Endocrine

Question 1

S+S of Diabetes Insipidus

Answer 1

Polyuria (dilute and pale urine)
Dehydration (tachycardia, hypotension, diminished peripheral pulses, dry mucous membranes)
Insomnia

Question 2

Lab values of DI

Answer 2

Increased sodium and osmolality
Decreased urine specific gravity

Question 3

Nursing interventions of DI

Answer 3

Administer desmopressin
Administer hypotonic fluids (0.45% NaCl)

Question 4

S+S of Diabetes mellitus

Answer 4

Polyuria
Polydipsia
Polyphagia
Ketoacidosis
Blurred vision
Nocturnal enuresis
Vaginal candidiasis

Question 5

How much carbs during exercise (with DM)?

Answer 5

10-15 carbs for every 30-45 min

Question 6

Hypoglycemia

Answer 6

BG < 70

Question 7

S+S of hypoglycemia

Answer 7

Diaphoresis
Pallor
Trembling

Question 8

Tx of hypoglycemia (alert/unconscious)

Answer 8

Oral quick-acting glucose if alert
IM glucagon if unconscious

Question 9

Patho of Diabetic Ketoacidosis

Answer 9

Lack of insulin -> intracellular starvation -> body breaks down fat for energy -> high levels of acidic ketones (metabolic acidosis) -> potential hypovolemic shock

Question 10

S+S of DKA

Answer 10

Polyuria
Polydipsia
N+V
Fruity odor on breath
Kussmaul respirations
Lethargy
Dry skin
Hypotension and tachycardia
Dizziness

Question 11

Lab studies of DKA

Answer 11

Elevated BG
Elevated ketones
Metabolic acidosis
Hyperkalemia

Question 12

Nursing interventions of DKA

Answer 12

Administer 0.9% sodium chloride
IV regular insulin
Monitor for rebound hypokalemia after IV insulin replacement

Question 13

Hypoparathyroidism labs

Answer 13

Decreased PTH
Decreased calcium
Increased phosphate

Question 14

S+S of hypoparathyroidism

Answer 14

Tingling, numbness
Trousseau sign
Chvostek sign
Muscle cramps
Prolonged QT interval
Severe tetany

Question 15

Nursing interventions for hypoparathyroidism

Answer 15

Seizure precautions
Monitor for dysrhythmias
High calcium and vitamin D, low phosphorus diet

Question 16

Patho of SIADH

Answer 16

Excessive renal water reabsorption resulting in:
Water retention
Increased total body water
Dilutional hyponatremia

Question 17

S+S of SIADH

Answer 17

Low urine output
Weight gain
HTN
Hyponatremia (changes in mental status)

Question 18

Labs of SIADH

Answer 18

Low urine volume
Increased urine specific gravity
Hyponatremia

Question 19

Nursing interventions of SIADH

Answer 19

Seizure precautions
Neuro checks
Fluid restriction
Diuretics
Oral salt tablets/hypertonic saline (3% NaCl)
Vasopressin antagonists

Question 20

Hyperthyroidism S+S

Answer 20

Tachycardia
Exphthalmos
Heat intolerance
Fine hand tremor

Question 21

Hypothyroidism S+S

Answer 21

Weight gain
Constipation
Cold intolerance

Question 22

Labs of hypothyroidism and hyperthyroidism

Answer 22

Hypo: Increased TSH and decreased T3/T4
Hyper: Decreased TSH and increased T3/T4

Question 23

Tx for hyperthyroidism

Answer 23

Radioactive iodine
PTU
Thyroidectomy

Question 24

Radioactive iodine tx for hyperthyroidism education

Answer 24

Avoid sharing utensils
Wash clothes separately
Sleep in separate rooms
Delay pregnancy attempts for 4-6 months
Use separate bathroom and flush 3x each use

Question 25

PTU

Answer 25

Slows thyroid down Used for hyperthyroidism Is an immunosuppressant

Question 26

Thyroidectomy (partial vs. total)

Answer 26

Partial: at risk for thyroid storm Total: need life-long hormone replacement; at risk for hypocalcemia; check Trosseau and Chvostek

Question 27

Interventions for thyroid storm

Answer 27

Best: cooling blanket First: ice packs O2 per mask at 10 L

Question 28

Postop risks for thyroidectomy

Answer 28

Airway first Then hemorrhage 12-48 hrs: Total=tetany; Sub-total=thyroid storm After: infx

Question 29

Rundown of DI

Answer 29

Polyuria, polydipsia -> dehydration High urine output

Question 30

Rundown of SIADH

Answer 30

Oliguria and no thirst Decreased urine output Increased urine specific gravity (due to decreased urine volume)

Question 31

Types of insulin

Answer 31

Regular NPH Lispro Glargine

Question 32

Regular insulin is

Answer 32

Clear

Question 33

NPH is

Answer 33

Cloudy

Question 34

What insulins can be mixed? With what?

Answer 34

NPH (intermediate) can be safely mixed w/ short-acting (regular) and rapid-acting (lispro) in one syringe

Question 35

Hypoglycemia looks like

Answer 35

Drunk and in shock Drunk: staggered, slurred, slow Shock: tachycardia, tachypnea, low BP, cold/clammy, mottled skin

Question 36

HHNS - think of

Answer 36

Dehydration

Question 37

HHNS S+S

Answer 37

Skin is dry, flushed, decreased turgor, increased HR

Question 38

Relationship b/w amt of urine and specific gravity

Answer 38

OPPOSITES More urine out, lower specific gravity

Question 39

S+S of Addison's

Answer 39

Hyperpigmented Doesn't adapt well to stress

Question 40

Tx of Addison's

Answer 40

Glucocorticoids

Question 41

S+S of Cushing's

Answer 41

Moon face High glucose Bruises Hypernatremia Stretch marks

Question 42

DM 1: DM 2:

Answer 42

DM 1: autoimmune destruction of pancreatic beta cells DM 2: impaired tissue response to insulin

Question 43

Metformin is a tx of what?

Answer 43

DM 2 Hold 48 hrs before surgery

Question 44

Tx of exophtalmos

Answer 44

Using artificial tears Taping eyelids shut during sleep Maintaining HOB in raised position Administering corticosteroids Using dark glasses to prevent irritation

Question 45

Priority tx of DKA

Answer 45

NS bolus: fluid resuscitation to prevent hypovolemic shock and normalize electrolyte and glucose levels