NR 325 Endocrine Disorders – Worksheet

NR 325 Endocrine Disorders – Worksheet

Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical Manifestations Diagnostic Tests Nursing Interventions and
Collaborative
Management
Possible Complications
and
Treatments/Interventio
ns for Complications
1
Diabetes Mellitus Type I
Rapid acting: Ex: lispro
(Humalog), aspart
(Novolog)
Onset: 10-30 min,
peak:30 min-3hr,
duration: 3-5 hr
Short acting: Ex: regular
(Humalin R, Novalin R)
Onset: 30 min-1hr, peak:
2-5 hr, duration: 5-8 hr
-ONLY INSULIN THAT
CAN BE GIVEN IV
Intermediate: Ex: NPH
(cloudy-Humulin N,
Novalin N)
Onset: 1.5-4 hr, peak: 4-
12 hr, duration: 12-18hr
Long Acting (nighttime):
Ex: glargine (Lantus),
detemir (Levemir), and
degludec (Tresiba)
Onset:0.8-4hr, peak:
NONE, duration: 12-24hr
ï‚ž Destruction of beta cells
in pancreas due to
autoimmune
dysfunction.
ï‚ž Patients are insulin
dependent.
ï‚ž Onset in people younger
than 40 yrs but it can
occur in any age.
ï‚ž Risk factors:
Genetics
Ethnicity (Hispanic, African,
Asian)
Insulin administration:
-absorption is fastest from
abdomen, then arm, thigh,
and buttock. Rotate sites.
SubQ so injects at 45-90
degree angle.
Insulin pump: continuous
infusion connected into subQ
tissue of abdominal wall.
Storage of insulin: do not
heat/freeze, in-use can be left
at room temp for 4wks, extra
should be refrigerated, avoid
exposure to direct sunlight,
extreme cold,
ï‚ž Ketoacidosis
ï‚ž Weight loss
ï‚ž 3 p’s: Polydipsia,
polyuria, & polyphagia
ï‚ž Weakness
ï‚ž Fatigue
ï‚ž Hx & physical
examination
ï‚ž HgbA1C of 6.5 or
higher
ï‚ž Fasting plasma glucose
ï‚ž Fructosamine
ï‚ž Random plasma
glucose of 200 mg/dL
or greater
ï‚ž Serum creatine
ï‚ž Electrolytes
ï‚ž Islet cell
autoantibodies
For exercise: eat carbs
before if BG is <100
Monitor levels frequently
Assess level of consciousness
Hydrate with hypertonic
solution
Administer insulin
Keep patient hydrated
Labs: blood glucose >300
mg/dL, ketones in blood
and urine, metabolic
acidosis
DM management
Nutritional therapy
Blood glucose monitoring
Medication
Exercise- 1 hr after meals,
snack to prevent
hypoglycemia
Insulin
Eye exam ever 5 years
after onset
15/15/15 rule!
Administer 15g of fast
acting card
Wait 15 min, recheck blood
glucose
Administer 15g more if
blood glucose remains less
than 70 mg/dL
Give 7g of protein when
blood glucose is within
normal limits
⦿ DKA (Diabetic
ketoacidosis): Life
threatening condition
w/bg >250 mg/dL &
Ketones in the
blood/urine,
metabolic acidosis.
S/S: hyperglycemia,
ketosis, acidosis,
dehydration [poor
skin turgor, dry
mucous membranes,
tachycardia,
orthostatic
hypotension),
lethargy and
weakness. Kussmaul’s
respirations, and
sweet fruity breath
odor
-Give D5 fluids, NS, and
regular insulin via IV
ï‚ž CVD: MI & HTN
ï‚ž Stroke
ï‚ž Impaired vision
ï‚ž Nerve damage,
leading to
neuropathic pain,
numbness, ischemia,
& infection.
ï‚ž Hypoglycemia
ï‚ž Hyperglycemia
ï‚ž Kidney failure
ï‚ž Problem w/ insulin

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