Med-Surg: Endocrine/2

Question 1

myxedema coma

Answer 1

rare, life threatening condition seen in untreated or uncontrolled hypothyroid

Question 2

rare, life threatening condition seen in untreated or uncontrolled hypothyroid

Answer 2

myxedema coma

Question 3

myxedema coma s/s

3

Answer 3

1. hypothermic
2. changes in mental functioning - depression to unconsciousness
3. severely decreased metabolism leading to respiratory depression and cardiac collapse

Question 4

hypothyroid med

1

Answer 4

levothyroxine

Question 5

levothyroxine administration

Answer 5

in the morning on an empty stomach

Question 6

thyroid storm s/s

4

Answer 6

1. hyperpyrexia (fever over 106)
2. tachycardia
3. HTN
4. exaggerated symptoms of hyperthyroid

Question 7

hyperthyroid meds and reasons

4

Answer 7

1. beta blocker - manage tachycardia, anxiety, tremors
2. PTU - blocks thyroid hormone production
3. methimazole - short term use to block production of thyroxine
4. iodides - decrease vascularity and inhibit the release of THs

Question 8

hyperthyroid surgery - med pre op

Answer 8

saturated solution of potassium iodide SSKI

Question 9

thyroidectomy post op

4

Answer 9

1. semi fowlers
2. assess dressing
3. monitor RR, keep trach tray, oxygen, and suction at bedside
4. keep calcium gluconate at bedside

Question 10

parathromone/PTH maintains

Answer 10

calcium and phosphate balance

Question 11

hypoparathyroidism meds acute and chronic

Answer 11

acute - calcium gluconate

chronic - oral calcium salts, vitamin D

Question 12

kidney stones is to

Answer 12

hyperparathyroidism

Question 13

hyperparathyroidism NIs

6

Answer 13

1. min. of 2L/day
2. low calcium, low vitamin D diet
3. prevent constipation
4. strain all urine
5. prevent fractures
6. encourage cranberry juice

Question 14

hyperparathyroid - hypercalcemia crisis
number and tx
4

Answer 14

occurs when calcium >15:

1. IV rehydration
2. phosphate therapy
3. calcitonin
4. dialysis

Question 15

hyperparathyroidism meds

Answer 15

1. calcimimetics such as cinacalcet mimi calcium in the blood
2. citonin
3. hydration and diuretics - lasix; avoid thiazide diuretics
4. biphospates

Question 16

metabolic syndrome

Answer 16

insulin reisstance leads to increased insulin production in an attempt to maintain glucose at a normal level

Question 17

metabolic syndrome s/s

3

Answer 17

1. HTN
2. hyperchloesterolemia
3. abd obesity

Question 18

normal fasting glucose

Answer 18

70-105

Question 19

normal postprandial blood glucose

Answer 19

<180

Question 20

NIs for hypoglycemia
15 g
4 examples

Answer 20

1. 3-4 glucose tabs
2. 4 oz juice or soda
3. 6-10 hard candies
4. 2-3 tsp of sugar of honey

Question 21

NIs for hypoglycemia - pt unconscious

Answer 21

glucagon IM or subq, repeat in 10 mins if client is still uncon.

Question 22

NIs for hypoglycemia - 15 15 15 rule

4

Answer 22

1. administer 15 g of fast acting carbs
2. wait 15 mins and recheck
3. administer 15 more Gs if <70
4. give 7 g protein when WNLs (i.e. 2 tbs PB, 1 oz cheese, or 8 oz milk)

Question 23

insulin pumps administers what

2

Answer 23

rapid acting

regular insulin

Question 24

insulin pump - change how often

Answer 24

q3days

Question 25

DM foot care

Answer 25

1. clean feet daily in warm, soapy water, rinse and dry carefully 2. trim nails straight across 3. wear supportive protective shoes 4. do not go barefoot

Question 26

DM sick day care | 3

Answer 26

1. take usual dose 2. check BG q3-4 h 3. encourage to consume 4 oz of sugar free, non caff. fluids every 30 mins to prevent dehydration

Question 27

DKA manif | 10

Answer 27

1. PPP 2. anorexia, NV 3. metabolic acidosis with ketonuria 4. kussmaul's 5. acetone breath/fruity breath 6. altered MS 7. blurred vision 8. headache 9. weak, rapid pulse 10. OH

Question 28

DKA - administer what | 3

Answer 28

IV fluids to promote perfusion 1. NS to maintain perfusion 2. follow with 45% saline infusion to replace total body fluid losses 3. add fluids containing dextrose when BG is around 250

Question 29

DKA - administer insulin | 3

Answer 29

1. infusion at 0.1 mg/kg/hr - regular insulin is the only insulin that can be given IV 2. BG check hourly 3. resume subq when possible

Question 30

hyperglycemic hyperosmolar state HHS

Answer 30

an acute, life threatening complication of diabetes - more common in type 2

Question 31

HHS is characterized by | 3

Answer 31

1. elevated BG levels >600 2. hyperosmolar state 3. fluid and electrolyte losses

Question 32

HHS CFs

Answer 32

1. acute illness 2. meds that exacerbate hyperglycemia - like thiazides 3. tx such as dialysis

Question 33

HHS manifs. | 3

Answer 33

1. dehydration - hypotension, tachycardia 2. elevated BUN 3. altered MS

Question 34

HHS NIs

Answer 34

1. replace fluids 2. administer insulin and electrolytes 3. monitor BG, LOC, VSs, electrolytes, acid base