Final Test Misc & Flashcards
Difference between endocrine & exocrine function of the pancreas…
Endo: Glucagon, Insulin, Somatatatins - Inside body - Blood Stream
Exo: Amalyse, Lipase, - enzymes for digestion - outside the body
Ketone bodies, break down product of fat in metabolism.
What is the major concern….
Metabolic acidosis
ABG interpretation
Marching Band Suit Method
PH…..
PaCO²….
HCO³….
Ph: Acid 7.35 - 7.45 Base
PaCO² Base 35 - 45 Acid
HCO³ Acid 22 - 26 Base
A1C
Normal
Pre diabetes
Diabetes
Diagnosis with a fasting glucose test needed.
Normal < 5.7
Pre 5.7 - 6.4
Diabetic > 6.5
Increase Insulin release from beta cells & Increase # of Insulin receptors….
Secretagogues
Sulfonylureas & Meglitinide
MANY DRUG INTERACTIONS
Which oral diabetic medication is most effective for type I DM…
None.
Only type II take oral meds
Lower glucose production
Increase sensitivity to insulin
Used in combination Insulin, Metformin, Sulfonylureas
Thiazolidinediones- “glitazones”
Insulin Sensitizers
This oral DM med has a black box warning Heart Related Death, Bone Fractures, Macular Edema.
Thiazolidinediones
Insulin Sensitizers
Lowers starch digestion & absorption
Used with Sulfonylureas, Metformin & insulin
Alpha-Glucosidase inhibitors
Acarbose & Miglitol
Hypoglycemia from insulin may cause hypo/Hyperkalemia
SS
Alkalosis
Shallow respirations
Irritability
Confusion & drowsiness
Weakness & fatigue
Arrhythmias (irregular HR, tachycardia, U waves)
Lethargy
Thready pulse
Hypokalemia
Releasing hormones are sent from where to where….
Stimulating hormones are sent from where to where….
Releasing from hypothalamus- pituitary gland
Stimulating hormone from pituitary gland to target organ
Calcitonins effect….
Its the oppsite of…
Lowers Calcium.
Oppsite of parathyroid hormone
Growth hormone deficit causes.. .
Osteoporosis
Bromocriptine
Use….
SE….
Used to treat Acromegaly
Dysrhythmias, coronary artery spasms, CSF leak
Lanreotide
Use…
SE….
Treats acromegaly
Considerations:
Somatostatin Analog
Administer deep subcutaneous injection (usually in the gluteal area).
Monitor blood glucose levels (can cause hyperglycemia or hypoglycemia).
Assess for gallbladder disease
Octreotide
Use…
Nursing considerations….
Treats acromegaly
Somatostatin Analog
Can be given subcutaneously, intramuscularly, or IV.
Monitor electrolytes due to diarrhea-related losses.
Watch for bradycardia and arrhythmias.
Assess for gallstones (long-term use increases risk).
Pegvisomant
Use…
SE….
Treats acromegaly
Growth Hormone Receptor Antagonist
Administer subcutaneously (rotate injection sites).
Monitor liver function tests (LFTs) regularly (risk of hepatotoxicity)
Watch for hypoglycemia in diabetic patients.
Desmopressin maybe given for this problem in the posterior Pituitary…
Diabetes Insipidus
IV desmopressin is ___ times stronger than oral form….
10
Na levels in DI & SIAD
DI Hypernatremia
SIAD Hyponatremia- too much water
Tolvaptan & conivaptan
Use….
In this setting only…
SIADH
Rids water and holds onto Na
HOSPITAL USE ONLY
Seizure precautions for SIADH or DI
SIADH
Fluid levels in Addison & Cushings…
Addison: Low / low Na
Cushings: High/ High Na
Metabolic _____ with Cushings
Alkalosis
Water and mucous buildup with hypothyroidism can lead too….
Myxedema/ coma
Non pitting edema everywhere
Tongue thick
Husky voice
Lower physiological function
This problem….
Myxedema coma
Myxedema coma
Best practices
Airway
Fluid
Levothyroxine
Cortisteroids
IV glucose
Hourly temp / BP
Turn Q2H
Warm blanket
(This class of drugs) includes (PTU, methimazole) inhibit thyroid hormone synthesis by blocking thyroid peroxidase.
(Methimazole/ PTU) also prevents T4 to T3 conversion, making it preferred in thyroid storm and first-trimester pregnancy.
(Methimazole/ PTU) is favored for long-term use due to fewer side effects.
Risks include agranulocytosis, hepatotoxicity (PTU), and rash, requiring CBC and LFT monitoring
Thionamides
PTU also prevents T4 to T3 conversion, making it preferred in thyroid storm and first-trimester pregnancy.
Methimazole is favored for long-term use due to fewer side effects.
Hypo____ may cause Hypoparathyroidism
In pts with malabsorption, CKD, malnutrition
Hypomagnesemia
Excessive muscle contractions
Finger, hand , elbow flexion
Maybe this problem….
Hypoparathyroidism
Kidney stones
Waxy skin
GI issues
Peptic ulcer
Fatigue
Maybe this problem…
Hyperparathyroidism
Cinacalcet maybe used for this problem…
Hyperparathyroidism
Hypercalcemia
