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N480 Critical Care > Week 5 Metabolism & Fluid Regulation > Flashcards

Week 5 Metabolism & Fluid Regulation Flashcards

1
Q

Hyperthyroidism

A
  • Problem
  • Result
  • Labs
  • Manifestations
  • Nutritional needs
  • Nursing interventions
  • Complications
  • Thyroid storm/crisis
    + Priority assessments
    + Nursing actions
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2
Q

Hyperthyroid med: Thionamides

A

Methimazole & Propylthiouracil (PTU)

  • MOA
  • Nursing interventions
  • Pt education
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3
Q

Hyperthyroid med: Beta-adrenergic blockers

A

Metoprolol

  • Uses
  • Nursing interventions
  • Side effects
  • Pt education
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4
Q

Hyperthyroid med: Med & prep for Thyroidectomy

A

Iodine Solutions

  • MOA
  • Thyroidectomy
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5
Q

Hypothyroidism

A
  • Problem
  • Result
  • Labs
  • Manifestations
  • Nutritional needs
  • Nursing interventions
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6
Q

Hypothyroid med: Thyroid hormone replacement therapy

A

Levothyroxine

  • MOA
  • Nursing interventions
  • Pt education
  • Complication
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7
Q

Posterior pituitary gland

A
  • Function
  • Location
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8
Q

Antidiuretic (ADH) hormone function

A
  • ↑Renal reabsorption of water => Water retention
  • ↑Na+ excretion
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9
Q

How can a head injury lead to posterior pituitary issues?

A

Damage/pressure to hypothalamus => Affects posterior pituitary

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10
Q

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

A
  • Problem
  • Results
  • Causes
  • Pathophysiology
  • Diagnostics and labs
  • Priority assessments
    + Early v Late s/s
  • Priority nursing interventions
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11
Q

SIADH med: Hypertonic Na+ IV Infusion

A

3% NaCl

  • MOA
  • Nursing interventions
  • Complications
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12
Q

SIADH med: Vasopressin antagonist

A

Tolvaptan & Conivaptan

  • MOA
  • Goal
  • Nursing interventions
  • Complications
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13
Q

Diabetes Insipidus (DI)

A
  • Problem
  • Results
  • Causes
  • Pathophysiology
  • Diagnostics and labs
  • Priority assessments
    + Early v Late s/s
  • Priority nursing interventions
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14
Q

DI meds: ADH Replacement Agents

A

Vasopressin & Desmopressin

  • MOA
  • Pt education
  • Complications
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15
Q

Diabetes Mellitus (general)

A
  • Leading cause of…
  • Major contributing factors
  • Insulin fxn
    + ↑Insulin
    + ↓Insulin
  • Normal glucose & insulin metabolism
  • Counter-regulatory hormones
  • Complications
    + Acute DM v Chronic DM
  • 3 P’s
  • Diagnostic studies
    + HbA1C
    + Fasting plasma glucose level
    + 2-hr random plasma glucose level during OGTT
  • Interprofessional care
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16
Q

Pre-diabetes

A
  • Manifestations
  • Priority
  • HbA1C
17
Q

Type 1 Diabetes Mellitus

A
  • Primary defect
  • Pathophysiology
  • Age of onset
  • Type of onset
  • Prevalence
  • Environmental factors
  • Islet cell antibodies
  • Endogenous insulin
  • Nutritional state
  • Symptoms
  • Ketosis
  • Nutrition therapy
  • Insulin
  • Vascular & neurologic complications
  • Treatment considerations
18
Q

Type II Diabetes Mellitus

A
  • Primary defect
  • Pathophysiology
  • Age of onset
  • Type of onset
  • Prevalence
  • Environmental factors
  • Islet cell antibodies
  • Endogenous insulin
  • Nutritional state
  • Symptoms
  • Ketosis
  • Nutrition therapy
  • Insulin
  • Vascular & neurologic complications
19
Q

Human insulin

A
  • Genetically engineered in labs from E. coli or yeast cells
  • Insulins differ by onset, peak action, & duration
  • Categories
20
Q

Rapid-acting insulin

A

Lispro (Humalog), aspart (Novolog, Fiasp), glulisine (Apidra)

  • Onset
  • Peak
  • Duration
21
Q

Short-acting insulin

A

Regular (Humulin R, Novocain R)

  • Onset
  • Peak
  • Duration
22
Q

Intermediate-acting insulin

A

NPH (Humulin N, Novocain N)

  • Onset
  • Peak
  • Duration
23
Q

Long-acting insulin

A

Glargine (Lantus, Toupee, Basaglar), detemir (Levemir), degludec (Tresiba)

  • Onset
  • Peak
  • Duration
24
Q

Inhaled insulin

A

Afrezza

  • Onset
  • Peak
  • Duration
25
Q

Insulin

A
  • Injection sites
  • Steps for insulin injection
  • Monitor
26
Q

Insulin plans: Basal-bolus regimen

A
  • Intensive or physiologic insulin therapy → Most closely mimics endogenous insulin production
  • Admin multiple daily injections (or insulin pump) w/ frequent self-monitoring of BG (or continuous glucose monitoring system)
  • Bolus - Rapid- or short-acting insulin before meals
  • Basal - Intermediate- or long-acting (background) insulin 1-2x/day
  • Goal: Achieve glucose level as close to normal as possible as much of time as possible
27
Q

Insulin plans: Mealtime insulin

A

Manage postprandial glucose levels

  • Rapid-acting synthetic (bolus)
  • Short-acting regular (bolus)
28
Q

Insulin plans: Combination insulin therapy

A
  • Can mix
    in same syringe
  • Provides mealtime & basal coverage in 1
    injection
  • Commercially premixed formula or pen; flexible
    dosing limited
  • Many self-mix from 2 vials
  • Consider visual, manual, or cognitive skills
29
Q

Insulin plans: Long-acting (basal) insulin

A

Degludec (Tresiba), detemir (Levemir), and glargine (Lantus, Toujeo, Basaglar)

  • Released steadily & continuously w/ no peak action for many people
  • Onset varies
  • Admin 1x or 2x/day
  • Do NOT mix or dilute w/ any other insulin or
    solution
30
Q

Insulin plan: Intermediate-acting insulin (NPH)

A
  • Duration
  • Peak
  • Can mix w/ short- & rapid-acting insulins
  • Cloudy => Agitate to mix
    + Lispro protamine & aspart protamine are also cloudy
31
Q

Diabetic Ketoacidosis (DKA)

A
  • Pathophysiology/Cause
  • Urine & blood ketones
  • ABGs
  • Characteristics
  • Precipitating factors
  • Clinical manifestations
  • Diagnostics & labs
  • Medications
  • Treatments
32
Q

Hyperosmolar Hyperglycemic Syndrome (HHS)

A
  • Pathophysiology/Cause
  • Urine & blood ketones
  • ABGs
  • Characteristics
  • Precipitating factors
  • Clinical manifestations
  • Medications
  • Treatments
33
Q

Priority nursing interventions for DKA & HHS

A
  1. Dehydration
  2. Elevated glucose
    - Ketones/Metabolic acidosis
    - Hypokalemia
34
Q

Shared assessments b/w DKA & HHS

A
  • Elevated glucose
  • Hyperosmolar blood
  • Polyuria → Dehydration → Tachycardia & confusion
  • Polydipsia & polyphagia
35
Q

Nursing management for DKA & HHS

A
  • Monitor
  • Assess
36
Q

Hypoglycemia

A
  • Pathophysiology
  • Clinical manifestations
    + Mild
    + Moderate to severe
  • Causes
  • Nursing care
  • Treatments

N480 Critical Care (9 decks)

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