Diabetes Insipidus/SIADH
In Diabetes Insipidus, ADH is ______ .
In SIADH, ADH is _______ .
LOW in DI
High in SIADH
Symptoms of DKA, name 3
hyperglycemia, polyuria, polydipsia, polyphagia, kussmaul respirations, ketones present in blood and urine, confusion, coma, acetone breath, kidney impairment
What is the onset of rapid-acting insulin (Humalog/Novolog)?
15 min
Hypoglycemia is defined as a blood sugar of _____mg/dL or less
70
What is the primary cause of Cushing's disease?
Adrenal tumor or Pituitary tumor
Name 3 symptoms of that occur with Diabetes Insipidus.
polyuria, polydipsia, nocturia, weight loss, dry skin, fatigue, hypotension, tachycardia, hypernatremia, weak pulse, dizziness, decreased skin turgor
After checking K+, what type of insulin will be administered?
Regular-->IV Drip (gtt)
What is the duration of long-acting insulin? (Levemir, Lantus)
24 + hour
Give 3 symptoms of hypoglycemia
hunger, HA, nervousness, irritability, diaphoresis, anxiety, palpitations, neurological changes, seizures, unconsciousness, death
For Cushing's: Name one lab finding that will be HIGH and one lab finding that will be LOW
Increased: ACTH (adrenocorticoid hormone), glucose, sodium
Decreased: WBC, Potassium, Calcium
Name one treatment of SIADH?
Fluid restriction (500-1,000 mL/day)
Loop diuretics
Hypertonic 3% NS fluid
How often should patient blood sugar be checked when admitted for DKA?
hourly
What is a complication of insulin?
hypoglycemia
What is a long term consequence of hyperglycemia?
Retinopathy, Nephropathy, Peripheral Neuropathy,
What is the primary cause of Addison's Disease?
Autoimmune Attack- immune system mistakenly attacks the adrenal cortex which enables the ability to produce hormones.
Lab Values with Diabetes Insipidus.
Blood will be __?___ and urine will be ___?___.
concentrated, diluted
Once insulin gtt is started, what electrolyte is pushed into cells and needs to be monitored closely?
K+
Name 4 insulin injection sites?
outer arm, abdomen, hip area, thigh
Hyperglycemia is defined as a blood sugar more than ____mg/dL in a fasting state or _____mg/dL when not fasting.
100, 140
What nursing care should be completed daily for a patient with a dx of Cushing's & Addison's?
I&O, daily weight
What antidiuretic hormone would be used for Diabetes Insipidus?
Vasopressin, Desmopressin
What is the most common cause of DKA?
Infection
Blood Glucose finding is typically ___?__ in a patient with HHS compared to DKA?
Higher!!
>600mg/dL
Explain the 15-15 Rule
consume 15 grams of fast-acting carbs
wait 15 min, recheck blood sugar
if below 70mg/dL, consume another 15 grams of fast-acting carbs
once your blood glucose is above 70mg/dL provide a protein and carbohydrate snack
What teaching points should be given to Addison's patient?
Increase dietary sodium, carbs (glucose)
Wear a medical alert bracelet
Take steroid replacement therapy as prescribed
Avoid stress, illness, and strenuous exercise
Monitor for hypoglycemia, dehydration, low blood pressure