NUR 445: Endocrine UPDATED ACTUAL Questions and
CORRECT Answers
What are four causes of HHS? (Hint: DIPN) - Not enough insulin
- Delay in treatment
- Poor oral intake
- Impaired renal function
What are five signs and symptoms you would see in - Blood glucose > 600
HHS? (Hint: "BEN has a pHD") - Neuro changes (alteration in LOC)
- pH greater than 7.4
- Dehydration
- Electrolyte imbalances
What are five interventions you would do for a client with - IV insulin
HHS? (Hint: FISHE) - Fluids (0.9% NS)
- Hourly Glucose checks
- Strict I&O
- Educate patient on management and treatment adherence
What is the main electrolyte we are concerned with DKA K+
or HHS?
What is DKA? Deficiency of insulin leading to the use of stored fats for energy. Leading to
ketosis and acidosis state.
DKA: What patient would you commonly see this Type 1 diabetic
condition in?
What are three causes of DKA? - Infection
- Stress
- Skipped/ missed insulin
What are seven signs and symptoms of DKA? (Hint: - Fruity breath
F.K.U.S.A.D.P) - Kussmaul breathing
- Urine/ serum ketones
- Serum glucose of >250
- Abdominal pain (n/v)
- Dehydration (increased HR / decreased BP)
- Positive anion gap
What is the anion gap formula? Na+ - (Cl- + HCO3-)
, What are six interventions for DKA? (Hint: "Hungry - Hydration (0.9% NS)
Hippos Munch Many Cheesy Nachos") - Hourly glucose check (give IV insulin dip 10%)
- Monitor for ketones. (I&Os)
- Monitor more when patient is sick
- Notify provider if serum glucose is >250 & N/V >24 hrs
- Check K+
What should we educate patient on how to manage sick - Assess blood glucose more often
days at home to prevent DKA? - Check for ketones.
- Fluid replacement.
How will you know if the problem is DKA or HHS? Check pH: DKA will have acidosis.
Which insulin do you give at night? Long-acting insulin (insulin glargine/ Lantus)
What is the onset, peak, and duration of insulin glargine? - Onset: 1 hr
- Peak: none
- Duration 10-24 hours
Remember: No mixing
How do you mix regular insulin with NPH insulin? (Hint: 6 1) Regular (short acting ex: Humulin R)
steps) 2) NPH (intermediate acting ex: Humulin N)
3) Inject air into cloudy (NPH)
4) Inject air into clear (regular)
5) Draw from clear
6) Draw from cloudy
Describe the patho and causes of hypothyroidism. Low T3 and T4 thyroid hormones
- Low iodine, antithyroid treatments
- Pituitary tumor
- Autoimmune: Hashimoto's (low and slow)
What are two causes myxedema coma? - Hypothyroidism
- Medication adjustment is not right.
CORRECT Answers
What are four causes of HHS? (Hint: DIPN) - Not enough insulin
- Delay in treatment
- Poor oral intake
- Impaired renal function
What are five signs and symptoms you would see in - Blood glucose > 600
HHS? (Hint: "BEN has a pHD") - Neuro changes (alteration in LOC)
- pH greater than 7.4
- Dehydration
- Electrolyte imbalances
What are five interventions you would do for a client with - IV insulin
HHS? (Hint: FISHE) - Fluids (0.9% NS)
- Hourly Glucose checks
- Strict I&O
- Educate patient on management and treatment adherence
What is the main electrolyte we are concerned with DKA K+
or HHS?
What is DKA? Deficiency of insulin leading to the use of stored fats for energy. Leading to
ketosis and acidosis state.
DKA: What patient would you commonly see this Type 1 diabetic
condition in?
What are three causes of DKA? - Infection
- Stress
- Skipped/ missed insulin
What are seven signs and symptoms of DKA? (Hint: - Fruity breath
F.K.U.S.A.D.P) - Kussmaul breathing
- Urine/ serum ketones
- Serum glucose of >250
- Abdominal pain (n/v)
- Dehydration (increased HR / decreased BP)
- Positive anion gap
What is the anion gap formula? Na+ - (Cl- + HCO3-)
, What are six interventions for DKA? (Hint: "Hungry - Hydration (0.9% NS)
Hippos Munch Many Cheesy Nachos") - Hourly glucose check (give IV insulin dip 10%)
- Monitor for ketones. (I&Os)
- Monitor more when patient is sick
- Notify provider if serum glucose is >250 & N/V >24 hrs
- Check K+
What should we educate patient on how to manage sick - Assess blood glucose more often
days at home to prevent DKA? - Check for ketones.
- Fluid replacement.
How will you know if the problem is DKA or HHS? Check pH: DKA will have acidosis.
Which insulin do you give at night? Long-acting insulin (insulin glargine/ Lantus)
What is the onset, peak, and duration of insulin glargine? - Onset: 1 hr
- Peak: none
- Duration 10-24 hours
Remember: No mixing
How do you mix regular insulin with NPH insulin? (Hint: 6 1) Regular (short acting ex: Humulin R)
steps) 2) NPH (intermediate acting ex: Humulin N)
3) Inject air into cloudy (NPH)
4) Inject air into clear (regular)
5) Draw from clear
6) Draw from cloudy
Describe the patho and causes of hypothyroidism. Low T3 and T4 thyroid hormones
- Low iodine, antithyroid treatments
- Pituitary tumor
- Autoimmune: Hashimoto's (low and slow)
What are two causes myxedema coma? - Hypothyroidism
- Medication adjustment is not right.
