T4 U9 ENDOCRINE Flashcards
patho of T1 diabetes?
autoimmune
destroys pancreatic cells that produce insulin (beta)
s/sx of T1 diabetes?
3 P’s
Polyuria
Polydipsia
Polyphagia
diagnostic levels of fasting BG for T1?
125
normal BG range for T1?
70-120
if a newly presenting diabetic pt has super high levels, whats the best course of action?
Don’t panic, its “normal”
monitor for s/sx of DKA
PANIC IF present super low
s/sx of DKA
fruity smelling urine/breath
Kussmals breathing
excessive thirst
s/sx of hyperglycemia?
confused
excessive thirst
flushed skin
deep rapid breaths
parathesia
blood test that diagnose T1 diabetes?
blood glucose
A1c
A1c level indicative of diabetes?
6+
s/sx og hypoglycemia?
Nervous
shaky/hungry
pallor/sweating
tachyC
shallow respirations
how to manage hypoglycemic crisis? & level
below 70
rapidly give 10-15 mg of carbs
amount of orange juice for hypogly crisis?
1/2 to 3/4 cup
how many glucose tablets/gels?
2
how often does home glucose monitoring happen?
3-6x per day
what is the name of primary short acting insulin?
Humalog/Novolog
when to take short acting insulin?
before meals
onset of short acting insulin?
10-15 min
regular insulin onset time?
30min
regular insulin peak?
55m
NPH insulin is intermediate acting bc it is ______
given in morning but effects are in afternoon
name of long acting insulin
lantus
action of Lantus?
24 acting with steady level & peak
how often/when to give Lantus?
daily, same time
edu about Lantus admin?
Has to be separate injection
given after meal based on carbs
how to include preschool in diabetes management?
let chose finger
take off bandaid
sick day rules for T1 diabetics
give normal dose of insulin
check every void/glucose often
give what they will eat (can do popsicles/gatorade for hydration)
what to do with a T1 diabetic that is going to OR?
give insulin as usual
DKA s/sx?
fruity breath
Kussmals breathing
3P’s
DKA diagnosis
Blood sugar 250+
pH less than 7.34
management for DKA
monitor K+
Fluid volume delivery (regular saline)
respiratory & neuro assessment
what is the normal insulin continuous infusion rate?
0.1u/kg/hr
diagnosis of T2 diabetes?
family hx
acanthosis nigricans (dark neck)
Lipids in 300’s
SGA
Asian, Native, Pacific islander, Latino, African American
prevention/management best for T2?
diet + exercise!
check blood sugar before/during and after
* may need snack during
how should T2 diet look?
complex carbs
fruits/veggies
quality proteins
complications of T2?
growth failure
delayed puberty
menstural disturbances
cataracts
edu about insulin admin?
rotate injection site
what is PKU?
error in metabolism - cant break down proteins
diet management of PKU?
phenylalanine free diet (no protein or diet coke)
no breast feeding –> need special formula
what CAN PKU pt eat?
fruits/veggies
pasta, cornstarch
infant s/sx of hypothyroidism?
prolonged jaundice
poor feeding
cool skin
hypotonia
ped s/sx of hypothyroidism?
short stature
weight gain
puffy face
protruding abdo
brittle/dry hair
what lab levels are low in hypothy?
low t4
low TSH
medication for hypothy?
levo/synthroid
s/sx to watch out for with levothyroxine?
tachyC & weightloss
how can you give synthroid to an infant?
crushed up into a syringe (NOT into their bottle)
what wouldnt put a person at risk for T2DM?
stature in 45th %tile (being short)
what is an example of a non iron rich food?
milk
what is priority when caring for 7Y with hypothroidism?
admin med as prescribed
how would a child present with hyperglycemia?
increased thirst & frequent urination
what random blood glucose level could indicate T1 diabetes?
150
below what value of sodium bicarbonate would = diabetes?
18
what s/sx may a nurse see in a child with hypothryroidism?
delayed tooth eruption
slow growth
priority intervention for DKA?
admin IV fluids
if a 9yr old asks why insulin injections are necessary, what is the most appropriate response?
will help your body absorb glucose from the blood
important for adolescents to know about self monitor blood glucose?
wash hands before using glucose meter
what nutrition choice would require INTERVENTION by the nurse?
cinnamon roll & juice
classic signs of T1?
polydipsia
polyphagia
polyuria
on a sick day how often do you check blood sugars?
Q4hr
best long term goal for adolescent pt with diabetes?
no evidence of long term complications
what can affect the feedback of the endocrine system?
stress
nutrition
temperature
how often should you monitor K level in DKA?
Q2-4hr
clinical manifestations of PKU?
developmental delays
intellecutal disabilities
seizures
what grains should PKU avoid?
wheat, oats, rye, barley & quinoa
what hormone would be high in a female pt with precocious puberty?
LH
potential long term effects of percocious puberty
infertility
what is the most common treatment for precocious puberty?
Hormonal therapy
ex of hormonal therapy for percocious puberty?
GnRH injections Q 3/4 wk
Histrelin/Supprelin LA-perm implant
