week 4 Flashcards

1
Q

what does PTH do

A

increases blood calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where is calcitonin released from and what does it do

A

the thyroid gland when calcium is high it moves it into bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are t3 and t4

A

t3 is the active form of thyroid hormone. T4 is the storage form it is what is usally given as thyroid replacement. T3 lasts 24 hours once it is activated. T4 lasts up to a week.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

levothyroxine admin

A

give 2 hours before breakfast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what follows a total thyroidectomy secondary to cancer

A

radioactive iodine therapy followed by a nuclear scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is a nuclear scan

A

scans the body for cancer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the two parts of the adrenal gland and what do they do

A

Cortex(outer): glucocorticoids, mineralocorticoids, androgens
Medulla: Catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why do steroids cause circulatory collapse if they arent tapered off

A

someone on steroids longterm has a hypernating adrenal gland. Therefore they wont have any catecholamines/aldosterone being produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the endocrine and exocrine functions of the pancreas

A

Exocrine(90%)-digestive enzymes

Endocrine(10%)-insulin and glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is thyroglobulin

A

a cancer marker should be non detectable (zero)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does NPH stand for

A

Neutral Protamine Hagedorn

-Protamine is a protein that delays the absorption of insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the acronym for before meal and before bed

A

AC

HC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how often should you change insulin sites

A

5-7 days for better absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the s/s of hypoglycemia

A
  1. cold clammy
  2. dizziness
  3. shakiness
  4. changed LOC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is your action if a hypoglycemic patient cannot intake PO

A

D50W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

if machine says B.S high what is your action.

A

check serum glucose and give highest sliding scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the normal A1Cs

A

normal below 6%
prediabetic: 6-6.5
diabetic above 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is normal fasting B.S

A

under 126

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

metabolic syndrome

A
  1. waist >40 or >35(w)
  2. triglycrides >150
  3. HDL <40 or 35(w)
  4. BP higher then 130/85
  5. fasting B.S >100
20
Q

what causes the chain reaction that leads to DKA

A

zero insulin which then leads to

  1. increased B.S and Fat metabolism
  2. B.S leads to polyuria which leads to decreased fluid volume which eventually leads to shock.
  3. The fat metabolsim also creates lactic acid and leads to metabolic acidosis
21
Q

what pH is incompatible with life

A

below 6.8 or above 7.8

22
Q

Priorities in DKA

A
  1. Airway
  2. fluids challenge (3-4L bolus)
  3. Bicarb IV
  4. Mix bicarb into IV fluids
  5. regular insulin IV and accu check every hour
  6. after B.S drops below 250 start D5W and stop insulin IV and start insulin SubQ. Accu checks every 2 hours
23
Q

how do you know someone is out of DKA

A

the anion gap which indicates normal metabolism is below 14

24
Q

what is a primary concern for DKA patients

A

hypokalemia from all the IV insulin

25
HHS
The main problem here is caused by low levels of insulin which lead to 1.high B.S -> polyuria ->high serum osmolality
26
who has higher B.S DKA or HHS and why
HHS because theyre breaking down glycogen therefore they go into shock faster
27
priority management in HHS
1. fluid challenge | 2. Insulin IV
28
Diabetes Insipidus
``` no B.S issues common in head trauma 3 types 1.Central 2.Nephrogenic 3.Psychogenic ```
29
what is central DI and how do you treat
central can be subcategorized as primary and secondary. Treat with desmopressin (DAVP)
30
what is the difference between vasopressin and desmopressin
Vasopressin is long acting taking 24 hours to take effect | Demsmopressin is short acting taking 8 hours to work
31
what is nephrogenic DI caused by and how do you treat it
caused by decreased sensitivity of the kidneys to ADH therefore giving more ADH wont help. We give them thiazide diuretics which improves the sensitivity of the kidneys to ADH
32
what is the water deprivation test
no fluids for an hour if urine specific gravity remains low then we confirm that there is a problem
33
SIADH risk factors
1. Thiazide diuretics 2. SSRI 2. Head injury 4. Cancer 5. High PEEP
34
what B.S level is considered hypoglycemia and what should you do
under 70 | give 15-20 grams of carbs recheck in 15 mins
35
how much does 10 grams of carbs raise B.S
40 over 30 mins
36
metformin actions
1. reduces production of glucose by the liver and 2. increases insulin sensitivity and 3. slows carbohydrate absorption
37
metformin SEs
1.GI flatulence, anorexia, n/v 2.lactic acidosis especially clients with kidney or liver dysorders 3.stop 48 hours before any test that requires iodine contrast (increase risk of lactic acidosis)
38
metformin interventions
1. take with food to decrease GI effects 2. instruct client to take B12 and folic acid supplements 3. lactic acidosis (myalgia(muscle pain), sluggishness, somnolence, hyperventilation)
39
what type of shoes should diabetics wear
1. avoid open toe, open heel shoes 2. leather shoes are preferred 3. wear slippers with soles 4. never go barefoot
40
why do we add D5W after glucose levels drop below 250 in DKA
to minimize the risk of cerebral edema associated with drastic changes in serum osmolarity and prevent hypglycemia
41
what can cause nephrogenic DI
hypokalemia and hypocalcemia
42
requirements for water deprivation test
1. normal sodium levels 2. urine osmolality less then 300 mOsm/kg (285-295) - increases with dehydration
43
what happens to the urine osmolality during water deprivation test is patients have nephrogenic vs central DI
1. it goes down because the kidneys are not able to concentrate the urine 2. it goes up because atleast 9%
44
normal range for ADH
1 to 5 pg/mL
45
what electrolytes indicate SIADH
1. low sodium | 2. decreased osmolality and increased urine osmolality
46
expected range for urine specific gravity
1.010 - 1.025