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ATI Comprehensive > Med-Surg: Endocrine/2 > Flashcards

Med-Surg: Endocrine/2 Flashcards

1
Q

myxedema coma

A

rare, life threatening condition seen in untreated or uncontrolled hypothyroid

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2
Q

rare, life threatening condition seen in untreated or uncontrolled hypothyroid

A

myxedema coma

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3
Q

myxedema coma s/s

3

A
  1. hypothermic
  2. changes in mental functioning - depression to unconsciousness
  3. severely decreased metabolism leading to respiratory depression and cardiac collapse
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4
Q

hypothyroid med

1

A

levothyroxine

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5
Q

levothyroxine administration

A

in the morning on an empty stomach

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6
Q

thyroid storm s/s

4

A
  1. hyperpyrexia (fever over 106)
  2. tachycardia
  3. HTN
  4. exaggerated symptoms of hyperthyroid
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7
Q

hyperthyroid meds and reasons

4

A
  1. beta blocker - manage tachycardia, anxiety, tremors
  2. PTU - blocks thyroid hormone production
  3. methimazole - short term use to block production of thyroxine
  4. iodides - decrease vascularity and inhibit the release of THs
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8
Q

hyperthyroid surgery - med pre op

A

saturated solution of potassium iodide SSKI

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9
Q

thyroidectomy post op

4

A
  1. semi fowlers
  2. assess dressing
  3. monitor RR, keep trach tray, oxygen, and suction at bedside
  4. keep calcium gluconate at bedside
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10
Q

parathromone/PTH maintains

A

calcium and phosphate balance

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11
Q

hypoparathyroidism meds acute and chronic

A

acute - calcium gluconate

chronic - oral calcium salts, vitamin D

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12
Q

kidney stones is to

A

hyperparathyroidism

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13
Q

hyperparathyroidism NIs

6

A
  1. min. of 2L/day
  2. low calcium, low vitamin D diet
  3. prevent constipation
  4. strain all urine
  5. prevent fractures
  6. encourage cranberry juice
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14
Q

hyperparathyroid - hypercalcemia crisis
number and tx
4

A

occurs when calcium >15:

  1. IV rehydration
  2. phosphate therapy
  3. calcitonin
  4. dialysis
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15
Q

hyperparathyroidism meds

A
  1. calcimimetics such as cinacalcet mimi calcium in the blood
  2. citonin
  3. hydration and diuretics - lasix; avoid thiazide diuretics
  4. biphospates
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16
Q

metabolic syndrome

A

insulin reisstance leads to increased insulin production in an attempt to maintain glucose at a normal level

17
Q

metabolic syndrome s/s

3

A
  1. HTN
  2. hyperchloesterolemia
  3. abd obesity
18
Q

normal fasting glucose

A

70-105

19
Q

normal postprandial blood glucose

A

<180

20
Q

NIs for hypoglycemia
15 g
4 examples

A
  1. 3-4 glucose tabs
  2. 4 oz juice or soda
  3. 6-10 hard candies
  4. 2-3 tsp of sugar of honey
21
Q

NIs for hypoglycemia - pt unconscious

A

glucagon IM or subq, repeat in 10 mins if client is still uncon.

22
Q

NIs for hypoglycemia - 15 15 15 rule

4

A
  1. administer 15 g of fast acting carbs
  2. wait 15 mins and recheck
  3. administer 15 more Gs if <70
  4. give 7 g protein when WNLs (i.e. 2 tbs PB, 1 oz cheese, or 8 oz milk)
23
Q

insulin pumps administers what

2

A

rapid acting

regular insulin

24
Q

insulin pump - change how often

A

q3days

25
Q

DM foot care

A
  1. clean feet daily in warm, soapy water, rinse and dry carefully
  2. trim nails straight across
  3. wear supportive protective shoes
  4. do not go barefoot
26
Q

DM sick day care

3

A
  1. take usual dose
  2. check BG q3-4 h
  3. encourage to consume 4 oz of sugar free, non caff. fluids every 30 mins to prevent dehydration
27
Q

DKA manif

10

A
  1. PPP
  2. anorexia, NV
  3. metabolic acidosis with ketonuria
  4. kussmaul’s
  5. acetone breath/fruity breath
  6. altered MS
  7. blurred vision
  8. headache
  9. weak, rapid pulse
  10. OH
28
Q

DKA - administer what

3

A

IV fluids to promote perfusion

  1. NS to maintain perfusion
  2. follow with 45% saline infusion to replace total body fluid losses
  3. add fluids containing dextrose when BG is around 250
29
Q

DKA - administer insulin

3

A
  1. infusion at 0.1 mg/kg/hr - regular insulin is the only insulin that can be given IV
  2. BG check hourly
  3. resume subq when possible
30
Q

hyperglycemic hyperosmolar state HHS

A

an acute, life threatening complication of diabetes - more common in type 2

31
Q

HHS is characterized by

3

A
  1. elevated BG levels >600
  2. hyperosmolar state
  3. fluid and electrolyte losses
32
Q

HHS CFs

A
  1. acute illness
  2. meds that exacerbate hyperglycemia - like thiazides
  3. tx such as dialysis
33
Q

HHS manifs.

3

A
  1. dehydration - hypotension, tachycardia
  2. elevated BUN
  3. altered MS
34
Q

HHS NIs

A
  1. replace fluids
  2. administer insulin and electrolytes
  3. monitor BG, LOC, VSs, electrolytes, acid base

ATI Comprehensive (17 decks)

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