NU 412 Test 4 With Complete Solutions
what are diagnostic labs you have to have to be diagnosed with diabetes mellitus? -
ANSWER A1C >6.5, Fasting glucose > 126, Oral glucose tolerance test >200
what are S&S of hypoglycemia? - ANSWER shaking, tachycardia, sweating, dizzy,
anxious, hungry, blurry vision, weakness, headache, irritability
what are S&S of hyperglycemia? - ANSWER extreme thirst, blurry vision, drowsy, dry
skin, need to urinate often, slow healing wounds, hungry
how do you diagnose DKA? - ANSWER BG >250, metabolic acidosis, positive serum
ketones, anion gap >20
what are S&S of DKA? - ANSWER polyuria, N/V, anorexia, met acidosis, ketonuria,
Kussmals respirations, acetone/fruity breath, altered mental status, tachycardia
how do you treat DKA? - ANSWER strict I&O, regular IV insulin, D5W or D5NS or 1/2 NS,
monitor and replace K as needed, monitor EKG
what are S&S of hyperglycemic hyperosmolar state (HHS)? - ANSWER BG >600, serum
osmolality >310, no acidosis, anion gap normal, profound dehydration, tachycardia,
hypotension, increased BUN, no ketosis, altered mental status, anorexia, polydipsia,
N/V
how do you treat HHS? - ANSWER fluid replacement!, insulin and electrolyte
replacement as ordered
what is the earliest clinical evidence of renal failure/nephropathy in diabetic patients? -
ANSWER microalbuminuria
what are biguanides (metformin)? - ANSWER decreases liver glucose production and
improves insulin action on peripheral tissue/increases insulin sensistivity; 1st line drug
for diabetes, does NOT cause hypoglycemia, do not give with contrast dye,
contraindicated in renal failure
what are glitazones/TZDs (pioglitazone, rosiglitazone)? - ANSWER increase peripheral
insulin sensitivity, does NOT cause hypoglycemia, risk for MI, monitor LFTs, BBW for
causing CHF; treats diabetes
what are sulfonylureas (glipizide, glimepride)? - ANSWER stimulates insulin secretion in
patients who have some beta cell function; cause hypoglycemia* and weight gain;
caution in liver failure, elderly, and CVD
what are GLP-1 receptor agonists (liraglutide, dulaglutide, semaglutide, tirzepatide)? -
ANSWER treat diabetes, delay gastric emptying, improve postprandial hyperglycemia
, by stimulating insulin production; cause weight loss, no hypoglycemia, BBW for thyroid
cancer*
what are DPP-4 inhibitors (sitagliptin, linagliptin)? - ANSWER prolong incretin effect and
stimulate insulin production; treats diabetes; do not give with liver failure
what are SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin)? - ANSWER lower
BG through urinary excretion of glucose, cause weight loss, no hypoglycemia, cause
UTI and genital infections, contraindicated in renal failure and DM1, BBW for
amputations
what is hypothyroidism? - ANSWER low T3 and T4, high TSH; decreased metabolism;
can progress to a myxedema coma (rare and lifethreatening); treat with lifelong
synthetic T4 (levothyroxine); low fat low cholesterol low calorie diet, rest
what is a myxedema coma? - ANSWER rare life threatening condition due to
uncontrolled hypothyroidism; S&S of hypothermia, decreased LOC, severely decreased
metabolism, respiratory depression, cardiovascular collapse; treat with IV
levothyroxine
what is hyperthyroidism? - ANSWER too much T3 and T4, low TSH; increased
metabolism; complication of a thyroid storm; Treat with monitor vitals, rest, high calorie
diet, beta blockers, PTU (propylthiouracil) and/or methimazole to block thyroid hormone
production, iodine, thyroidectomy
what is a thyroid storm? - ANSWER life threatening condition due to uncontrolled
hyperthyroidism; S&S of high fever, tachycardia, HTN, exaggerated hyperthyroid
symptoms; treat with beta blockers, thyroid hormone blockers, iodine
what are S&S of hyperthyroidism? - ANSWER bulging eyes, tachycardia, weight loss,
HTN, amenorrhea, fine straight hair
what are S&S of hypothyroidism? - ANSWER hair loss, apathy, lethargy, dry skin,
constipation, bradycardia, weight gain, facial edema, intolerance to cold, brittle nails
what is hypoparathyroidism? - ANSWER low PTH, low calcium, high phosphorus; S&S of
chvosteks, trousseaus sign, muscle cramps, tetany, dysrhythmias, seizures; treat with
calcium supplement and phosphate binder and vitamin D
what is hyperparathyroidism? - ANSWER high PTH, high calcium, low phosphate; S&S of
kidney stones, osteoporosis, abdominal pain, NVC, muscle weakness, fatigue, HTN,
dysrhythmias; treat with cranberry juice, increased fluids, calcimemetics, calcitonin,
lasix, bisphosphonates
what is a hypercalcemic crisis? - ANSWER calcium level >15, treat with IV fluids,
phosphate therapy, calcitonin, dialysis
what is Addison's disease? - ANSWER adrenal insufficiency, low cortisol, S&S of
hypoglycemia, bronze skin, weakness, orthostatic hypotension, weight loss; treat with
what are diagnostic labs you have to have to be diagnosed with diabetes mellitus? -
ANSWER A1C >6.5, Fasting glucose > 126, Oral glucose tolerance test >200
what are S&S of hypoglycemia? - ANSWER shaking, tachycardia, sweating, dizzy,
anxious, hungry, blurry vision, weakness, headache, irritability
what are S&S of hyperglycemia? - ANSWER extreme thirst, blurry vision, drowsy, dry
skin, need to urinate often, slow healing wounds, hungry
how do you diagnose DKA? - ANSWER BG >250, metabolic acidosis, positive serum
ketones, anion gap >20
what are S&S of DKA? - ANSWER polyuria, N/V, anorexia, met acidosis, ketonuria,
Kussmals respirations, acetone/fruity breath, altered mental status, tachycardia
how do you treat DKA? - ANSWER strict I&O, regular IV insulin, D5W or D5NS or 1/2 NS,
monitor and replace K as needed, monitor EKG
what are S&S of hyperglycemic hyperosmolar state (HHS)? - ANSWER BG >600, serum
osmolality >310, no acidosis, anion gap normal, profound dehydration, tachycardia,
hypotension, increased BUN, no ketosis, altered mental status, anorexia, polydipsia,
N/V
how do you treat HHS? - ANSWER fluid replacement!, insulin and electrolyte
replacement as ordered
what is the earliest clinical evidence of renal failure/nephropathy in diabetic patients? -
ANSWER microalbuminuria
what are biguanides (metformin)? - ANSWER decreases liver glucose production and
improves insulin action on peripheral tissue/increases insulin sensistivity; 1st line drug
for diabetes, does NOT cause hypoglycemia, do not give with contrast dye,
contraindicated in renal failure
what are glitazones/TZDs (pioglitazone, rosiglitazone)? - ANSWER increase peripheral
insulin sensitivity, does NOT cause hypoglycemia, risk for MI, monitor LFTs, BBW for
causing CHF; treats diabetes
what are sulfonylureas (glipizide, glimepride)? - ANSWER stimulates insulin secretion in
patients who have some beta cell function; cause hypoglycemia* and weight gain;
caution in liver failure, elderly, and CVD
what are GLP-1 receptor agonists (liraglutide, dulaglutide, semaglutide, tirzepatide)? -
ANSWER treat diabetes, delay gastric emptying, improve postprandial hyperglycemia
, by stimulating insulin production; cause weight loss, no hypoglycemia, BBW for thyroid
cancer*
what are DPP-4 inhibitors (sitagliptin, linagliptin)? - ANSWER prolong incretin effect and
stimulate insulin production; treats diabetes; do not give with liver failure
what are SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin)? - ANSWER lower
BG through urinary excretion of glucose, cause weight loss, no hypoglycemia, cause
UTI and genital infections, contraindicated in renal failure and DM1, BBW for
amputations
what is hypothyroidism? - ANSWER low T3 and T4, high TSH; decreased metabolism;
can progress to a myxedema coma (rare and lifethreatening); treat with lifelong
synthetic T4 (levothyroxine); low fat low cholesterol low calorie diet, rest
what is a myxedema coma? - ANSWER rare life threatening condition due to
uncontrolled hypothyroidism; S&S of hypothermia, decreased LOC, severely decreased
metabolism, respiratory depression, cardiovascular collapse; treat with IV
levothyroxine
what is hyperthyroidism? - ANSWER too much T3 and T4, low TSH; increased
metabolism; complication of a thyroid storm; Treat with monitor vitals, rest, high calorie
diet, beta blockers, PTU (propylthiouracil) and/or methimazole to block thyroid hormone
production, iodine, thyroidectomy
what is a thyroid storm? - ANSWER life threatening condition due to uncontrolled
hyperthyroidism; S&S of high fever, tachycardia, HTN, exaggerated hyperthyroid
symptoms; treat with beta blockers, thyroid hormone blockers, iodine
what are S&S of hyperthyroidism? - ANSWER bulging eyes, tachycardia, weight loss,
HTN, amenorrhea, fine straight hair
what are S&S of hypothyroidism? - ANSWER hair loss, apathy, lethargy, dry skin,
constipation, bradycardia, weight gain, facial edema, intolerance to cold, brittle nails
what is hypoparathyroidism? - ANSWER low PTH, low calcium, high phosphorus; S&S of
chvosteks, trousseaus sign, muscle cramps, tetany, dysrhythmias, seizures; treat with
calcium supplement and phosphate binder and vitamin D
what is hyperparathyroidism? - ANSWER high PTH, high calcium, low phosphate; S&S of
kidney stones, osteoporosis, abdominal pain, NVC, muscle weakness, fatigue, HTN,
dysrhythmias; treat with cranberry juice, increased fluids, calcimemetics, calcitonin,
lasix, bisphosphonates
what is a hypercalcemic crisis? - ANSWER calcium level >15, treat with IV fluids,
phosphate therapy, calcitonin, dialysis
what is Addison's disease? - ANSWER adrenal insufficiency, low cortisol, S&S of
hypoglycemia, bronze skin, weakness, orthostatic hypotension, weight loss; treat with
