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nurs 216 > hormone and glucose regulation > Flashcards

hormone and glucose regulation Flashcards

1
Q

paracrine hormones

A

act on other cells than where they are synthesized

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2
Q

hyposecretion

A

usually caused by a defect, disease, or ageing

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3
Q

hypersecretion

A

usually caused by genetics, tumors, or environment

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4
Q

SIADH

A

caused by CNS trauma, infection or surgery
- hypertension, decreased urine, low osmolality, edema, headache

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5
Q

SIADH treatment

A

diuretics is key, no fluids, 3% NaCl

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6
Q

Diabetes insipidus

A

passing “tasteless” water; opposite of SIADH

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7
Q

DI cause

A

CNS issues, renal dysfunction
- too little ADH, high urine output, high thirst

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8
Q

fluids and synthetic ADH (Desmopressin)

A

DI treatment

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9
Q

thyroid hormones

A

stimulate metabolism

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10
Q

iodine

A

makes up T3 and T4

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11
Q

TRH

A

released from hypothalamus; stimulates TSH release

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12
Q

TSH

A

released from anterior pituitary gland; activates thyroids functional cells

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13
Q

T3

A

20%; very active, potent, short acting
- what binds to receptors

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14
Q

T4

A

80%; long half life and inactive

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15
Q

calcitriol

A

active form of vitamin D; supports calcium absorption in the GI and deposition in bone

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16
Q

calcitonin and PTH

A

serum calcium homeostasis

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17
Q

hashimoto disease

A

common cause of hypothyroidism; slow destruction with high incidence in women

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18
Q

idoine absence

A

common cause of hypothyroidism

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19
Q

myxedema coma

A

severe metabolic insufficiency; due to untreated hypothyroidism

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20
Q

hypothyroid agents

A

treat hypothyroidism

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21
Q

levothyroxine (Synthroid, Eltroxin), liothyronine (Cytomel)

A

hypothyroid agents; treat hypothyroidism
- T4 preferred, long half life, highly PPB, slow onset of action

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22
Q

extra glucose

A

stored as glycogen in liver and muscles as well as triglycerides in adipose cells

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23
Q

fatty acids

A

distributed via lymph to circulation; cannot be used by brain for energy

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24
Q

ketone metabolites

A

made if there is high lipolysis; happens in people who fast
- will cause metabolic acidosis which lowers pH below 7.35

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25
Q

insulin

A

pancreatic hormone that is synthesized in beta cells

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26
Q

insulin actions

A

glucose cellular uptake, promotes storage formation, prevents glycogen and fat lysis

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27
Q

glucagon

A

synthesized in alpha cells; treat hypoglycemia

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28
Q

glucagon actions

A

promotes glycogenolysis, gluconeogenesis, lipolysis, triggered by low plasma glucose levels

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29
Q

high blood glucose pathway

A

pancrease releases insulin –> cells take up glucose from blood and liver produces glycogen–> blood glucose falls

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30
Q

low blood glucose pathway

A

pancreas releases glucagon–> liver breaks down glycogen–> blood glucose rises

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31
Q

beta cells

A

insulin synthesis and the stimulant is high serum glucose

32
Q

insulin secretion process

A

glucose enters beta cell–> metabolized by glucokinase into ATP–> closes K channels –> depolarization–> insulin is secreted–> enters hepatic circulation–> 50% is 1st pass metabolized

33
Q

insulin inhibition

A

somatostatin (D cell produced)

34
Q

synergy hormones released in high glucose demand situation

A

glucocorticoids, catecholamines, growth hormone

35
Q

glucocorticoids

A

cortisol; mobilizes utilization of all energy stores

36
Q

catecholamines

A

epinephrine; stimulates glycogenolysis and later lipolysis

37
Q

growth hormone

A

increased in long term stress or starvation; inhibits glucose uptake to increase serum glucose–> stimulating higher insulin secretion

38
Q

beta cell destruction

A

dysfunction of glucose, fat, and protein metabolism causing disabled transport of glucose into cells

39
Q

hyperglycemia

A

increased glucose in plasma

40
Q

polydipsia

A

high solute concentration triggering thirst and high osmolality

41
Q

polyuria

A

high urine production

42
Q

proteolysis

A

causes weight loss and muscle wasting

42
Q

lipolysis

A

causes fatty acid oxidation leading to ketones

43
Q

normal blood glucose

A

6-8

44
Q

diabetes mellitus type 1

A

sweet urine; genetic/autoimmune; immune reaction to beta cell antigens

45
Q

diabetes mellitus type 2

A

idiopathic

46
Q

diabetes mellitus diagnosis

A

fasting glucose > 7; usually diagnosed in early years of life

47
Q

diabetes mellitus treatment

A

insulin

48
Q

basal insulin levels

A

5-15

49
Q

peak rise insulin levels

A

60-90

50
Q

rapid acting insulin

A

-onset in 10-15 min
- peak is 1-2 hours
- duration is 3-5 hours
- ideal for meal time
- pump not IV
- can have slow infusion over long time

51
Q

Humalog (Lispro), Novorapid (Aspart), Apidra (Glulisine), Fiasp (Aspart)

A

rapid acting insulin

52
Q

long acting insulin

A

-onset in 90 min
- plateaus for up to 24 hours
- not used for meals; administered 1-2 times daily
- Never IV

53
Q

Levemir (Detemir), Lantus (Glargine)

A

long acting insulin

54
Q

Tresiba (Degludec)

A

ultra long acting insulin ( >30 hours)

55
Q

short acting insulin

A

-onset in 30 min
- peak in 2-3 hours
- duration is 6.5 hours
- ideal 30-45 min pre meal
- causes higher risk for hypoglycemia

56
Q

Novolin, Humulin R

A

short acting insulin

57
Q

entuzity

A

short acting insulin that is 5x more concentrated

58
Q

intermediate acting insulin

A

-onset 1-3 hours
- peak 5-8 hours
- duration up to 18 hours
- 1-2 times daily
- evening snack very important

59
Q

Humulin N, Novolin

A

intermediate acting insulin

60
Q

total daily insulin

A

0.55 (U) x Pt. wt. (kg)
- give one half background requirement, the other half at mealtime

61
Q

BBIT

A

basal (long acting insulin) in am, bolus (short/rapid acting) at meals, Inulin correction (short/rapid) if necessary
titrate doses to achieve normal levels

62
Q

basal insulin

A

long acting in AM to avoid hypoglycemia at night

63
Q

carb counting

A

45-60g/meal
-15g = 1 unit rapid acting insulin

64
Q

bolus insulin

A

rapid or short acting insulin pre meal time (3x a day)
- check blood glucose post meal
- too high is >10- need more insulin
- too low is <4- too much insulin

65
Q

ketones

A

due to insufficient insulin-glucose transport causing fatty acid breakdown

66
Q

illness and sugar balance

A

increase in levels due to cortisol release

67
Q

exercise and sugar balance

A

decreases sugar levels

68
Q

hyperglycemia most telling signs

A

thirst, fatigue

69
Q

hypoglycemia most telling signs

A

loss of focus, nervousness, shakiness
- rapid onset

70
Q

hyperglycemia

A

high plasma glucose with a shift of potassium out of cells
- high osmolality, low cellular function, ketone accumulation

71
Q

DKA

A

occurs due to insufficient insulin
- N&V, kussmaul breathing, blood and urine ketones, fruity breath

72
Q

regular insulin IV, IV fluids, KCl

A

DKA treatment

73
Q

hypoglycemia

A

low blood glucose due to diet change, activity, or too much insulin
- weakness, tachycardia, tremors, diaphoresis

74
Q

glucose tablet and apple juice

A

conscious hypoglycemia treatment

75
Q

50% dextrose and glucagon

A

unconscious hypoglycemia treatment

nurs 216 (8 decks)

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