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NU116 Endocrine/DM
| Question | Answer |
|---|---|
| What are the red flags that may indicate endocrine deviations? What are the 3 P’s? | Growth alteration, altered metabolism, mental delay, altered sexual dev,Polyuria |
| What are the clinical manifestations of congenital hypothyroidism? | Lethargy, poor feeding, sluggish reflexes, characteristic facial features, poor feeding, constipation |
| What is normal head circumference for a one year old? | 46 cm, grows 1cm per month after 1 yr |
| What is Diabetes Insipidus? | Deficiency of ADH (anti diuretic hormone) |
| What are some clinical manifestations of Diabetes Insipidus? | a. Excretion of large amounts of dilute urine, polyuria, polydipsia b. *Serum sodium high, decreased specific gravity |
| How is DI treated? | Replace ADH (DDAVP vasopressin), intranasally |
| What disease is the opposite of DI? | a. SIADI – Syndrome of inappropriate ADH secretion b. *Decreased serum sodium, elevated spec gravity |
| What is the difference between Type I and II Diabetes Mellitus? | a. Pancreas stops producing insulin completely in type 1 b. Type 2 is insulin resistant, pancreas still makes insulin |
| What are the different lab values and what do they indicate? | a. FBS>126 – morning, fasting b. Random >200 – middle of morning/afternoon |
| Why is HgbA1C especially important in testing children? | a. Measures previous 3 mos, <6.5%, what is going on w/ the pancreas and how well is the body dealing with glucose |
| How is Type II treated? | a. Oral hypoglycemic = metformin b. Weight loss, diet c. May require insulin |
| Name and describe rapid-acting insulins: | humolog, lispro, novolog, 5-15mins before meal 9may be after w/ infants and toddlers) |
| Name and describe fast-acting insulins: | humulin R, Novolin R, 30mins before meals (can be given IV, prime tubing!) |
| Name and describe inter immediate-acting insulins: | Humulin N, Novolin N, SQ before bfast and dinner, can be mixed w/ rapid &fast acting |
| Name and describe long-acting insulins: | (glargine, lantus) glargine cannot be mixed! Basal insulin, no peaks,valleys, once a day |
| Which insulin can be given by IV? | REGULAR |
| Which insulin cannot be mixed? | GLARGINE |
| What do you draw up first for insulin clear or cloudy? | clear |
| When will blood sugar be the lowest? | peak |
| Where on the body is insulin administered? And how quickly will it be absorbed and what can increase this? | a. Abdomen = fastest b. Thighs = slower c. Buttocks = slowest |
| What blood sugar level indicates hypoglycemia? | <80 |
| What are s/s of hypoglycemia? | Light-headed, shaky, sweaty, clammy, cool, nauseas |
| What is hypoglycemia it caused by? | a. Exercise b. Not eating, too little food c. Too much insulin |
| How would you treat it? And when would you recheck the reading? | a. (example. BS=72), 4oz orange jc (rapid acting simple carb) b. Check it again in 10 min, follow with protein (crackers and peanut butter = sustain BS) c. Notify endocrinologist if oj doesn’t work |
| When would you give glucagon? | Only if child is not responsive, or unable to take anything orally |
| What can be expected if a child gets sick? | Increase stress on the body – may have increased requirement of insulin, spilling ketones in urine is expected |
| How frequently should sick day kids blood sugars be checked? | Q4hrs |
| What is diabetic ketoacidosis? | Glucose is unavailable to cells for metabolism; body breaks down protein and fat stores which leads to wasting of muscle mass. |
| What are the manifestations of DKA? | ketonuria) and lungs (acetone breath). Respirations increase in rate and depth (Kussmaul respirations). |
| How frequent will you do cap sticks on the DKA patient? | Hourly |
| What is the somogyi effect? | Symptoms of low BS, happens overnight, combo of low BG where body rebounds and then has high morning BS |
| What is the treatment of somogyi effect? | Decrease amt of bedtime insulin, higher bedtime snack |
| At what age is a child responsible enough to handle their own injections? | 7 |
| When is the risk for diabetic retinopathy increased? | Children less than 10yrs old |
| When is vision screening recommended? | Time of diagnosis, or within 3-5yrs of diagnosis then annually after |
Created by:
epeace874
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