Unit 4 Pillitteri Flashcards
Hypothyroid and pregnancy
Don't ovulate Spontaneous miscarriage Always cold Obese Low energy Thyroid Meds increase 25% for pregnancy
Reading
536-545
929-932
1420-1423
1427-1439
Hyperthyroidism
(Graves Disease) Rapid HR Exopthalmos Always hot Nervous Skinny
Diabetes patho
Cells can't use GLU Liver breaks down glycogen GLU > 150 then kidneys excrete Dehydration Decreased oxygenation Lactic Acid buildup Cells die
Hyperthyroid meds
Takes 2 weeks Olol first Zoles PTU Teratogens and excreted in breast milk
Hyperglycemia and Pregnancy
Insulin needs increase last trimester
Amniotic fluid increases
Increase infection/hypertension
Increased congenital anomalies/miscarriage
Gestational diabetes Risk Factors
Obese >25 yrs old Macro babies PCOD Hispanic, Asian, N American
Gestational assessments
Glu ingested, test at 60 min
If 2/4 fasting GLU during 3 hour test > 95 then diabetes
HBA1C
Measure of GLU attached to HGB
Accurate for previous 4-6 weeks
Exercise and Insulin
Don’t inject into muscle that will be exercised
Exercise causes GLU fluctuation for 12 hours
Eat before exercising
Short term Insulin Administration
Eat directly after admin
Insulin Ratios
2/3 given in the morning
2/1 breakfast
1/1 dinner
Insulin pump need to know
Can’t get wet
Don’t leave off for > 1 hr
Initially wake up during the night to check
Decrease eating strategies
Journal
Counseling for emotional response
Eat in one place
Set fork down after each bite
PBI
Protein Bound Iodine
Low PBI causes
Low albumin
Low Iodine
Dilauntin
Congenital Hypothyroidism
Not present until 3 months with formula fed
6 months in breast fed
Linked to maternal hyperthyroidism
Girls 2x more
Infant hypothyroidism decreases
Poor latch
VS
Short Thick neck
Muscle Tone
Infant Hypothyroidism increases
Sleep Enlarged tongue Noisy respirations Cold extremities Lethargy
Infant Hypothyroidism treatment
Gradually increasing Thyroxine
Vit D
Therapy
Thyroxine admin
Crushed with food
Hashimoto’s
10-11 yr onset TSH increases to activate thyroid Goiter occurs \+ Radioactive iodine test confirms - Signifies cancer
Alternative Hyperthyroid treatments
Radioactive ablation
Thyroidectomy
Four criteria for type 1 Diabetes
SS of diabetes
Random GLU > 200
Fasting >126
2 hour plasma GLU > 200 during Oral TT
Other Helpful diabetes labs
HBA1C
PCO2
PH
WBC Elevated
Acute diabetes procedure
Check policy on tubing
Room temp IV insulin 0.1-0.2 U/KG in NS
GLU to infusion if needed
Rotating injection sites
Rotate within same site then move
No rotation causes scar tissue and less absorption
Type 1 Diet ratio
55% Carb
15% Pro
30% Fat
Honeymoon period
Pancreas begins producing insulin for 1-12 months but then fails again
Chronic Hyperglycemia problems
Arteriosclerosis
Infertility after 35
Eye problems
Kidney disease
