Endocrine Exam 2 Flashcards Preview

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Flashcards in Endocrine Exam 2 Deck (52)
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1

what is metabolic syndrome

SYNDROME X

risk factors: obesity, HTN, high BG, and abnormal cholesterol, all cluster together

--> leads to the chance of developing heart disease, STROKE, and diabetes

2

glyburide (Micronase, DiaBeta, Glynase)

Action-
• Stimulates insulin release from pancreas, causing a decrease in blood sugar levels
• Increases tissue sensitivity to insulin
Pt teaching-
• Administer 30 min before meals
• Monitor for hypoglycemia and report frequent episodes to the provider
• Instruct client to avoid alcohol due to disulfiram effect

3

hyperglycemia

too much sugar

4

intermediate acting insulin

Onset- 1-2 hour
Peak- 6-14 hour
Duration- 16-24 hour
Administered for glycemic control between meals and at night

5

hypoglycemia S/S

o Mild shakiness
o Mental confusion
o Palpitations
o Sweating
o Headache
o Lack of coordination
o Blurred vison
o Seizures
o Coma
o “Cold and Clammy, Need some Candy”

6

HHS treatment

1. Administer IV fluids (0.9% sodium chloride followed by 0.45% sodium chloride to treat dehydration

2. When BG reaches 250-300 mg/dL, switch to dextrose 5%W.

3. Administer IV insulin to reverse hyperglycemia and potassium to treat hypokalemia

7

Metformin (Glucophage)

Action-
• Reduces the production of glucose by the liver (gluconeogenesis)
• Increases tissue sensitivity to insulin
Pt teaching-

8

what is DKA

rapid onset

breakdown of body fat for energy and an accumulation of ketones in the blood and urine.

9

diabetic retinopathy

chronic complication

impaired vision and blindness

10

HHS labs

o SERUM GLUCOSE - >600mg/dL
o SERUM SODIUM - increased
o SERUM POTASSIUM - initially decreased
o BUN - >30mg/dL
o CREATININE - >1.5 mg/dL
o KETONES – Absent in serum and urine
o OSMOLARITY - > 320 mOsm/L
o SERUM pH ABG – Absence of acidosis. pH > 7.4

11

DM type 1 treatment

consistant management of BG levels

administer insulin

exercise

eat healthy

12

DM type 2 nursing considerations

BG levels
I and O/ weight
skin integ
sensory alterations
visual alterations
SMBG sk

13

DKA S/S

FRUITY BREATH
• Polydipsia
• Polyphagia
• Weight loss
• N/V
• Abdominal pain
• Blurred vision
• Headache
• Weakness
• Orthostatic hypotension
• Fruity odor of breath
• Kussmaul respirations
• Metabolic acidosis
• Mental status changes

14

normal serum glucose level

70 - 110

15

diabetic nephropathy

chronic complication

Renal disease that increases the risk for CAD and mortality from MI.

earliest manifestation is:
MICROALBUMINURIA

16

Glipizide (Glucotrol)

• Stimulates insulin release from pancreas, causing a decrease in blood sugar levels
• Increases tissue sensitivity to insulin
Pt teaching-
• Administer 30 min before meals
• Monitor for hypoglycemia and report frequent episodes to the provider
• Instruct client to avoid alcohol due to disulfiram effect

17

diabetic diet

exercise and good nutrition

smoking cessation

limit calories and decrease fat 30%

diet low in sat fat

include omega 3 from fish

should include carbs from fruit, veggies, who grains, legumes, and low fat milk

18

DM type 2 treatment

consistent management of BG levels

Lifelong commitment to:
oral anti diabetics
exercise regularly
eat healthy

19

hypoglycemia

low blood sugar

20

what are names of intermediate active insulin

NPH insulin (Humulin N

21

HHS education

encourage medical bracelet

take measures to decrease dehydration

monitor BG q4h

consume liquids with carbs

22

symptom x treatment

weight loss through diet/exercise

antihypertensive drugs

cholesterol lowering drugs

anti diabetic drugs

23

hallmark risk factors of DM type 2

OBESITY, PHYSICAL INACTIVITY, HIGH TRIGLYCERIDES, AND HTN.

24

fast blood glucose level

<100mg/dL

25

sick guidelines

• Monitor blood glucose every 3-4 hours
• Continue to take insulin or oral antidiabetic med
• Consume 4 oz of sugar free, non-caffeinated liquid every 30 minutes to prevent dehydration
• Meet carbohydrate needs through soft food (custard, cream, soup, gelatin, graham crackers) 6-8 times per day if possible. If not, consume liquids equal to usual carbohydrate content.
• Test urine for ketones and report to provider if they are outside than expected reference range (-ve to small).
• Rest

26

DM type 1 nursing considerations

BG levels
I and O/ weight
skin integ
sensory alterations
visual alterations
SMBG skills

27

diabetic retinopathy education

encourage yearly eye exams

manage BG levels

28

hypoglycemia teaching

o Avoid excess insulin, exercise, and alcohol on empty stomach
o Check blood glucose level
o If glucose is 70mg/dL or less, take 15-20 grams of absorbable carbs
♣ 4-6 oz fruit juice, 3-4 glucose tabs, 8-10 hard candies
♣ recheck blood sugar in 15 minutes
o repeat administration of carbs if not WNL, and recheck in another 15

29

diabetic nephropathy
nursing considerations

monitor I and O and kidney fx tests

report hourly output of less than 30mg/dL

monitor bp

30

what are names of rapid-acting insulin

Lispro (humalog)
aspart insulin (novolog)
glulisine insulin (apidra)