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ATI-MedSurge-Endocri
Med Surge ENDOCRINE review
| Question | Answer |
|---|---|
| DM-1, pt. teaching re: alcohol consumption | ingest alcohol with meal to reduce alcohol-induced hypoglycemia |
| insulin dosage may need to be [increased or decreased] due to hypoglycemic effect of alcohol | decreased |
| how many fat exchanges should be substituted for every alcoholic beverage? | 2 fat exchanges |
| alcohol will [increase or decrease triglyceride] levels? | increase |
| proper procedure to draw insulin glargine (Lantus) and regular insulin | draw into separate syringes (glargine cannot be mixed) |
| DM patient reports feeling anxious, nurse expect hypoglycemia due to... | cool, clammy skin |
| postprandil blood glucose level reference range | <180 mg/dL |
| bedtime blood glucose level reference range | 100 - 140 mg/dL |
| preprandil blood glucose level reference range | 90 - 130 mg/dL |
| propylthiouracil (PTU) considered when weight [increases or decreases] | increase weight |
| propylthiouracil (PTU) is given to ___ thyroid hormone | inhibit (suppress) |
| propylthiouracil (PTU) causes an [increase or decrease] in diaphoresis | decreased disphoresis |
| propylthiouracil (PTU) causes an [increase or decrease] bowel movements | decreased bowel movement |
| propylthiouracil (PTU) causes an [increase or decrease] in appetite | decrease in appetite |
| client with SIADH retains fluid which causes | dilutional hypoNATREMIA |
| DM patient with peripheral neuropathy can protect injuries to feet by | - examine skin/feet daily - monitor temp of bath water w/thermometer |
| DM patients should shop for shoes ___ time of day | late [when feet are slightly swolen] |
| [brady or tachy] cardia - expected finding of diabetes insipidus | tachycardia |
| hematocrit level will [increase or decrease] in pt. with diabetes insipidus | increase |
| increased urine output leads to... | - dilute urine - low specific gravity |
| BUN level will do what in relation to dehydration? | increase |
| Priority nursing intervention - preOP client w/pheochromocytoma | avoid palpating abdomen [decrease risk for CVA] |
| Laryngeal stridor is a? | harsh, high-pitched sound on inspiration, indicates respiratory obstruction |
| thyroid replacement meds should be taken? | in the morning on an empty stomach to promote proper absorption |
| vanillymandelic acid test, pt. needs to restrict? | foods containing caffeine 2 - 3 days prior to test |
| in primary Cushing's disease, which lab level is expected to be elevated? | Blood Glucose |
| in Thyroid Storm - Beta 2 Blockers (eg. Propranolol) is given to | reduce effects of thyroid hormone on the sympathetic nervous system |
| proper administration of metered dose spray - pt. should... | blow nose gently prior to using the nasal spray |
| What is? Acute adrenal insufficiency... | is a life-threatening condition that occurs when there is not enough cortisol, a hormone produced by the adrenal glands |
| Hydrocortison succinate (Solu-Cortef) is administered to? | replace cortisol deficiency |
| Cortisol is a? | glucocorticoid |
| Cortisol's functions - | - helps regulate blood sugar - holds back the immune response - released as part of the body's response to stress |
| The primary adrenal insufficiency disease is? | Addison's Disease |
| HbA1C test is an indicator of? | glucose levels over a 3-month period |
| Target goal of HbA1C test is | <7% |
| Hyperthyrodism - symptoms | STING S Sweating T Tremor or Tachycardia I Intolerance to heat, Irregular menstruation, and Irritability N Nervousness G Goiter and Gastrointestinal (loose stools/diarrhea) |
| T3 - reference range | 70 to 205 ng/dL |
| T4 - reference range | 4.0 to 12.0 mcg/dL |
| TSH stimulation test - reference range | 0.4 to 6.15 microunits/mL |
| Cushing's Disease - symptoms | C Central Obesity U Urine free cortisol S Suppressed immunity, Striae H Hyper-cortisol -glycemia -tension -cholesterol and Hirsutism I Increased admin. of corticosteroids or Iatrogenic N Neoplasms or Non-iatrogenic G Growth retardation |
| Hypothyroidism - symptoms | MOM'S SO TIRED M Memory loss O Obesity M Malar flush/Menorrhagia S Slowness S Skin and hair become dry O Onset is gradual T Tired I Intolerance to cold R Raised blood pressure E Energy levels are low D Depressed |
| Steroid Withdrawal Syndrome - symptoms | fatigue, joint pain, muscle stiffness, muscle tenderness, or fever |
| Steroid meds should be taken... | after a full meal or with antacid as this may help reduce irritation of the stomach |
| Long term use of steroids can cause? | Altered Response to Physical Stress Infection GI Ulcers or Bleeding Osteoporosis Weight gain Insomnia Mood Changes Fluid Retention Elevated Blood Pressure Elevated Blood Sugar Cataracts or glaucoma Atherosclerosis Aseptic Necrosis (Muscle wast |
| Adenocorticotropic Hormone (ACTH) test is most definitive for which diease? (Elevated levels) | Addison's Disease |
| Serum ACTH levels | morning - 25 to 200 pg/mL evening - 0 to 50 pg/mL |
| Decreased ACTH levels are evident in which disease? | Cushing's Disease |
| Urinary cortisol - reference range | 10 to 100 mcg/day |
| Salivary cortisol - sample is collected? | usually at midnight |
| Salivary cortisol - reference range | < 2.0 ng/mL |
| Hyperglycemic-hyperosmolar state - reference ranges | Glucose level > 600 mg/dl Serum pH > 7.30 |
| Hyperglycemic-hyperosmolar state - symptoms | Dry, parched mouth Extreme thirst Warm, dry skin that does not sweat High fever (101+) Sleepiness or confusion Loss of vision Hallucinations Weakness on one side of the body |
| Hypocalcemia - symptoms | CATS C Convulsions A Arrhythmias T Tetany, Tingling (hands/feet) S Spasms and stridor |
| Hypocalcemia - reference levels | < 9.0 mg/dL |
| Hypercalcemia - symptoms | MISHAP M Malignancy I Intox of Vitamin D & A S Sarcoidosis H Hyperparathyroidism A Alkali Syndrome P Paget’s Disease of Bone |
| In adrenal insufficiency, calcium levels may be? | Elevated |
| Fasting blood glucose - level | <110 mg/dL |
| Oral glucose tolerance test | <140 mg/dL |
| Fasting blood glucose - test prep | - NPO for 8 hrs prior to test - Antidiabetic meds postpone until after test |
| Oral blood glucose - test prep | - Consume a balanced diet for the 3 days prior to the test and - NPO 10 to 12 hr prior to the test - Fasting blood glucose is drawn at start of test - Give pt. glucose - Blood glucose drawn 30 min for 2 hr - Checked for hypoglycemia during test |
| DM pt. on Vasopressin (Pitressin) intranasal aqueous - pt. teaching | increased urination/thirst is an indication of need for another dose |
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