Metabolic or Endocrine Condition Flashcards
Beta cell destruction in pancreas (insulin dependent)
Autoimmune – genetic with precipitating factors
DM 1
Signs and symptoms:
Polyuria/Polydipsia/
Polyphagia
Weight loss
Fruity breath
What is it??
DM 1
Diagnosis of DM 1:
Elevated blood glucose >200
Elevated hemoglobin
A1C >7.0
+glucose and ketones in urine
Signs and symptoms:
Fruity breath
Kussmaul breathing
Fatigue, malaise, N/V, 3P’s, weight loss
What is it??
Diabetic Ketoacidosis (DKA)
Diagnosis of Diabetic Ketoacidosis (DKA):
Significantly elevated blood glucose
+glucose and ketones in urine
Lab values (CO2
Nursing Care for DKA
IV fluids & replace electrolytes
Insulin drip
Resistance to insulin
Increasingly common in pediatrics with obesity epidemic
Reversible
Type II Diabetes
Diagnosis of Type II Diabetes
Two fasting glucose levels >125 or two random glucose levels >200
Hemoglobin A1C >6.5
Nursing care for Type II Diabetes:
Oral medications if hgb A1C 6.2-9.0
Insulin for hgb A1C >9.0
function as messengers and coordinators
hormones
Function of endocrine system
secrete hormones to regulate bodily functions
Signs and symptoms Delayed growth within first 2 years of life (
Hypopituitary (Growth Hormone Deficiency)
Diagnosis of Hypopituitary (Growth Hormone Deficiency)
Growth chart evaluation, labs (endocrine), bone age x-ray, Brain MRI
Normal puberty onset for girls and boys
Girls: 8-13y Boys: 9.5-14y
Incidence of puberty is 5x higher in girls than boys
Pituitary Hyperfunction (Precocious Puberty)
Signs and symptoms: Boys: facial hair, penile growth, increased masculinity Girls: breast development, onset of menarche Increase in LH, FSH, testosterone What is it??
Pituitary Hyperfunction (Precocious Puberty)
What do you give a patient with Pituitary Hyperfunction (Precocious Puberty)
GnRH agonist administration
Excessive amounts of GH releasedcausing excessive growth of long bones in adulthood after growth plates closed
Acromegaly
Excessive amounts of GH releasedcausing excessive growth of long bones in childhood before growth plates close
Gigantism
Complications of Acromegaly and Gigantism:
cardiomegaly, diabetes
Medication for Acromegaly and Gigantism:
GnRH antagonists
Signs and symptoms Insufficient production of antidiuretic hormone (ADH) What is it??
Diabetes Insipidous
Two types of Diabetes Insipidus
Central and Nephrogenic
Signs & Symptoms: Polydipsia Polyuria Enuresis What is it?
Diabetes Insipidous
Diagnosis of Diabetes Insipidus:
Water deprivation test
Medication for Central Diabetes Insipidous:
Oral doses of desmopressin (DDAVP)
Medication for Nephrogenic Diabetes Insipidous:
Diuretics, Monitor I/O, Low solute diets
Rare in children Signs and symptoms Excessive levels of antidiuretic hormones Results in water intoxication N/V What is it??
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing care for SIADH
Fluid restrictions 50-75% of maint. Daily weights Monitor I/O
Signs and symptoms
Delayed growth
Inability to tolerate cold
Constipation
Fatigue
Poor feeding
What is it??
Hypothyroidism
What medication would be given for Hypothyroidism?
Levothyroxine (Synthroid)
Causes
Overproduction of TSH
Autoimmune
Hyperthyroidism (Graves’ Disease)
Signs and symptoms
Goiter
Protruding/reddened eyes
Tachycardia
What is it??
Hyperthyroidism (Graves’ Disease)
What medications would you give for Hyperthyroidism (Graves’ Disease)?
Antithyroid mediation, Beta-blockers, Radioactive iodine, surgery
Complication of Hyperthyroidism (Graves’ Disease)
Thyroid storm
Signs and symptoms:
Causes a decrease in calcium levels and increase phosphate levels in blood
Vomiting
Headaches
Mental Deficiency (DiGeorge syndrome)
Painful spasms of face, hands, arms, and feet
Poor tooth development, apneic episodes, abdominal distention
What is it??
Hypoparathyroidism
What medication would you give to a patient with hypoparathyroidism?
Supplemental calcium/vitamin D
Caused by rapid withdrawal from steroids, sepsis, surgical stress
Acute Adrenocortical Insufficiency (Adrenal Crisis)
Signs and symptoms
LIFE THREATENING, failure to make enough adrenocorticotropic hormone (ACTH)
Weakness, N/V/D, low blood pressure, fever, confusion
What is it??
Acute Adrenocortical Insufficiency (Adrenal Crisis)
What medications would you give to a patient with Acute Adrenocortical Insufficiency (Adrenal Crisis)?
IV steroid and antibiotics, rehydration, vasopressor
Underactive adrenal gland
Cause unknown
Chronic Adrenocortical Insufficiency (Addison Disease)
Signs and symptoms
Under physical stress: weakness, fatigue, dizziness, rapid pulse, dark skin
What is it??
Chronic Adrenocortical Insufficiency (Addison Disease)
What medication would you give to a patient with Chronic Adrenocortical Insufficiency (Addison Disease)?
Cortisol (PO or IM), monitor for dehydration (fluid and electrolyte imbalance)
Inability to produce cortisol
Negative feedback system fails excessive corticosteroid releasing hormone released and ACTH from ant pituitary
Overproduction of ACTH causes adrenals to become hyperplastic excessive androgens released
Congenital Adrenal Hyperplasia
Signs & symptoms
Ambiguous genitalia in females, precocious puberty in males
What is it??
Congenital Adrenal Hyperplasia
Diagnosis of Congenital Adrenal Hyperplasia
newborn screening
What medication would you give to a patient with Congenital Adrenal Hyperplasia?
Glucocorticoid, genital surgery for females
