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Ch 44-45 - Endocrine

Endocrine Disorders

QuestionAnswer
Ductless gland that produces an internal secretion discharged into the lymph or bloodstream and circulated to all parts of the body; hormones, the active substances of these glands, cause an effect on certain organs or tissues Endocrine glands
Disease resulting from a deficiency of ACTH caused by destruction or dysfunction of the adrenal glands; Addison's disease
Disease caused by inadequate secretion of ADH by the posterior pituitary gland; Diabetes insipidus
Disease of middle-aged adults resulting from overproduction of GH by the anterior pituitary gland; acromegaly
characterized by increased pigmentation of the skin and mucous membranes, weakness, fatigue, hypotension, nausea, weight loss, and hypoglycemia Addison's disease
symptoms include excessive urination, thirst, and dehydration Diabetes insipidus
characterized by enlargment of the facial bones, nose, lips and jaw; also associated with decreased libido, moodiness, fatigue, muscle pains, sweating and headache acromegaly
type of hormone secreted by the adrenal cortex and invovled in the regulation of fluid and electrolyte levels in the body mineralocorticoids
disorder caused by excess antidiuretic hormone production SIADH (syndrom of inappropriate antidiureticd hormone)
symptoms include decreased urination, edema, and fluid overload SIADH (syndrom of inappropriate antidiureticd hormone)
disorder resulting from excessive glucocorticoids in the body as a result of hypersecretion of the pituitary cushing's syndrome
caused by prolonged administration of large doses of exogenous steroids cushing's syndrome
symptoms include fat deposits in the neck and abdomen, fatigue, weakness, edema, excess hair growth, glucose intolerances, skin discoloration and mood swings cushing's syndrome
class of adrenocortical hormones that affects protein and carbohydrate metabolism and helps protect the body against stress cathecholamines
chemical (dopamine, epinephrine, norepinephrine) released at sympathetic nerve endings in response to stress glucocorticoids
hormones produced by the ovaries, adrenal glands, and fetoplacental unit in females that are responsible for the development and maturation of females estrogen
disease caused by exessive growth hormone in children and young adolescents, resulting in excessive proportional growth gigantism
disease caused by the hypersecretion of glucocorticoids as a result of excessive release of adrenocorticotropic hormone by the pituitary gland cushing's disease
hormones produced bu the adrenal cortex, and testes that stimulate the development of male characteristics androgens
surgical removal of all or part of the pituitary gland hypophysectomy
epinephrine adrenaline
a powerful vasoactive substance produced by the medulla or adrenal gland in times of stress or danger, allowing the body to react by fight or fleeing adrenaline
The first symptoms of a problem in hyperpituitarism is often _________________. visual deficit and headaches
A disease that occurs in early childhood or puberty in which the diaphysis of the long bones grows to great lengths stimulated by excess GH is _________________________. gigantism
A disease that appears when adults are in their 30s and 40s in which bones increase in thickness and width after epiphyseal closure is ________________________________. acromegaly
a syndrome characterized by a water imbalance related to an increase in ADH secretion is called ________________________. SIADH
Kidneys retain fluid due to the elevation of _________________. excess water
Plasma voume expands when ADH is elevated in SIADH, causing an increased ___________________. blood pressure
when the ADH level is elevated, the patient experiences water intoxication and the body's sodium is duluted, resulting in ________________. hyponatremia
weight gain without edema is one of the main symptoms of ____________________. SIADH
the treatment of SIADH promotes the elimination of __________________. excess water
in patients with SIADH, fluids are restricted and patients are given _________________. sodium chloride
patients with SIADH have fluid volume excess related to excess secretion of ______________. ADH
Addison's disease results in the loss of aldosterone and _________________. cortisol
A test that is necessary for a definitive diagnosis of hypoadrenalism, such as Addison's disease, is ______________. ACTH stimulation test
The mainstay of treatment of patients with Addison's disease is replacement theraphy with mineralocorticoids and ________________. glucocorticoids
potassium excretion is decreased when cortisol is not secreted, resulting in ________________. hyperkalemia
secondary adrenal insufficiency is a result of dysfunction of the hypothalamus or the _______________. pituitary gland
decreased levels of aldosterone alter the clearance of potassium, water, and ____________. sodium
when sodium and water excretion rates accelerate, problems such as hyponatremia and _____________ can result. hypovolemia
acute adrenal crisis is also called __________________. addisonian crisis
impaired secretion of corisol results in decreased liver and muscle glycogen and decreased ____________________-. gluconeogenisis
secondary adrenal insufficiency leads to decreased production of cortisol and _____________. androgens
primary adrenal insufficiency is also called _______________. addison's disease
decreased supplies of available glucise, which occurs as a result of impaired secretion of cortisol, is called _________________. hypoglycemia
patients with either primary or secondary adrenal insufficiency are at risk for episodes of _________________. addisonian crisis
a condition that occurs because hyperkalemia promotes hydrogen ion retention is ______________. metabolic acidosis
prolonged administration of high doses of corticosteroids may cause cushing's syndrome; this is an example of a ____________________ cause. exogenous
an initial screening for Cushing's syndrome is the overnight ____________ test. dexamethasone
In the immediate posoperative period of adrenalectomy patients, _______________ may be needed to maintain blood pressure. vasopressors
the most common cause of cushing's syndrome is long-term exogenous __________________ use. corticosteroids
corticotropin-secreting pituitary tumors may cause cushing's syndrome; this is an example of a ________________________ cause. endogenous
patients with a pheochromocytoma exhibit episodes of hypertension, hypermetabolism, and __________________. hyperglycemia
excessive production of ACTH resulting from a pituitary tumor is called _______________. cushing's disease
hypersecretion of the adrenal cortex may result in the production of excess amounts of ___________________. steroid
the prevention of infections in adrenalectomy patients is maintained through observance of _____________. asepsis
a tumor of the adrenal medulla that causes secretion of excessive catecholamines is a ____________________. pheochromocytoma
the condition that results from excessice cortisol is called ___________________. cushing's syndrome
patients who take drugs that suppress adrenal function are at risk for acute _____________. adrenal crisis
hormone that stimulates the growth and development of bone, muscles, or organs growth hormone
hormone that controls ovulation or egg release in the female and testosterone production in the male luteinizing hormone
hormone that controls the release of glucocorticoids and adrenal androgens adrenocorticotropic hormone (ACTH)
hormone that stimulates the development of eggs in the ovary of the female and the production of sperm in the testes of the male Follicle-stimulating hormone (FSH)
another name for the somatotrophic hormone growth hormone
hormone that stimulates breast milk production in the female prolactin
hormone that promotes pigmentation Melanocyte-stimulating hormone
another name for lactogenic hormone prolactin
hormone that causes the reabsorption of water from the renal tubules of the kidney antidiuretic hormone
hormone that causes contractins of the uterus in labor and the release of breast milk oxytocin
another name for vasopressin antidiuretic hormone
hormone that controls the secretory activities of the thyroid gland thyroid-stimulating hormone (TSH)
Diabetes Insipidus: Increased plasma osmolarity stimulates the osmoreceptors, which in turn relay information to the cerebral cortex, causing the person to expreience _________________. thirst
Diabetes Insipidus: Massive dehydration leads to severe __________________ imbalances. electrolyte
Diabetes Insipidus: With ADG deficiency, massive dehydration occurs, which leads to decreased intravascular volume, circulatory collapse, and ___________________. hypotension
Diabetes Insipidus: Electrolyte imbalances contributes to circulatory collapse causing arrhythmias and impaired contractility of the _______________. heart
Diabetes Insipidus: Massive diuresis results in increased plasma ________________. osmolarity
Laboratory results would be expected to increase in patients with Addison's disease: Potassium BUN
Laboratory results would be expected to decrease in patients with Addison's disease: serum cortisol level fasting glucose sodium
Cushing's Syndrome Nursing Intervention: Avoid exposure to infections Risk for infection
Cushing's Syndrome Nursing Intervention: Report minor signs, such as low grade fever, sore throat, or aches to the physician Risk for infection
Cushing's Syndrome Nursing Intervention: Seek a psychatric referral if mood swings continue to be a problem Disturbed thought process
Cushing's Syndrome Nursing Intervention: Assist patient to change positions at least every 2 hours Risk for impaired skin integrity
Cushing's Syndrome Nursing Intervention: Protect patients from falls or trauma Risk for injury
Cushing's Syndrome Nursing Intervention: Discuss bruises, abnormal fat distribution, and hirutism with the patient if they cause embarrassment Disturbed body image
Cushing's Syndrome Nursing Intervention: Teach patient about the importance of continuing drug theraphy uncer medical supervision Ineffective management of therapeutic regimen
Age related changes in older person regarding pituitary function: Function is adequate ADH secretion may be decreased Ability to concentrate urine may be decreased Risk for dehydration increases
Signs and symptoms that indicate meningitis: elevated WBC count Sudden rise in temperature headache neck rigidity
Medications given as hormone replacement theraphy following hypophysectomy are: thyroid medication ADH Cortisol
Activities that may disrupt the surgical site and CSF leakage after hypophysectomy are: coughing straining vomitting
Manifestations of acute adrenal crisis are: dehydration confusion hyponatremia hypoglycemia hyperkalemia tachycardia hypotention hypercalcemia
Types of stressors that can initiate acute adrenal crisis are: infection illness trauma emotional/psychiatric disturbances
Drug used to suppress adrenocortical function adrenalcortical cytoxic agents antifungal agents
Drugs that stimulate reabsorption of sodium and excretion of potassium and hydrogen ions mineralocorticoids
Drugs that stimulate the formation of glucose and promote the storage of glucose as glycogen glucocorticoids
drug used to treat adrenal insufficiency glucocorticoids
Florinef mineralocorticoids
hydrocortisone (Cortef) glucocorticoids
Diagnostic test used to detect diabetes mellitus and hyperpituitarism glucose tolerance test
Diagnostic test where serum levels are measured to detect elevations or deficiencies of pituitary hormones pituitary hormone serum levels
Diagnostic test given to stimulate release of ADH to detect diabetes insipidus hypertonic saline test
Diagnostic test that measures cortisol, which increases with adrenal hyperplasia and Cushing's syndrome dexamethasone suppresion tests
Diagnostic test that detects changes in specific graviy and osmolality after vasopressin given; used to detect diabetes insipdus fluid deprivation test
Diagnostic test that uses radiographs to create images of internal structures and detect tumors cerebral computed tomography scan
Diagnostic test results that determines the presence of Addison's disease are: decreased fasting glucose hyponatremia low serum low urinary cortisol level hyperkalemia increased BUN
Nursing Diagnosis: Excess fluid volume related to excess ADH secretion SIADH
Nursing Diagnosis: Risk for infection related to high serum cortisol levels Cushing's syndrome
Nursing Diagnosis: Ineffective tissue perfusion related to electrolyte imbalances Addison't disease
Nursing Diagnosis: disturbed body image related to changes in physical appearance hyperpituitarism
Nursing Diagnosis: Deficient fluid volume related to excessive urine output Diabetes insipidus
Nursing Diagnosis: Sexual dysfunction related to hormone deficiency Hypopituitarism
In the healthy older person, there may be increased secretion of ADH, which may lead to ________________-. fluid imbalance
the production of excess GH may lead to the development of ______________________. atherosclerosis and hyperglycemia
GH antagonizes insulin and interferes with its effects, thus leading to ________________. hyperglycemia
Because GH mobilizes stored fat for energy, levels of free fatty acids are elevated in the bloodstream, leading to the development of ___________________. atherosclerosis
visual problems occur in hyperpituitarism due to pressure on the ____________________. optic nerves
patients with gigantism and acromegaly initially present with increased strength, progressing rapidly to complaints of __________________________. weakness and fatigue
One drug commonly prescribed for patients with acromegaly is ______________. octreotide (sandostatin)
A common nursing dianosis for patients with hyperpituitarism is ____________________. disturbed body image
Bromocriptine (Parlodel) inhibits the release of prolactin and GH from ________________. the pituitary glands
Following hypephysectomy, the nurse asks the patient to place the chin to the chest to assess for nuchal rigidity, which is associated with __________________. meningeal irritation/inflammation
changes in assessment findings following hypophysectomy that may reflect edema due to the manipulation of tissues or bleeding intracranially include ___________________. decreasing alertness
strict documentation of I&O and measurement of specific gravity are important because postoperative hypophysectomy patients are at risk for _____________________. diabetes insipidus
Because CSF leaks sometimes occur in postoperative hypophysectomy patients, the nurse should check for ________________. nasal packing
A bedside test can be done with a chemical strip to detect whether drainiage in postoperative hypophysectomy patient is CSF, since CSF has a high content of ____________. glucose
decreased pigmentation of the skin results in _______________. pallor
the patient who has a complete hypophysectomy requires hormone replacement _________________. for a lifetime
In patients with hypopituitarism, insufficient thyroid hormone is available for normal metablosim and _____________. heat production/thermogenesis
If there is a lack of melanocyte-stimulating hormone, the skin exhibits decreased __________________. pigmentation
Deficiency of thyroid-stimulating hormones necessitates thyroid replacement with a drug such as __________________________. levothyroxine (Synthroid)
To produce or maintain linido, secomdary sexual characteristics, and well-being, males with hypopituitirism should receive ____________________. testosterone
drug related diabetes insipidus is often caused by _______________________. lithium carbonate (Eskalith)
A 24 hr urine output of greater than 4 liters of fluid suggests a diagnosis of ________________________. diabetes insipidus
In order to maintain adequate blood volume in patients with diabetes insipidus, two measures that are required include IV fluid volume replacement and ____________________. vasopressors (to maintain adequate blood pressure)
The level of consciousness deteriorates and the patient may have seizures or lapse in a coma when water intoxication affects the ______________________. CNS
A nursing diagnosis for patietns with SIADH is Risk for Injury related to confusion associated with _______________________. water intoxication/cerebral edema
To prevent progressive cerebral edema in patietns with SIADH, patients are placed in which position in bed? semi-fowler's position
In postmenopausal women, the primary source of endogenous estrogen is the ______________. adrenal cortex
A common skin finding in patients with adrenal dysfunction is _____________________. bronze pigmentation
An age-related change that affects the adrenal glands is that adrenal function _______________. decreases in epinephrine
The response to sodium restruction and to position changes is less effecient in older adults because of declines in the secretion of plasma renin and _______________________. aldosterone
Signs and symptoms of hyperkalemia that should be reported to the physician by patients with Addidon's disease include ____________________. weakness and paresthesia
Which substance may be used liberally in the diet of patients with Addison's disease? Salt
What is a common sign of diabetes insipidus? massive diuresis dehydration thirst
What is the priority nursing diagnosis specific to the patient who has had an adrenalectomy? Risk for injury related to acute adrenal insufficiency.
What are the manifestations of adrenal insufficiency that exhibited by a patient? Nausea, vomitting, and diarrhea weight loss weakness darkening of the skin on his face and arms inadequate skin perfusion confusion disorientation
Facial edema that develops with sever, long-term hypothyroidism; sometimes used as a synonym for hypothyroidism Myxedema
Enlargement of the thyroid gland, causing the neck to appear swollen goiter
Steady muscle contraction caused by hypocalcemia Tetany
Small mass of tissue that can be palpatated Nodule
Spasmodic closure of the larynx Laryngospasm
Permanent metal and physical retardation caused by congenital defieciency of thyroid hormones Cretism
Excessive metabolic stimulation caused by elevalted thyroid hormone level Thyrotoxicosis
Inflammation of the parotid (salivary) gland Parotiditis
Inflammation of the thyroid gland Thyroiditis
Substances that suppress thyroid function goitrogen
protusion of the eyeballs associated with hyperthyroidism exophthalmos
Two things that should be placed at the bedside before the patient who is having a thyroidectomy? Suction equipment Emergency tracheotomy tray
Two reasons that respiratory distress can result follwing thyroidectomy: Compression of the trachea Spasms of the larynx due to nerve damage or hypocalcemia
Following thyrpodectomy surgery, where should the nurse check for bleeding? Check behind the neck
If thyroid enlargement is mild and thyroid hormone production is normal, what treatment is required? No intervention is required
The most common form of hyperthyroidism are Graves' disease and _____________. Multinodular goiter
If hyperthyroidism may lead to _____________. Thyrotoxiscosis (thyroid storm)
Symptoms of thyrotoxicosis include tachycardia, heart failure and ________________. hyperthermia
Drugs that block the synthesis, release, or activity of thyroid hormones antithyroids
two classes of drugs commonly used as antithyroid drugs are thiomides and __________________. iodides
When a patient is taking drugs that interfere with thyroxine secretion, the nurse should monitor for edema, weight gain, and ________________. cold tolerance
Examples of thiomides are methimazole (Tapazole) and ______________. Propylthioracil (PTU)
One main disadvantage of the thioamides is that they can cause __________________. agranulocytosis
A condition in which deposits of fat and fluid behind the eyeballs make them bulge forward is called ________. Exophthalamos
A complication in patients undergoing thyroidectomies that can be prevented by preoperative treatment with antithyroid drugs is ______________. calcium salts
Signs and symptoms of poor oxygenation due to airway obstruction that may occur after thyroidectomy include restlessness, increased pulse and ________________. dyspnea
signs of laryngeal nerve damage include the inability to speak and ________________. hoarseness
A complication of thyroidectomies include injury to the parathyroid glands, which results in _______________. laryngospasms
the most serious side effect of hypocalcemia is _________________. tetany
signs of severe hyperthyroidism include fever, confusion and _____________. tachycardia
symptoms of infection that should be reported after thyroidectomy include fever, wound swelling, and _____________________. foul discharge
the results of inadequate secretion of thyroid hormones is called ___________________. hypothyroidism
parathyroid hormones play a critical role in regulating ________. calcium
the most notable effect of hyperthyroidism is _________________. hypercalcemia
people who undergo kidney transplantation after being on dialysis for a long time may experience _________________. hyperparathyroidism
when the serum calcium levels falls, ______________ is secreted. PTH
generally, calcium retention by the kidney is balanced by the loss of _______________. phosphates
a spasm of the facial muscle when the fave is tapped over the facial nerve is _______________. chvostek's sign
a carpopedal spasm that occurs when a blood pressure cuff is inflated beyond a patient's systolic blood pressure and is left in place for several minutes is ___________________. throusseau's sign
after radioactive iodine is given and the amount of iodine taken up is measured, a high uptake indicated hyperthyroidism. radioactive iodine uptake test
provides high-quality images of thyroid and any nodules thyroid ultrasonography
an elevated T3 serum level indicated Graves' disease serum T3 and T4 measurements
after iodine isotope is given, a sanner detects pattern of uptake by the thyroid gland thyroid scan
elevated T4 serum level indicates hyperthyroidism serum T3 and T4 measurements
assesses response of the pituitary to TRH; differentiates types of hypothyroidism TRH simulation test
test that can differentiate benign and malignant nodules and detect other abnormalities thyroid scan
material from thyroid nodules is aspirated and is guided by ultrasonography fine needle aspiration biopsy
used to treat hyperthyroidism by interfering with synthesis of thyroid hormones antithyroid drugs
concentrates un thyroid tissue for diagnostic scans radioactive iodine
used to treat hypothyroidism and thyroiditis thyroid replacement drug
reduces the size and vascularity of thyroid gland in hyperthyroidism iodides
promotes calcium absorption from digestive tract vitamin d
corrects calcium deficiency die to hypothyroidism calcium salts
inhibits bone resorption and reduces serum calcium biophosphonates
increases metabolic rate thyroid hormone replacement
Manifestations of hyperparathyroidism are: bone pain demineralization fractures
______________ is secreted when serum calcium levels are high to limit the shift of calcium from the bones into the blood. calcitonin
Hyperthyroid patients often experience sleep disturbances and _______________. restlessness
Poor tolerance of heat and excessive perspiration are symptoms of _______________. hyperthyroidism
If untreated, hyperthyroidism may lead to ________________. thyrotoxicosis (thyroid storm)
Signs of iodine toxicity include: sweeling and irritation of mucous membranes and increased salivation
elevated thyroid hormones result in ____________________. increased pulse and blood pressure
An important nursing diagnosis for patient with exophthalmos is _________________. disturbed body image
A complication of thyroidectomies includes injury to the parathyroid gland which results in _____________. tetany
results of two test that are indicative of hypocalcemia are ________________ and _______________. positive Chvostek's and Trousseau's sign
An early symptom of tetany is _____________ tingling sensation around the mouth, fingers and toes
Graves' disease is characterized by _______________. decreased metabolic rate
_____________ are drug that stains the teeth and should be sipped through a straw. SSKI
In patients with toxic diffuse goiter (Graves' disease), there is a risk for injury related to ______________. intolerance to heat
Lack of iodine is associated with _____________. goiter
Thyroxine, triiodothyronin and calcitonin are hormones produced by the _______________. thyroid gland
Which drug is used to treat hypothyroidism? Synthroid
an inadequate amount of insulin to meet daily requirements characterizes__________. Type 2 DM
insulin is released in the body in response to the ingestion of ______________. carbohydrates
the absence of endogenous insulin charaterizes ____________. Type 1 DM
when insulin is absent, the blood becomes thich with glucose, causing the patient to experience ______________. polydipsia
tissue breakdown and burning of lean body mass send hunger signals to the hypothalamus; consequently, the patient experiences ________________. weight loss
the hormone that stimulates the active transport of glucose into the cells of muscle and adipose tissue is ______________. insulin
life treatening emergency caused by a relative or absolute deficeincy of insulin diabetic ketoacidosis
complication in which signs and symptoms are classified as adrenergic and neuroglucopenic acute hypoglycemia
complication caused by rough shoe linings, burns, or chemical irritation neuropathic foot ulcers
symptoms range from tingling, numbness, and burning to complete loss of sensation caused by sensory and automic nerve impairment polyneuropathy
glycosuria, along with hypertension, gradually destroy the capillaries that supply the renal glomeruli nephropathy
characterized by macular edema retinopathy
dangerous drop in blood glucose caused by taking too much insulin, not eating enough food or eating at the right time acute hypoglycemia
results from inadequate blood supply and is experienced as sharp, stabbing pains in the muscle mononeuropathy
nerve tissue involvment affects the sympathetic and parasympathetic nervous system autonomic neuropathy
diabetes is the leading cause of ____________. end stage renal disease
with diabetic retinopathy, the vitreous humor becomes cloudy and vision is lost as a result of _________________. hemorrhage
a symptom of eye problems for patients with diabetes is the presence of spots which is called ? floaters
people with diabetes account for a large percentage of patients with renal disease, which is called? ESRD
elevated insulin levels circulating in the blood of patients with diabetes contribute to the premature development of ? atherosclerosis
treatment of ketoacidosis is aimed at correction of three main problems, which are acidosis, dehydration and ? electrolyte imbalances
the patient with ketoacidosis may have lost a large colume of fluid as the result of vomitting, hyperventilation and? polyuria
replacement of potassium is vital in patients with ketoacidosis because hypokalemia can lead to severe? cardiac dysrhythmias
a life threatening emergency caused by lack of insulin or inadequate amounts of insulin is called diabetic? ketoacidosis
air hunger, seen in patients with ketoacidosis is observed as __________. kussmaul respirations
the movement of potassium from extracellular compartment into the cells is enhanced by ____________. insulin
ketoacidosis results in disorders in the metabolism of carbohydrates, fats, and ______________. protein
the electrolyte of primary concern in ketoacidosis is ______________. potassium
organs of the body that do not depend on insulin for the transport of glucose into them are? brain and nerve cells lens of the eye heart
risk factors of type 2 DM are: people who are overweight family history latin american/hispanic african-american native american
causes of foot problems in the person with diabetes are: impaired blood supply impaired nerve supply
situations that put patient with diabetes at risk for ketoacidosis are: people eat too much food and does not take enough insulin patient experiences stress such as infection or surgery DM has not been diagnosed
explain why patients receiving total parenteral nutrition or dialysis are likely to have hyperosmolar nonketotic coma IV solutions containing large amounts of glucose are administered to the patients digestive system is bypassed no stimulus to trigger the pancreas to release insulin
Areas of injection sites for insulin are: upper arm abdomen thighs
it is best to rotate sites from one area of the body to another .
the site with the fastest absorption rate is the abdomen. .
exercise increases the absorption rate of insulin .
heat and massage increase the absorption rate .
symptoms of hypoglycemia blurred vision anxiety hunger diaphoresis disorientation
a reading greater than 200 mg/dL indicates a diagnosis of DM serum glucose levels
reflects glucose levels over the past few months glycosylated hemoglobin levels
bloodis drawn at 30 min to 1 hr after the ingestion of glucose then hourly for 3 to 5 hrs when patient is suspected of having DM Oral glucose tolerance test
catergory that inludes NPH and Lente insulin intermediate-acting insulin
catergory that includes ultralente and insulin glargine (lantus) long acting insulin
catergory that includes exubera inhaled rapid short acting insulin
humalog and novolog rapid acting
regular insulin short acting
onset occurs in less than 15 min rapid acting
peak occurs in 2-3 hrs short acting
peak occurs in 30-90 min inhaled rapid short acting
duration in 20-36 hrs long acting
onset is 30 min-1hr short acting
insulin that can be given IV short acting
which insulins are clear in appearance? humalog novolog lantus
what are exogenous causes of hypoglycemia? insulin alcohol oral hypoglycemic drugs
which is the most frequent cause of hypoglycemia? insulin
____________-inhibits the conversion of glycogen to glucose. insulin
which herbal supplement can lower blood glucose? ginseng garlic onion dandelion
the diagnosis of diabetes is based on serum ____________. serum glucose levels
represents normal fasting serum glucose level 70-120 mg/dL
the american diabetes association recommends that 60-70% of the total daily calories should come from? carbohydrates and monosaturated fats
the most commonly used insulin concentration is? U100
the prescription for insulin, including schedule for dosages, type and amounts is written to mimic the action of a normal +______________. pancreas
regular insulin should be given _____________. before meals
which injection site has the fastest rate of absorption for insulin? abdomen
the two oral sulfonylurea hypoglycemic agents that are recommended for older patietns are Glucotrol and ______? diabeta micronas (glyburide)
when mixing regular and longer acting insulins, which should be drawn into the syringe first? ultralente U insulin (longer acting)
a reason for avoiding long acting oral sulfonylurea hypoglycemic agents in older patients is that decreased renal function in older adults make them more prone to ____________-. hypoglycemia
which is a side effect of sulfonylureas used in the treatment of DM? hypoglycemia
patients who require insulin injections need to self monitor levels of __________. blood glucose
late signs of hypoglycemia include _____________. confusion unconsciousness
to detect possible changes in the eyes associated with DM, the nurse inquires whether the patients has had floaters, blurred vision or ________. diplopia
during the physical assessment of the diabetic patient, the nrse inspects the feet carefully for lesions, discoloration, and______________. edema deformities pallor
a nursing diagnosis for patients with diabetes is chronic pain related to ___________. neuropathy
patients with diabetes may have disturbed sensory perception related to ___________. neurologic and circulatory changes
altercations in tactile sensations in diabetic patients may result in _______________-. burns or frostbite
disturbed thought processes in diabetic patients, including confusion, anger, and decreased level of consciousnessm may be due to: ketoacidosis hypoglycemia
hypoglycemia is defined as a syndrome that develops when the blood glucose level falls to less than: 45-50 mg/dL
endogenous hypoglycemia occurs when internal factors cause an excessive secretion of insulin or an increase in the metabolism of: glucose
when blood glucose falls rapidly the four substances that are secreted by the body in an attempt to increase glucose levels are: cortisol glucagon growth hormone epinephrine
early signs of hypoglycemia include weakness and hunger
whoch group of oral antidiabetic agents does not cause hypoglycemia as a side effect? alpha-glucosides inhibitors (precose)
patients with hypoglycemia are at risk for injury related to: dizziness weakness
hyperosmolar nonketotic coma is loss of consciousness caused by extremely high serum: glucose
when a patient is given insulin for diabetic ketoacidosis, the nurse should monitor for: hypoglycemia
when a patient's serum glucose is 260 mg/dL and ketoacidosis is present, the patient should: avoid exercise
you patient has taken NPH insulin at 8am. At what time of day should he avoid exercise in order to prevent hypoglycemia? 1-2 hours because of peak
which type of insulin is a clear solution? Insulin glargine (lantus)
the goal of a diabetic diet is to: normalize plasma glucose levels
the overall mission of the endocrine system is to: maintain homeostatis
hormoes secreted by the posterior pituitary inclue the following: antidiuretic hormone
an patient who has recently started treatment for acromegaly says, "I will be so glad to look like myself again!" The most appropriate response is: treatment will keep your symptoms from getting worse but will not reverse all of them
after surgery to remove a pituitary adenoma, the patient complains of neck stiffness. You should: look for other signs of infection
patients with hypopituitarism who wish to habe children must be treated with follicle-stimulating hormone and: luteinizing hormone
the main symptom of SIADH is: water retention
the patients with diabetes insipidus must maintain records of: urine specific gravity
fluid and electrolyte imbalances associated with Addison's disease include: hyponatremia
a patient who is brought to the ER has BP 88/40, P 108 thready, and dry skin and mucous membranes. He is confused. A medical alert card in his wallet states that he htakes drugs for Addison's disease. You know he has signs and symptoms of: acute adrenal crisis
nursing care of the patient with cushing's syndrome should indiclude the following: protect the patient from visitors and other patients with infection
the primary function of thyroid hormones is to regulate: metabolism
you are notified that a patient with severe hypothyroidism is being admitted to your nursing unit. Which action is appropriate? have extra blankets put in the room
which of the following findings is most likely in a patient with severe hyperthyroidism? HR of 120 BPM
during shift report, it is stated that a hyperthyroid patient has exophthalmos. You would expect to see: prominent, bulging eyeballs
a 6-wk course of treatment with propythiorucil (PTU) is prescribed for a patient who is scheduled for a thyroidectomy. the patient asks why she has to take this medication. Your best response: it reduces your thyroid activity, which makes surgery safer for you
in the immediate postoperative period after thyroidectomy, the first priority is to: maintain a patent airway
the purpose of measuring serum thyroglobulin in a patient who has had thyroid cancer is to: detect any recurrence of the thyroid cancer
which statement best describes the relationship between parathyroid hormone and serum calcium? increased secretion of PTH causes the kidney to retain calcium
a patient had a parathyroid adenoma removed 2 days ago. She is now complaining of muscle cramps in her hands and feet. you shuld suspect: hypocalcemia
nursing implications in administering iodide solutions to a patient include which of the following: dilute in milk or jiuce and provide a straw
a function of insulin is to: help transport glucose for energy
he incidence of DM is greates among people of which ethnicity? hispanic
one type of macrovascular complication of DM is: CAD
what is the rationale for limiting protein intake in the patient with DM? high protein intake indirectly contibutes to the development of nephropathy
the advantage of human insulin over beef and pork insulin is: people do not form antibodies for human insulin
which type of oral medication is least likely to cause hypoglycemia? alpha-glucosidase inhibitors
the classic sign and symptoms of DM are: Polyphagia polyuria polydipsia
a patient who was newly diagnosed with diabetes says, "Everyone I know with diabetes has had one or both legs amputated." what is the most appropriate reply? there are many things you can do to reduce your risk of future amputations.
Created by: jleycomiller