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Term 3 Stanbridge > Endocrine Exam 2 > Flashcards

Endocrine Exam 2 Flashcards

(52 cards)

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1
Q

what is metabolic syndrome

SYNDROME X

A

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

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

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2
Q

glyburide (Micronase, DiaBeta, Glynase)

A

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

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3
Q

hyperglycemia

A

too much sugar

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4
Q

intermediate acting insulin

A

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

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5
Q

hypoglycemia S/S

A 
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”
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6
Q

HHS treatment

A
  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
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7
Q

Metformin (Glucophage)

A

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

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8
Q

what is DKA

A

rapid onset

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

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9
Q

diabetic retinopathy

A

chronic complication

impaired vision and blindness

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10
Q

HHS labs

A 
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
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11
Q

DM type 1 treatment

A

consistant management of BG levels

administer insulin

exercise

eat healthy

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12
Q

DM type 2 nursing considerations

A 
BG levels
I and O/ weight
skin integ
sensory alterations
visual alterations
SMBG sk
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13
Q

DKA S/S

A 
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
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14
Q

normal serum glucose level

A

70 - 110

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15
Q

diabetic nephropathy

A

chronic complication

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

earliest manifestation is:
MICROALBUMINURIA

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16
Q

Glipizide (Glucotrol)

A

• 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

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17
Q

diabetic diet

A

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

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18
Q

DM type 2 treatment

A

consistent management of BG levels

Lifelong commitment to:
oral anti diabetics
exercise regularly
eat healthy

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19
Q

hypoglycemia

A

low blood sugar

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20
Q

what are names of intermediate active insulin

A

NPH insulin (Humulin N

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21
Q

HHS education

Study These Flashcards
A

encourage medical bracelet

take measures to decrease dehydration

monitor BG q4h

consume liquids with carbs

22
Q

symptom x treatment

Study These Flashcards
A

weight loss through diet/exercise

antihypertensive drugs

cholesterol lowering drugs

anti diabetic drugs

23
Q

hallmark risk factors of DM type 2

Study These Flashcards
A

OBESITY, PHYSICAL INACTIVITY, HIGH TRIGLYCERIDES, AND HTN.

24
Q

fast blood glucose level

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) ```
31
DKA treatment
treat for dehydration * Initially administer 0.9% NaCl at a rapid rate to rehydrate the client to replace lost sodium. * After 2 to 3 hours, switch the IV to 0.45% NaCl to prevent hypernatremia. Maintain the rate relatively high. * Once the glucose is level is 250-300mg/dL, switch to D5W. * Administer regular insulin, to reverse ketoacidosis. * Monitor IV potassium
32
HbA1c
o The best indicator of the average blood glucose level over the last 120 days, which is the average lifespan of a red blood cell. o Expected range is 4%-6%. Target less than 7%.
33
what are names of short-acting insulin
regular insulin (humulin R, Novolin R)
34
diabetic neuropathy nursing actions
monitor BG levels and keep WNR provide foot care encourage podiatrist annually
35
rapid acting insulin
Onset- 15-30 min Peak- 0,5-2.5 hour Duration- 3-6 hours Administer before meals to control postprandial rise in blood glucose
36
diabetic neuropathy
chronic complication Caused from damage to sensory nerve fibers resulting in numbness and pain. Can affect every aspect of the body and can lead to ischemia and infection.
37
hyperglycemia education
oral intake of sugar free foods administer insulin as prescribed restrict exercise when BG levels are under 250 test for ketones
38
hyperglycemia S/S
hot, dry skin fruity breath "hot and dry, sugar is high"
39
what is DM type 1
total insulin dependence results from destruction of pancreatic beta cells. usually young age
40
acarbose (Precose)
* Slows carbohydrate absorption from the intestinal tract * Reduces postmeal hyperglycemia Nursing actions- • Alert the client that GI discomfort (abd. Distention, cramps, excessive gas, diarrhea) is common with these meds • Monitor LFTs every 3 months • Treat hypoglycemia with dextrose, not table sugar (prevents table sugar from breaking down) Pt teaching- • Instruct the client to have LFTs performed every 3 months • Take the med with the first bite of each meal in order for the med to be effective • Have available dextrose paste to treat hypoglycemia. Lab values- AST- 5-40
41
what is DM type 2
insulin reststance
42
HHS S/S
``` o Polyuria o Polydipsia o Blurred vision o Headache o Weakness o Orthostatic hypotension o Mental status changes o Seizures, myoclonic jerking o Reversible paralysis ```
43
what is HHS
Formerly called hyperglycemic hyperosmolar non-ketotic syndrome acute complication of diabetes characterized by hyperglycemia (600g/dL) slow onset
44
exenatide (Byetta)
Incretin mimetic exenatide (Byetta)- oral hypoglycemic Action- • Mimics the function of intestinal incretin hormone by decreasing glucagon secretion and gastric emptying; • Decreases insulin demand by reducing fasting and postprandial hyperglycemia Nursing actions- • Administer subQ 60 min before morning and evening meal • Monitor for GI distress Pt. teaching- • Do no administer after meal • Oral antibiotic, oral contraceptive or acetaminophen should never be given within 1 hr of oral exenatide or 2 hrs after injection of exenatide • Can have decreased appetite and weight loss • Wait for next dose if you miss a dose
45
short acting insulin
Onset- 0.5-1 hour Peak- 1-5 hour Duration- 6-10 hour Administer 30-60 min before meals
46
diabetic foot care
inspect daily wash with mild soap and warm water always dry completely apply mild foot powder on sweaty feet nail care after showers no hot water bottles or heating pads
47
DM type 1 S/S
``` o THE THREE P’s ♣ Polyuria (excessive urine) ♣ Polydipsia (excessive thirst) ♣ Polyphagia (excessive hunger) o Fatigue/Weakness/Malaise/Lethargy o Smell of acetone o Kussmaul respirations o Blurred vision o Mood changes o Numbness in tingling in extremities o Dry skin, and mucous membranes o Infections (UTI, Vaginal yeast infections) o Weight loss (most often in Type 1) o Muscle wasting o Ketonuria (ketones – acids – in urine from breakdown of proteins and fats. High ketone levels can lead to DKA) ```
48
long acting insulin | Lantus
Onset- 70 min Peak- None Duration- 24 hour Offer snacks at peak to prevent hypoglycemia
49
oral glucose tolerance test
o A fasting BG is drawn at the start of the test o Client is instructed to consume a specified amount of glucose o Glucose levels are obtained q30 minutes for 2 hours o Must be checked for hypoglycemia throughout the procedure • Client Education o Instruct to consume a balanced diet for 3 days prior to test o Instruct patient to fast for 10-12 hours prior to the test
50
DM type 2 S/S
``` o THE THREE P’s ♣ Polyuria (excessive urine) ♣ Polydipsia (excessive thirst) ♣ Polyphagia (excessive hunger) o Fatigue/Weakness/Malaise/Lethargy o Blurred vision o Mood changes o Numbness in tingling in extremities o Dry skin, and mucous membranes o Infections (UTI, Vaginal yeast infections) o Weight grain o Muscle wasting o Increased serum osmolality ```
51
diabetic nephropathy education
o Encourage yearly urine analysis, BUN, and serum creatinine o Encourage client to avoid soda, alcohol, and toxic levels of acetaminophen or NSAIDS o Consume 2-3L of fluid per day form food and beverage sources o Drink adequate water Report decrease of output to provider
52
syndrome x S/S
``` o Abdominal obesity o Darkening of the skin on neck or under arms o Irregular or absent menses o Acne o Hirsutism, alopecia ```

Term 3 Stanbridge (9 decks)

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