Nursing Endocrine Patient Flashcards
What is diabetes mellitus?
Type 1 - Lack of insulin
Type 2 - Lack of ability to respond to insulin
What is a nurses role for a diabetic patient?
- diagnostic procedures e.g. glucose curve
- stabilisation of patient
- Helping owner understand, create routine, type of food, how to give insulin, exercise, recording and monitoring, Storage of meds, disposal of needles, what to do if pet is off.
- monitoring patient and maintaining stabilisation
What must we ensure before administering insulin and why?
Patient is eating. The dose will have been calculated for a certain amount of food.
What should an owner do if they can’t remember if they already gave their pet insulin that day?
Don’t give another dose - under dose is way less serious than an overdose.
What should a diet for a canine diabetic be ideally?
- high protein
- normal levels of carbohydrate and fat
- no simple sugars
- high fibre (helps reduce glucose surge)
- Same diet, same time, same amount each day - ideally 2 feeds (half with each injection)
- NO titbits
What should a diet of a feline diabetic be ideally?
- high protein; low carbohydrate
- may graze if preferred
- ideally feed a dry diet if they’ll eat it
- weight control is very important - reduced weight results in less Beta cell destruction
What exercise should a diabetic patient do?
Regular, same time of day, same intensity each day
Important to maintain for weight control
How can we monitor a diabetic patient?
- regular trips to practice / clinic
- owner observations
- look for long term effects -> cataracts, plantigrade stance
- blood tests - blood glucose using a glucometer
- urine testing
- recording
What should you check if a patient is potentially becoming unstable?
identify cause:
- insulin in date?
- insulin damaged/ spoiled?
- technical issues with blood tests
- owner dosing incorrectly
- is the patient getting secret treats? (especially cats maybe being fed by neighbours - can get collars)
What is diabetic ketoacidosis and what should you do if a patient is admitted with this?
- the body has been breaking down muscle and fats for far too ling and it has caused a build-up of acidic products
- check patients airway
- administer IV fluids- lactated ringers or 0.9% saline
- rapid acting insulin
What would you do for a patient admitted with hypoglycaemia?
- feed immediately or give glucose water (owners can keep glucose powder in their house for emergencies)
- IV glucose
What nursing care should you provide to a patient with hyperadrenocorticism?
- reduce stress
- may require dietary fat restriction
- ensure RER being met - monitor BW,BCS and MCS
- monitor by doing ATCH stimulation tests
- monitor skin integrity and infections (including urine infections)
- educate the owner
What nursing care should you provide to a patient with hypoadrenocorticism CRISIS?
- asap get on IVFT (0.9% NaCl) at shock rates to flush out any excess potassium
- medical management
- monitor BP, ECG (potassium affects the heart), electrolytes and acid-base
What nursing consideration are there for a patient with hypoadrenocorticism?
- stabilise
- reduce stress
- care handling painful abdomen
- monitor for clinical signs
- WBC counts and Na:K ratio
What can be done to treat hyperthyroidism in a patient?
- medical management by giving a thyroid replacement
- dietary control by restricted iodine
- radioactive iodine treatment
- thyroidectomy
