ disease?
Diagnosis: labs = low TSH, increased T4 and T3
Treatment: antithyroid drugs, thyroidectomy, and radioiodine ablation.
what are the nursing considerations for Graves’ disease?
treat the S/S, calm environment for patients, monitor for hypothyroidism and treatment SE “thyroid storm”, no vigorous exercise until therapy is complete, and education: signs of hypothyroidism/thyroid storm and when to call HCP.
what is T1DM?
young age, genetic, environmental factors, no insulin – producing beta cells, inadequate glucose – starvation response breaks down fatty acids – producing ketones – acidotic state.
what are the characteristics of T1DM?
age of onset <20 YO, abrupt onset, S/S: polyphagia, polydipsia, polyuria. Underweight, islet cell autoantibodies (90%), ketoacidosis is common, and insulin therapy is necessary.
what are the diagnosis and testings for T1DM?
Diagnosis: glucosuria, 3 “Polys”, HX of weight loss or failure to gain and metabolic acidosis with or without coma.
Testing: fasting BG >126 mg/dL, random BG > 200 mg/dL with hyperglycemia S/S, oral glucose tolerance test (OGTT) > 200 mg/dL in a 2 H sample, and HgbA1c > 6.5%.
what are the CM for T1DM?
polyphagia, polyuria, polydipsia, weight loss, enuresis, cranky, decreased attention span, easily frustrated, dry or flushed skin, blurred vision, poor wound healing, fatigue, headache, and frequent infections. Hyperglycemia and glucosuria, and DM ketoacidosis.
what is the management and treatment for T1DM?
Management: multidisciplinary, peds endocrinologist, nutritionist, DM educator, exercise.
Treatment: replaced insulin, rapid-acting (Novolog), short-acting (Novolin R): onset 30M, peak 2-4H, and duration 4-8H. Intermediate-acting (Novolin N): onset 2-6H, peak 4-14H, and duration 14-20H. Long-acting (Lantus): onset 6-14H, peak (no peak, if peak small 10-16H), duration 20-24H.
what is T2DM?
older age, HX gestational DM of mom, insulin resistance – improper use by the body, family HX, sedentary, overweight/obese, prediabetes, and HTN.
