Endocrine
Insulin is secreted by the _________ and is increased following the ingestion of a meal, specifically with ________ being the main trigger of insulin secretion.
pancreas, carbohydrates
Hyperthyroidism leads to increased cellular regulation and metabolism.
Target blood sugar goals for a patient with diabetes
80-130 mg/dL pre-prandial
<180 mg/dL post-prandial
What is the priority nursing intervention for a patient experiencing transfusion reaction
DC transfusion and tubing and start a new infusion with 0.9% NS
pH 7.21
PCO2 61
HC03 22
Respiratory alkalosis
This condition is caused by excessive growth hormones related to pituitary tumors
Acromegaly
Elevated TSH with decreased T3 and T4 is diagnosed as
Hypothyroidism
4 to 6 oz (15g) of fast acting carbohydrate like juice
What type of IV solution would be administered to replace blood loss and increase blood pressure
Lactated Ringers
pH 7.24
Co2 28
HCO3 18
Metabolic acidosis with respiratory compensation
Name an intervention for a patient with SIADH
Fluid restriction, measure I&O, Loop diuretics, seizure and fall precautions, HOB flat, frequent neuro checks
What position should a patient post thyroidectomy be placed in?
Semi-fowlers
A1C >6.5
Fasting plasma glucose >126
2 hour OGTT >200
Symptomatic random glucose >200
Serum sodium
pH 7.22
C02 51
HC03 24
Respiratory acidosis
Elevated 24 hour urine cortisol, buffalo hump, thinning hair, purple streaks on the abdomen, and moon face are indicative of
Cushing's Syndrome
Patient complains of fatigue with difficulty walking to the mailbox, constipation, and cold intolerance. You suspect
hypothyroidism
Three assessment findings of complications related to diabetes
vascular disease- ulcers, decreased pedal pulses, necrotic areas on the toes and feet, thickened or crumbling toenails, changes to vision
neuropathy- decreased sensation to the extremities, numbness, and tingling, impotence, n/v/d
kidney disease- decreased urine output
A patient with DKA is prescribed regular insulin and IV fluid. What fluid do you anticipate to be ordered initially?
Normal Saline
pH 7.32
C02 47
HCO3 27
Partially compensated respiratory acidosis
Hyperpigmented skin of the face, neck and hands, weight loss, and postural hypotension are indicative of
Addison's disease
Patient 48 hours post thyroidectomy presents with a temp 104.8, tremors, HR 152, and agitation. What do you suspect is going on?
Acute thyrotoxicosis/thyroid storm
Patient with T2 DM the flu has n/v/d, abdominal pain, fatigue, dry mucous membranes, increased dark urination with ketones in urine. Blood sugar 321, 80/64, 14 RR, 101.3, 95%. What is the priority nursing diagnosis?
DKA
IV potassium should not be ran over how man mEq/hr
10 mEq/hr
pH 7.48
C02 36
Hc03 29
Metabolic alkalosis
Patient related education related to radioactive iodine treatment includes
mouth and throat may be irritated, may take up to 3 mos for max effectiveness, lifelong supplementation, flush the toilet twice after each use
A patient post thyroidectomy presents with tremors and a twitch of the facial muscles elicited by tapping the facial nerve just in front of the ear. What is the cause of these findings?
hypocalcemia related to parathyroidectomy
positive chovostek's sign is seen with tremor, treat with Ca Gluconate
Name 3 sick day protocol interventions for diabetic patients
Call the doctor for blood sugars >300, inability to keep fluids down due to v/d, or ketones are seen in urine. Continue to eat small soft foods at least 6-8 times a day if you cannot eat full meals. Continue to take insulin and all other medications.
A patient exhibits difficulty concentrating, nausea, and vomiting. You suspect this electrolyte to be decreased.
Sodium
pH 7.38
C02 38
HC03 24
Normal ABG