Glucose/thyroid/CV

Question 1

Onset, peak, duration: lispro

Answer 1

15 min
30-90 min
2-5 hr

Question 2

Onset, peak, duration: regular

Answer 2

30-60 min
2-4 hr
5-7 hr

Question 3

Onset, peak, duration: NPH

Answer 3

60-90 min
4-12 hr
Up to 24 hr

Question 4

Onset, peak, duration: glargine

Answer 4

2-4 hr
None
24 hr

Question 5

3 microvascular damages

Answer 5

Retinopathy
Neuropathy (numb, tingling)
Nephropathy

Question 6

3 macrovascular damages

Answer 6

CAD/MIs
CVD/strokes
PVD/gangrene,amputations

Question 7

Foot care educations diabetics

Answer 7

Daily inspections & washing
Wash: warm, dry thouly, no soaking)
Never sandals/barefoot
Soft skin (lotion not btwn toes)
Can use pumice stone
Trim nails straight accross

Question 8

Glucose prick where

Answer 8

Lateral side of finger

Question 9

Diabetic exercise advice

Answer 9

3x/wk dont miss >2days
Carry a snack due to BS lowering

Question 10

Diabetic nutrition

Answer 10

Fiber improves BS
Low cholesterol
15g carbs = 1U
Alcohol ok
Non-nutritive sweetener ok

Question 11

Hypoglycemic tx home/hospital

Answer 11

PO: 15-20g carb as juice, check q15min

Home 1mg glucagon IM/SQ
Hospital 25-50ml D50W IV

Question 12

Metabolic syndrome

Answer 12

Htx, high cholesterol, adb obesity

Question 13

Sick day rules

Answer 13

Fluids
Nver skip meds
Check BG & ketones every 3-4hr (+ketones call provider)

Question 14

Criteria for diagnosing diabetes

Answer 14

Fasting bs >110
Random bs >200 w/ symptoms
GLucose tolerance test >200
A1C >6.5%

Question 15

DKA signs & bs

Answer 15

Bs 250-800
Fruity breath
Kussmaul (rapid shallow to deep)
Ketones +

Metabolic acidosis

Question 16

DKA biggest compensation

Answer 16

Cerebral edema

Question 17

DKA tx

Answer 17

IV fluids: NS. When bs 300, switch to 5% dextrose.
Regular insulin IV.
Monitor: K+ (dka high, insulin low)
Caridac monitor,
Bs q15min
Lung sounds/I&Os

Question 18

Strip interpretation

Answer 18

P: atrial contraction/depolarization
Qrs: ventricular depolarization
T: ventricular REpolarization (rest)
STEMI

Question 19

1 cause & interventions of bradycardia

Answer 19

Hypoxia

Assess LOC!
Stable- monitor
Unstable-
1. O2
2. Atropine .5mg q3-5min
3. Pacing w/AED/defib

Question 20

Red flags of unstable arrythmias

Answer 20

ALOC
Chest discomfort/pain
Synope
Hypotension
Dizzy
Decreased perfusion

Question 21

Causes & tx of tachycardia

Answer 21

Hypovolemia- fluids

Fever- antipyretics
Stress- benzos/breathing
Blood loss- 🩸
Pain- pain meds

Question 22

Afib risk factors

Answer 22

Age, htx, obesity, smoking
Diabetes, renal disease, HF

Question 23

AFib tx

Answer 23

Anticoagulant- clopidogrel/warfarin
Amiodorone
BB - metoprolol
CCB- diltixem

Stoke risk
Electric cardioversion w/in 48hr if flutter persists
Final- catheter ablation

Question 24

If diagnosed afib & have chest pain-

Answer 24

Seek medical attention

Question 25

Angina tx

Answer 25

12ld EKG (cardiac monitor) ONMA O2, IV labs, NTG, morphine, asprin whenever

Question 26

CV diseasea education na/exercise

Answer 26

Only 2g sodium/day (& lower LDLs) Walk 30min/day Manage stress Smoking cessation!! (Powerful vasoconstriction, increase HR/BP/CO in blood)

Question 27

PAD s/s

Answer 27

Calf pain (intermittent claudication) Cold, numb skin Wk lowet pulses Unhealing ulcers Gangrene, amputation

Question 28

Contraceptives can cause what CV problem?

Answer 28

HTN

Question 29

Hypertensive emergency

Answer 29

180/120 Esp w/ HA, dizzy, vision, n/v

Question 30

HF tx

Answer 30

Furosemide 2L fluid limit Daily weights (call md if gain >2lbs/day) (Na,exercise,smoke)

Question 31

Levothyroxine must be taken

Answer 31

In morning, w/water, on empty stomach

Question 32

Myxedema

Answer 32

Severely advanced hypothyroid Hypothermic, low loc & rr, coma, shock

Question 33

Thyroid storm signs & tx

Answer 33

S: fever over 101.3, HR >130 Methimazole, PTU (not lifelong). acetaminophen for fever. Hydrocortisone/steroids. NO nsaids. Ice packs, iv fluids. Calm environment

Question 34

Hyperglycemia s/s

Answer 34

3 ps Weight loss, blurry vision, sleepiness