Endocrine & Respiratory NUR 445 A C T U A L E X A M 1
COMPLETE EXAM QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100%
CORRECT ANSWERS) /ALREADY
GRADED A+
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 condition in?
Type 1 diabetic
What are three causes of DKA?
- Infection
- Stress
- Skipped/ missed insulin
,What are seven signs and symptoms of DKA? (Hint: F.K.U.S.A.D.P)
- Fruity breath
- 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 Hippos Munch Many
Cheesy Nachos")
- Hydration (0.9% NS)
- 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 days at home to
prevent DKA?
- Assess blood glucose more often
- 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 steps)
1) Regular (short acting ex: Humulin R)
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.
What are nine clinical manifestations of myxedema coma? (Hint:
H.C.L.F.G.C.W.H.H)
- Hypoxia
- Carbon dioxide retention
- Lethargy
- Fatigue
- Goiter
- Cold intolerance
- Weight gain
- Hypoglycemia
- Hyponatremia
COMPLETE EXAM QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100%
CORRECT ANSWERS) /ALREADY
GRADED A+
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 condition in?
Type 1 diabetic
What are three causes of DKA?
- Infection
- Stress
- Skipped/ missed insulin
,What are seven signs and symptoms of DKA? (Hint: F.K.U.S.A.D.P)
- Fruity breath
- 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 Hippos Munch Many
Cheesy Nachos")
- Hydration (0.9% NS)
- 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 days at home to
prevent DKA?
- Assess blood glucose more often
- 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 steps)
1) Regular (short acting ex: Humulin R)
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.
What are nine clinical manifestations of myxedema coma? (Hint:
H.C.L.F.G.C.W.H.H)
- Hypoxia
- Carbon dioxide retention
- Lethargy
- Fatigue
- Goiter
- Cold intolerance
- Weight gain
- Hypoglycemia
- Hyponatremia
