Term
| What does ductless glands do? |
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Definition
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Term
| Hypothalamus secretes releasing hormones that..... |
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Definition
| stimulate pituitary gland |
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Term
| Endocrine disorders are caused by? |
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Definition
| hypo and hyper secretions of hormones from the endocrine glands |
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Term
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Definition
| hormone replacement or hormone suppression |
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Term
| 3 things that can cause hypothyroidism |
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Definition
*too little TRH released from the hypothalamus
*too little TSh secreted from pituitary
*too little T4 & T3 secreted by the thyroid gland |
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Term
| Effects of severe hypothyroidism |
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Definition
*retarded growth & mental development in children
*myxedema coma in adults |
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Term
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Definition
| Hormone replacement therapy |
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Term
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Definition
dry skin
lack of energy
muscle weakness
slowed thinking processes
overweight
constipation
intolerance to cold- because metabolism is slow |
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Term
| Drugs used to treat Hypothyroidism |
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Definition
Levothyroxine sodium (synthroid) -synthetic T4
Liothyronine sodium (Cytomel)- synthetic T3
Liotrix (Euthroid)- combination of T3 & T4 |
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Term
| Nursing Considerations for hypothyroidism |
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Definition
*daily life long therapy
*take before breakfast
*monitor for drug-induced hyperthyroidism (nervousness, insomnia, tachycardia+) |
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Term
| _____________ &____________ decreases absorption of exogenous thyroid hormones |
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Definition
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Term
| ___________ thyroid hormones decrease effectiveness of beta blockers, digoxin, insulin and oral anti-diabetic agents |
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Definition
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Term
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Definition
| works better than generic Levothyroxine |
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Term
| Hyperthyroidism is caused by |
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Definition
| *hypersecretion of T3 & T4 from thyroid gland |
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Term
| Effects of hyperthyroidism |
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Definition
| Thyrotoxicosis (grave's disease)- metabolic processes accelerated |
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Term
| Treatment of Hyperthyroidism |
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Definition
*partial surgical removal of thyroid
*radiation of thyroid gland
*pharmacotherapy to block production or uptake of T3 & T4. |
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Term
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Definition
nervousness & hyperactivity
Insomnia
tremors
weight loss
rapid heart rate
sweating
intolerance to heat
exophthalmos- bulging eyeballs **may have to use eye lubricants |
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Term
| Nursing considerations for Hyperthyroidisms |
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Definition
*agents can cause hypothyroidism
*concomitant use of Lithium- increases occurrence of hypothyroidism
Thiomides- decrease wbc (monitor cbc, infections)
Thiomides- increase effects of Coumadin, digoxin, theophyllin
*iodine & iodine solutions cause discolor teeth, dilute and take after meals ++use straw
potassium iodine- do not used with ace inhibitors or potassium sparing diuretics (hyperkalemia)
exophthalmos- eye lubricants prevent corneal drying |
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Term
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Definition
| chronic metabolic syndrome |
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Term
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Definition
*deficiency or absence of endogenous insulin secretion
*poor cellular utilization of endogenous insulin |
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Term
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Definition
- cause damage to membrane of blood vessels
- increases risk of MI, CVA, RF, PVD |
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Term
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Definition
fasting; below 100
100- 120 - prediabetic |
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Term
| What does the A1C measure? |
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Definition
| average glucose over 3 month period; normal 4-6 |
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Term
| DM Type 1 is also known as |
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Definition
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Term
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Definition
*reduced or absent endogenous insulin secretion
*due to autoimmune process; cox sickie virus
*10% of all diabetes
*rapid onset; before age 30 |
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Term
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Definition
*90% of all diabetics
*after age 40
*genetic pre-disposition, obesity, sedentary lifestyle
*progressive disease
*early diet, weight management, oral anti-diabetic drugs
*later- insulin |
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Term
| 2 types of Exogenous Insulin |
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Definition
pork- taken from pancreas of a pig
human- made in lab |
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Term
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Definition
*measured in international units per milliter
*insulin syringes 100 U/ml
*not given orally
*pre-filled pens
*insulin pumps (young child/young adult) *brittle diabetic*
*BS extremely high- decrease it rapidly by IV route
*Regular insulin is the only insulin given Iv
*meals conincide with insulin administration |
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Term
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Definition
poluyuria- increases urine output
polydipsia- increases thirst
polyphagia- increases hunger
Blood sugar increased: Glucocorticoids, Thiazide diuretic, Epinephrine |
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Term
| Treament of Hyperglycemia |
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Definition
*acute- insulin
*chronic- oral antidiabetics and/ or insulin
*Diet |
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Term
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Definition
Nervousness
trembling
lack of coordination
cold, clammy skin
headache
if severe?- loss of consciousness |
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Term
| Treatment of hypoglycemia |
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Definition
| administer sugar, glucagon |
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Term
| ___________ measures glucose at intervals |
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Definition
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Term
| There are two short acting insulin: |
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Definition
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Term
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Definition
onset: 5 min
Peak: 30 min- 1 hr
Duration: 2- 4hr |
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Term
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Definition
onset: 30 min- 1hr
Peak: 2- 4 hr
duration: 6-8 hr |
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Term
| Short acting insulins are what color? |
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Definition
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Term
| Patient must be fed at the ______. |
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Definition
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Term
| Intermediate-Acting Insulin |
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Definition
Lente (humulin L, Novolin L)
NPH (humulin N, Novolin N) |
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Term
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Definition
Onset: 2- 4hr
Peak: 8- 12hr
Duration: 18-24hr |
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Term
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Definition
onset: 1-2hr
Peak: 6-12hr
duration: 18-24hr |
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Term
| Intermediate acting insulin |
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Definition
| can be given alone or in combination with regular insulin |
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Term
| Always draw up _____ to _______ |
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Definition
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Term
| Lantus( insulin glargine) is _________. |
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Definition
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Term
| Lantus should be given at________. |
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Definition
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Term
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Definition
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Term
| Levemir (insulin detemir) |
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Definition
peak: 6-8hr
duration: 24hr |
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Term
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Definition
| cant be mixed with other insulin in the same syringe |
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Term
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Definition
Pramlintide(symlin)
*type 1 & type 2 diabetes with poor *glucose control with insulin therapy
*adjunct to insulin
*synthetic analog of hormone amylin
*suppresses secretion of glucagon
*injected SQ into abdomen or thigh |
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Term
| Guidelines for oral antidiabetic therapy for type 2 diabetes |
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Definition
*onset age 40 or older
*diagnosis less than 5 yrs
*normal weight or overweight
*fasting blood sugar less than 200 mg/dl
*less than 40 units insulin per day
*normal renal and liver function |
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Term
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Definition
| stimulates beta cells in the Islets or Langerhans to release endogenous insulin. |
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Term
| Sulfonylureas (oral antidiabetics) |
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Definition
sulfa based
hypoglycemia, weight gain and long term failure of the pancreas
bs significant decrease several weeks |
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Term
| Examples of Sulfonylureas |
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Definition
Glyburide(diabeta, micronase); glipizide (Glucotrol)
onset: 15-30min
Peak: 1- 2hrs
duration: 24hrs |
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Term
| Meglitinides (oral antidiabetics) |
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Definition
similar in action to sulfonylureas; not in structure
take 3 times a day
less incidence of hypoglycemic reactions+++++
can be taken alone or in combination with Metformin |
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Term
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Definition
*Nateglinide (starlix)
*Repaglinide (prandin)
****Peaks in a hour**** |
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Term
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Definition
| reduce insulin resistance which makes cells more open to receive insulin |
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Term
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Definition
decrease hepatic glucose output
decrease intestinal glucose absorption
increase peripheral glucose utilization |
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Term
| Nursing considerations for Biguanides |
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Definition
monitor liver function
give 2-3x per day with meals
++++hypoglycemia is not a problems with this drug because it is given with meals!++++ |
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Term
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Definition
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Term
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Definition
| reduces insulin resistance |
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Term
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Definition
increase cellular utilization of insulin
decrease hepatic glucose output |
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Term
| Nursing considerations for TZD's |
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Definition
| monitor liver enzymes regularly |
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Term
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Definition
Pioglitazone(Actose)
Rosiglitazone(Avandia) |
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Term
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Definition
| taken of the market because of increased MI, and CVA's |
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Term
| Alpha Glucosidase Inhibitors |
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Definition
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Term
| Alpha Glucosidase Inhibitors |
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Definition
taken with first bite of meal
can cause hypoglycemia if taken alone; not if taken with sulfonylureas or meglitinides |
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Term
| examples of Glucosidase Inhibitors |
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Definition
Acarbose (precose)
Migitol (Glyset) |
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Term
|
Definition
| reduces the amount of insulin needed |
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Term
| OTC herbs that lower blood sugar levels |
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Definition
bilberry
black cohosh
chromium++
cinnamon
garlic
ginseng |
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Term
| Nursing considerations for insulins |
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Definition
schedule meals at peak of the action
giving fast and intermediate in the same syringe ++draw clear to cloudy
Long acting insulins cannot be mixed with other insulins in the same syringe
give intermediate acting shortly after drawing up
only short acting has a sliding scale
rotate injection sites
you can only give regular insulin IV
you perform capillary blood glucose fingersticks |
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