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Med Surge ENDOCRINE review

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
Created by: fluency