Endocrine
Endocrine
EENT
Endocrine
Endocrine
100
Treatment for an unconscious patient who is hypoglycemic
place pt in lateral positon to prevent aspiration
administer glucagon subQ or IM or IV D50 and notify provider
repeat in 10 mins if pt is still unconscious and continue to treat until BS is over 70
100
Diagnosis of DKA
BS greater than 250 mg/dl
blood pH<16
HCO3 < 16
moderate to large ketones in the blood or urine
100
Treatment for retinal detachment
laser photocoagulation,
scleral buckling – client will need
to lay prone post-op
100
Metformin
Monitor for GI Effects
Monitor kidney function due to nephrotoxicity
Stop medication for 24 to 48 hours before any type of radiographic test that has
IV contrast dye and restart 48 hours after test
100
Diabetic Education for Illnesses
If they are sick, they need to monitor their
blood glucose levels more frequently (ie.
every 2 to 4 hours).
• They need to continue taking their insulin
• Maintain hydration & nutrition
• Call their provider if:
• Blood glucose level of 250 mg/dL that
does not decrease with treatment
• They have a fever grater than 38.6
(101.5)
• Feel disoriented or confused
• Have rapid breathing
• Persistent nausea, vomiting or diarrhea
200
What is the treatment dawn phonomenon
Increase insulin dosage/adjust administeration time.
200
Types of Diabetes Insipidus
Primary neurogenic-A lack of ADH production or release, caused by defects in the hypothalamus or pituitary gland
Secondary Neurogenic-A lack of ADH production or release, caused by infection, tumors in or near the hypothalamus, head trauma, or brain surgery
Nephrogenic-Renal tubules do not react to ADH, can be inherited, the result of kidney damage, or an adverse medication effect(lithium, demeclocycline)
200
severe eye pain,
headache, blurred vision, seeing
halos around light, hazy eye,
tunnel vision
Acute angle glaucoma
200
What is the biggest concern for DKA
potassium
generally high due to the acidotic state, but will turn into hypokalemia due to insulin and fluid administration
200
When do you want to administer rapid acting insulin
Administer before meals to control post-prandial rise
in blood glucose
• Onset: 10-30 min
300
HbAIC reference range for a non diabetic
4-6%
300
Labs associated with hypothyroidism
T3 and T4 decreased
TSH increased
300
loss of central
vision STILL has peripheral
macular degeneration
300
medication for Cushings
300
Mechainism of action for Second-Generation Sulfonylureas (ie. Glipizide, Glimepiride,
Glyburide)
Stimulates insulin release from the
pancreas causing decrease in blood sugar levels
• Nursing Actions
• Monitor for hypoglycemia
• Administer 30 min. before meals
400
Diagnostic criteria for DM
2 findings on seperate days of atleast one of the following
Fasting BS greater than 126
Random BS greater than 200 + manifestations of DM
2 hr glucose greater than 200 with oral glucose tolerance test-preg woman
400
Pateint education for levothyroxine
Should not D/C without consulting provider
Take med on empty stomach typically 30-60 mins before breakfast
Monitor for toxicity
Tremors/nervousness
tachycardia
palpitations
heat intolerance
Rapid weight loss
Hight thyroid levels
High metabolism
Insomina
Dietary supplements can interfere with absorption
400
Conductive hearing loss
condition in the outer or middle ear impair the transission of sound through air to inner ear
COmmon causes: otitis media with effusion, impacted cerumen, perforation of the tympanic membrane, otosclerosis, and narrowing of the external auditory canal
400
An easy way to figure out which one is causing morning hyperglycemia
Take BS between 2 and 4 am and monitor for symptoms of hypoglycemia
400
when treating DKA when do you want to add dextrose to the IV solution?
when blood glucose gets around 250mg/dl to prevent hypoglycemia
500
what distinguishes from Type 1 DM from Type 2 DM
presence of autoantibodies
500
Methimazole and propylthiouracil
Inhibits production of thyroid horomone
Monitor s/s of hypothyroidism
can become hepatotoxic
take med with meals
500
Red, bulging, painful tympanic membrane, fever,malaise, kids will pull on their ear
Acute otitis media
500
Why can't you exceed dropping regular insulin less than 100 mg/dl per hour
It can cause cerebral edema
500
Foot care education for your pt with DM
Foot Care Education
• Inspect and wash feet daily with a mild soap and
warm water. No soaking! Client should pat feet dry
(especially between the toes).
• No lotions
• If they have any wounds, calluses or corns – they
need to consult their provider and/or podiatrist
• Shoes
• No open toe shoes or barefoot. Leather shoes
are preferred.
• Shoes must fit correctly.