Thyroid
What are some symptoms of Hyperthyroidism in adults?
Name two corticosteroids that bring symptoms under control with "burst" dosing
Hydrocortisone and Prednisone
What is Type 1 vs Type 2 diabetes
Type 1: autoimmune disorder, does not produce adequate amounts of insulin
Type 2: Target cells become unresponsive to insulin (not using insulin efficiently)-can be corrected with diet and exercise
What can insulin be administered to pt's
SubQ injection, Subq infusion, IV infusion
Metformin is used for prevention of type 2 diabetes, what kind of pt would be well suited for this drug?
Pt's who skip meals due to loss of appetite, N+V, metallic taste and PO w/ breakfast+dinner
Which labs do you monitor with hypothyroidism?
TSH-elevated, T3 and T4 levels diminished
Which corticosteroid can only be given PO
Prednisone
What does insulin do in the body
insulin trasports glucose into cells, inhibits the breakdown of fat and glycogen (these produce sugar when broken down), increases protein synthesisand inhibits gluconeogenesis.
What are the types of insulin
Short duration: rapid acting
Short duration: slower acting
Intermediate duration
Long duration
What are the contraindications for metformin
advanced kidney diseaser, HF, liver failure, history of lactic acidosis, Toxicity (causes lactic acidosis), Alcohol
Red flag: any radiology procedures
What is the MOA for levothyroxine and what is the primary use?
MOA: increases metabolic rate of body tissues and restores normal hormone balance. (Increases T4 levels and decreased TSH levels)
USE: replacement therapy in pt's with low thyroid functions
Name 2-3 nursing considerations for corticosteroids
What is regular insulin
human insulin: identical to insulin produced by the human pancreas
When is a pt most at risk when on insulin and why?
Peak: low blood sugar
What are the two sulfonylureas and what is their moa
glucotrol and glyburide-promote insulin release
What is Graves' disease?
What is Addison's Disease
A deficiency of both corticosteroids and mineralocorticoids-result of autoimmune response.
What are some monitoring treatments of Diabetes?
Fasting plasma glucose (>126mg/dl indicates diabetes), self-monitoring of blood glucose, continuous glucose monitoring, hemoglobin A1c (>6.5% indicates diabetes)
What are some complications of insulin treatment
Hypoglycemia, lipohypertrophy (accumulation of subQ fat), allergic reactions, hypokalemia, drug interactions
What is the contradiction for sulfonylureas
sulfa allergies
What are the adverse effects to the antithyroid agent: methimazole?
symptoms of hypothyroidism, can be hepatotoxic (check liver functions), blood dyscrasias
What are some symptoms of Addison's Disease
Labs: Hypoglycemia, low plasma cortisol and high plasma ACTH levels. Fatigue, ortho hypotension, darkening skin pigmentation, joint pain, GI disturbances
Severe: confusion, coma
What is the greatest concern with insulin therapy in Type 1 Diabetes?
Hypoglycemia
How should insulin be stored and how long can it be kept after opening
refrigerated unopen until needed-once opened one month
What are some of the AE's for the sulfonylureas
hypoglycemia, wt gain, GI distress, hepatotoxicity; ETOH can cause disulfirm-like reaction (flushing, palpitations, N)--drug to drug reaction