Medical Surgical nursing – Endocrine with verified solutions already graded a+

Corticosteroids released by adrenal cortex, effect every cell on the body. used to treat adrenocortical disorders, immunosuppression, and reduce inflammation Common corticosteroids hydrocortisone, methlprednisilone, prednisone, dexamethasone Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:09 / 0:15 Full screen uses of corticosteroids allergies, Addison's, inflammation, cerebral edema, anaphylactic reaction Corticosteroid side effects sodium retention, nausea, acne, anxiety, insomnia, mood swings, increased appetite, impaired wound healing, masks infections corticosteroid nursing implications monitor weight, b/p, blood sugar, cushingoid signs, stress level, infection. Sudden withdrawal can be fatal, decrease effectiveness of anti diabetic agents, combing with aspirin and NSAIDS increase risk for ulcers, non-potassium sparing diuretics may lead to hypocalcemia and hypokalemia, corticosteroids patient education timing of doses, tapering is required, eat potassium rich foods, monitor for signs of infection, and adrenal insufficiency, corticosteroid categories glucocorticoids and mineralocorticoids Addison's disease primary adrenal insufficiency. occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone secondary adrenal insufficiency due to a deficiency of ACTH, damage to the pituitary gland causing hypocortisolism. symptoms of adrenal insufficiency starts gradually, fatigue, muscle weakness, weight loss, low b/p, hyper pigmentation. Function of insulin assist in glucose transport into cells, stimulate storage of glucose in the liver, signal liver to stop release of glucose, enhances storage of adipose tissue, transport of amino acids categories of insulin rapid acting short acting intermediate acting very long acting Rapid acting insulin novolog, humalog, onset 10-30 minutes, peak 30 minutes to 3 hours. duration 3-6 hours Short acting insulin humulin R, novolin R. onset 30-60 minutes, peak 1-5 hours, duration 6-10 hours intermediate acting insulin NPH, humulin N, novolin N, onset 1-2 hours, Peak 6-14 hours, duration 16-25 hours Long acting insulin levemir, lantus. Onset 1-2 hours, no peak, duration 24 hours Oral hyperglycemics used with type 2 diabetes who cannot be treated with diet and exercise alone insulin nursing implications accuracy of dose, do not interchange insulin, monitor blood glucose level, monitor activity level, subcutaneous, rotate injection site, make sure other treatment regimens are being utilized, weekly weight insulin patient education side effects, educate on sites and technique, educate on process of diabetes mellitus, carry id alert, how to recognize hypo and hyperglycemia, smoking decreases insulin absorption, glucose testing, diet, exercise type 1 diabetes disorder in which the body cannot produce enough insulin, diagnosed young, have islet cell antibodies, little to no insulin production, type 2 diabetes progressive disorder in which body cells become less responsive to insulin onset usually after 30 years old, obese, no islet cell antibodies, decrease insulin production with time due to insulin resistance islets of langerhans areas of pancreatic cells that produce insulin and glucagon complications of insulin injections hypoglycemia, lipoatrophy, lipohypertrophy, lipohypertrophy buildup of subcutaneous fat at the site of repeated injections antihypoglycemics used to increase blood glucose levels, dextrose, treatment must be immediate, can give regular juice, hard candies, honey. retest blood glucose in 15 minutes, retreat if >70. provide snack with protein and carbs. emergency hypoglycemic measures if patient cannot swallow or is unconscious use subcutaneous or IM glucagon hypoglycemic nursing implications requires immediate treatment, causes nausea/vomiting, monitor blood glucose, give carbs orally, may have headache, make sure they are using their treatment regimens hypothyroidism poorly functioning thyroid or low TSH from the pituitary gland thyroid medication synthroid, levothyroxine, liotrix, levothroid, cytomel, hypothyroidism nursing implications monitor weight, vital signs, thyroid function studies, take at same time each day hyperthyroidism overactive thyroid condition management of hyperthyroidism radioactive therapy to reduce function, surgery to remove part of thyroid, relapse is common, treatment may cause hypothyroidism pituitary hormones 15 different hormones from hypothalamus and pituitary. not many are used in pharmacotherapy posterior pituitary hormones ADH, maintains fluid homeostasis, replacement therapy increases the reabsorption of water in the kidneys - vasopressin and oxytocin anterior pituitary hormones ACTH, Growth hormones - used with growth failure in children. antigrowth hormone - use with acromegaly prolactin hypothalamus Controls hunger, thirst, and body temperature. pituitary glands regulates growth and controls other endocrine glands thyroid regulates metabolism parathyroid in the neck; controls the calcium levels in your body, and normals the bone growth pancreas gland that secretes pancreatic juice into the duodenum, where it mixes with bile to digest food adrenal cortex outer section of each adrenal gland; secretes cortisol, aldosterone, and sex hormones adrenal medulla secretes epinephrine and norepinephrine gonads reproductive glands-male, testes; female, ovaries diabetes group of metabolic diseases characterized by increased levels of glucose in the blood, resulting in defects in insulin secretions, actions or both insulin production insulin is secreted by the beta cells of the pancreas etiology of diabetes glucose from food cannot be stored in the liver, causing increased blood sugar. excess sugar is spilled by the kidneys insulin inhibits breakdown of stored glucose and produce new glucose from amino acids fat breakdown occurs Diabetic ketoacidosis symptoms fruity breath, hyperglycemic, ketosis, metabolic acidosis. weight loss, nausea/vomiting, abdominal pain, dehydration with electrolyte loss, polyuria, polydipsia, fatigue, blurred vision, headache, hypotension, decreased level of consciousness IDDM type 1 diabetes NIDDM type 2 diabetes diabetes presenting symptoms polyuria, polydipsia, polyphagia, fatigue and weakness, sudden vision changes, tingling and numbness, wounds that don't heal type 1 diabetic risk factors early onset, familial history, genetic predisposition, immunologic or environmental factors type 2 diabetic risk factors obesity, age, previous impaired fasting glucose tolerance, hypertension, HDL <35 or triglycerides >250, history of gestational diabetes urinalysis for pancreatic disorders focus on protein, sugar and ketone, all should be negative, specific gravity may increase Fasting blood sugar less than 100, prediabetes 100-125, diabetes 125 or greater postprandial blood sugar measurement of blood sugar level after a meal, 2 hr pp 65-139 2h pp prediabetes 140-199 Glucose tolerance test diabetes diagnosis with blood sugar greater than 200 after 2 hours of test Hgb A1C average of 1-3 months of blood sugars. Normal 4-5.5% Prediabetic 5.7-6.4 uncontrolled >8 Diabetic dyslipidemia insulin resistance causes glucose and triglycerides to build in the blood Creatinine levels for diabetes determine renal function and affects of diabetes on nephron function Exercise and diabetes Lowers blood glucose, improves circulation, weight loss, lowers blood lipids, insulin dependent must eat 15 gm of CHO before exercise to avoid post exercise hypoglycemia