Endocrine & Respiratory NUR 445
Exam 1 Questions and Answers
What test will be run before discharging DKA patient? - answer- HbAc
What A1ACH is good for a diabetic patient? - answer- 7
What is HHS? - answer- Have some insulin but body might be resistance causing
blood glucose to be high for a long period of time.
Who do you see commonly have HHS? - answer- Type 2 DM
What are four causes of HHS? (Hint: DIPN) - answer- - Not enough insulin
- Delay in treatment
- Poor oral intake
- Impaired renal function
What are five signs and symptoms you would see in HHS? (Hint: "BEN has a pHD")
- answer- - Blood glucose > 600
- Neuro changes (alteration in LOC)
- pH greater than 7.4
- Dehydration
- Electrolyte imbalances
What are five interventions you would do for a client with HHS? (Hint: FISHE) -
answer- - IV insulin
- 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 or HHS? - answer- K+
What is DKA? - answer- 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? - answer- Type 1
diabetic
What are three causes of DKA? - answer- - Infection
- Stress
- Skipped/ missed insulin
What are seven signs and symptoms of DKA? (Hint: F.K.U.S.A.D.P) - answer- -
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? - answer- Na+ - (Cl- + HCO3-)
What are six interventions for DKA? (Hint: "Hungry Hippos Munch Many Cheesy
Nachos") - answer- - 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? - answer- - Assess blood glucose more often
- Check for ketones.
- Fluid replacement.
How will you know if the problem is DKA or HHS? - answer- Check pH: DKA will
have acidosis.
Which insulin do you give at night? - answer- Long-acting insulin (insulin glargine/
Lantus)
What is the onset, peak, and duration of insulin glargine? - answer- - Onset: 1 hr
- Peak: none
- Duration 10-24 hours
Remember: No mixing
How do you mix regular insulin with NPH insulin? (Hint: 6 steps) - answer- 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. - answer- Low T3 and T4 thyroid
hormones
- Low iodine, antithyroid treatments
- Pituitary tumor
- Autoimmune: Hashimoto's (low and slow)
What are two causes myxedema coma? - answer- - Hypothyroidism
- Medication adjustment is not right.
, What are nine clinical manifestations of myxedema coma? (Hint:
H.C.L.F.G.C.W.H.H) - answer- - Hypoxia
- Carbon dioxide retention
- Lethargy
- Fatigue
- Goiter
- Cold intolerance
- Weight gain
- Hypoglycemia
- Hyponatremia
What medication is used for hypothyroidism? - answer- Levothyroxine
What are four interventions you would do for a patient with myxedema coma? (Hint:
SIMI) - answer- - Slow warming
- Monitor T3 T4 levels
- IV levothyroxine
- Intubation equipment ready (due to hypoxia and carbon dioxide retention)
How do you know if its hypothyroidism and hyperthyroidism? - answer- - Look at the
TSH
- Increased T3 & T4 / Decreased TSH (hyper)
- Decreased T3 & T4 / increased TSH (hypo)
If the thyroid regulates metabolism what would a decreased metabolic rate indicate?
- answer- Hypothyroidism
What is the patho. and causes of hyperthyroidism? - answer- High T3 and T4 thyroid
hormones
- Too much iodine
- Too much thyroid medication (ex. Levothyroxine)
- Autoimmune: Gave = GAINS "HIGH"
What causes hyperthyroidism which can lead to a thyroid storm? - answer- - Sudden
illness of surgery
- Untreated hyperthyroidism
What are four cues that would indicate hyperthyroidism? (Hint: E.S.T.F) - answer- -
Exophthalmos (bulging eyes)
- Sever agitation
- Tachy
- Fever
What medication would be given to patient with thyroid storm (hyperthyroidism)? -
answer- Methimazole
What three other interventions would you do for hyperthyroidism patients? (Hint:
F.F.B) - answer- - Fluid replacement
- Fever reduction
- Beta blockers like atenolol for HR
Exam 1 Questions and Answers
What test will be run before discharging DKA patient? - answer- HbAc
What A1ACH is good for a diabetic patient? - answer- 7
What is HHS? - answer- Have some insulin but body might be resistance causing
blood glucose to be high for a long period of time.
Who do you see commonly have HHS? - answer- Type 2 DM
What are four causes of HHS? (Hint: DIPN) - answer- - Not enough insulin
- Delay in treatment
- Poor oral intake
- Impaired renal function
What are five signs and symptoms you would see in HHS? (Hint: "BEN has a pHD")
- answer- - Blood glucose > 600
- Neuro changes (alteration in LOC)
- pH greater than 7.4
- Dehydration
- Electrolyte imbalances
What are five interventions you would do for a client with HHS? (Hint: FISHE) -
answer- - IV insulin
- 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 or HHS? - answer- K+
What is DKA? - answer- 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? - answer- Type 1
diabetic
What are three causes of DKA? - answer- - Infection
- Stress
- Skipped/ missed insulin
What are seven signs and symptoms of DKA? (Hint: F.K.U.S.A.D.P) - answer- -
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? - answer- Na+ - (Cl- + HCO3-)
What are six interventions for DKA? (Hint: "Hungry Hippos Munch Many Cheesy
Nachos") - answer- - 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? - answer- - Assess blood glucose more often
- Check for ketones.
- Fluid replacement.
How will you know if the problem is DKA or HHS? - answer- Check pH: DKA will
have acidosis.
Which insulin do you give at night? - answer- Long-acting insulin (insulin glargine/
Lantus)
What is the onset, peak, and duration of insulin glargine? - answer- - Onset: 1 hr
- Peak: none
- Duration 10-24 hours
Remember: No mixing
How do you mix regular insulin with NPH insulin? (Hint: 6 steps) - answer- 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. - answer- Low T3 and T4 thyroid
hormones
- Low iodine, antithyroid treatments
- Pituitary tumor
- Autoimmune: Hashimoto's (low and slow)
What are two causes myxedema coma? - answer- - Hypothyroidism
- Medication adjustment is not right.
, What are nine clinical manifestations of myxedema coma? (Hint:
H.C.L.F.G.C.W.H.H) - answer- - Hypoxia
- Carbon dioxide retention
- Lethargy
- Fatigue
- Goiter
- Cold intolerance
- Weight gain
- Hypoglycemia
- Hyponatremia
What medication is used for hypothyroidism? - answer- Levothyroxine
What are four interventions you would do for a patient with myxedema coma? (Hint:
SIMI) - answer- - Slow warming
- Monitor T3 T4 levels
- IV levothyroxine
- Intubation equipment ready (due to hypoxia and carbon dioxide retention)
How do you know if its hypothyroidism and hyperthyroidism? - answer- - Look at the
TSH
- Increased T3 & T4 / Decreased TSH (hyper)
- Decreased T3 & T4 / increased TSH (hypo)
If the thyroid regulates metabolism what would a decreased metabolic rate indicate?
- answer- Hypothyroidism
What is the patho. and causes of hyperthyroidism? - answer- High T3 and T4 thyroid
hormones
- Too much iodine
- Too much thyroid medication (ex. Levothyroxine)
- Autoimmune: Gave = GAINS "HIGH"
What causes hyperthyroidism which can lead to a thyroid storm? - answer- - Sudden
illness of surgery
- Untreated hyperthyroidism
What are four cues that would indicate hyperthyroidism? (Hint: E.S.T.F) - answer- -
Exophthalmos (bulging eyes)
- Sever agitation
- Tachy
- Fever
What medication would be given to patient with thyroid storm (hyperthyroidism)? -
answer- Methimazole
What three other interventions would you do for hyperthyroidism patients? (Hint:
F.F.B) - answer- - Fluid replacement
- Fever reduction
- Beta blockers like atenolol for HR
