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Maternity and Women's Health Care, 11th Ed., Lowerdermilk, Perry, Cashion & Aldon, 2016/
29 - Endocrine and Metabolic DisordersAce Your Maternity and Women's Health Care, 11th Ed., Lowerdermilk, Perry, Cashion & Aldon, 2016 Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Maternity and Women's Health Care, 11th Ed., Lowerdermilk, Perry, Cashion & Aldon, 2016 | Registered Nurse (RN) School Study Aid
Graves' Disease Characteristics
- Women 20-40 years old
- Pathophysiology
- Anti-TSH Receptor Antibodies
- Symptoms
- Ophthalmopathy
- Exophthalmos
- Hyperthyroidism
- Goiter
- Pretibial Myxedema
1 min
Graves' Disease Labs and Treatment
- Labs
- Decreased TSH
- Increased T3
- Increased T4
- Radioactive Iodine Uptake (RAIU)
- Treatment
- Beta blocker
- Methimazole
- Radioiodine Ablation
1 min
Transdermal Medication Administration
- Application
- Patch or Disc
- Directly on Skin of Arms, Chest, Upper Back
- Benefits
- Avoids First Pass Metabolism
- Sustained Administration of Medication
- Nursing Considerations
- Clean Skin After Removal
- Rotate Sites of Patches
- Apply to Dry Skin
- Avoid Shaved Skin
- Avoid Heat
- Nitro Effects Lost After 24 Hours
2 mins
Metformin (Glucophage)
- Mechanism
- Decrease Glucose Production
- Increase Insulin Sensitivity
- Indications
- Type 2 Diabetes
- Polycystic Ovary Syndrome (PCOS)
- Side Effects
- GI Distress
- Decreased Appetite
- Lactic Acidosis
- Considerations
- IV Contrast
- Limit Alcohol Consumption
2 mins
Hemoglobin A1c Lab Value
- 4-6%
1 min
Diabetes Assessment
- Assessment Type 1
- Juvenile Onset
- Absent Insulin Production
- Ketosis Prone
- Assessment Type 2
- Adult Onset
- Insulin Resistance
- Obesity
- Gestational Diabetes
- Onset During Pregnancy
- Glucose Intolerance
- Complications
- Retinopathy
- Peripheral Vascular Disease
- Nephropathy
- Neuropathy
2 mins
Pregnant Diabetic Patient Interventions
- First Trimester
- Increase Insulin then Decrease
- Metformin
- Nutrition
- Exercise
- Second Trimester
- Increase Insulin
- More Likely to Develop Hypoglycemia than Hyperglycemia
- Third Trimester
- Double or Quadruple Insulin
- Early Delivery
- Postpartum
- Drastically Decrease Insulin
- Monitor Neonate for Hypoglycemia
3 mins
Hyperglycemia
- Mechanism
- Insulin Resistance
- Too Little Insulin/Medication
- Infection/Illness
- Corticosteroids
- Assessment
- Elevated Blood Glucose
- Polyphagia
- Polydipsia
- Polyuria
- Hypotension
- Fatigue/Drowsiness
1 min
Hypoglycemia Intervention
- Interventions
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Considerations
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Patient Education
- Hypoglycemia Prevention
- Encourage Self-Monitoring
3 mins
Hypoglycemia Assessment
- Mechanism
- Too much insulin
- Decreased glucose
- Assessment
- < 70 mg/dL
- Change in LOC
- Lethargic
- Confusion and Irritability
- Tremors
- Diaphoresis
- Tachycardia
- Vision Changes
- Weakness
- Seizures
2 mins
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
2 mins
Mixing NPH and Regular Insulin for Injection
- Verify Order
- Roll NPH Insulin
- Alcohol to Multiuse Vials
- Inject Air into NPH Insulin (Cloudy)
- Inject Air into Regular Insulin (Clear)
- Withdraw Regular Insulin Units
- Withdraw NPH Units
- Verify with 2nd Nurse
- Discard if Error
3 mins
Insulin
- Rapid Acting
- Insulin Lispro (Humalog)
- Insulin Aspart (Novolog)
- Insulin Glulisine (Apidra)
- Short Acting
- Regular Insulin (Humulin R)
- Intermediate Acting
- Isophane NPH (Humulin N)
- Long Acting
- Detemir (Levemir)
- Glargine (Lantus)
2 mins
Diabetes Education
- Self-Monitoring (Blood Glucose)
- SubQ Injection Technique
- Lifestyle Changes
- Symptoms of Hyperglycemia and Hypoglycemia
- Sick Day Care
- Foot Care
- Exercise Therapy
- Medication
1 min
Glucagon (GlucaGen)
- Mechanism
- Increases Glucose
- Indications
- Hypoglycemic Emergency
- Side Effects
- Nausea and Vomiting
- Considerations
- Reconstitute Powder
- Consume Oral Carbohydrates
- 50% Dextrose IV (If No Effect)
2 mins
Oral Glucose Tolerance Test (OGTT)
- Used for Diabetes Screening
- Fasting State
- Samples Drawn
- Baseline
- Normal < 100 mg/dL
- 30 and 60 Minutes
- Normal < 200 mg/dL
- 120 Minutes
- Normal < 140 mg/dL
2 mins
Glyburide and Glipizide (2nd Generation Sulfonylureas)
- Mechanisms
- 2nd Generation Sulfonylureas
- Blocks Potassium Channels in Beta Cells
- Stimulate Release of Insulin
- Indications
- Type 2 Diabetes
- Side Effects
- Hypoglycemia
- Considerations
- More Potent
- Beta Blockers Reduce Effects
- Avoid Alcohol
- Avoid Breastfeeding
2 mins
Hyperemesis Gravidarum
- Signs and Symptoms
- Excessive Vomiting
- Significant Weight Loss
- Dehydration
- Hypotension
- Electrolyte Imbalance
- Interventions
- Antiemetics
- Frequent Small Meals
- IV Therapy
2 mins
Chlorpromazine (Thorazine)
- Mechanism
- Low Potency Antipsychotic
- Indications
- Schizophrenia
- Hiccups
- Side Effects
- Sedation
- Weight Gain
- Orthostatic Hypotension
- Anticholinergic Effects
- QT Prolongation
- Neuroendocrine Effects
- Caution in Seizure Patients
- Corneal Deposits
2 mins
Promethazine (Phenergan)
- Mechanism
- Histamine H1 Receptor Antagonist
- Weak Dopamine Antagonist
- Indications
- Nausea and Vomiting
- Motion Sickness
- Side Effects
- Respiratory Depression
- Sedation
- Anticholinergic Effects
- Extrapyramidal Symptoms
- Considerations
- Use Large Bore IV
- Monitor for Tissue Necrosis
2 mins
Hyperthyroidism Assessment
- Assessment
- Heat Intolerance
- Exophthalmos
- Warm, Moist Skin and Silky Hair
- Tremors
- Goiter
- Diarrhea
- Weight Loss
- Tachycardia
- Hypertension
- Amenorrhea
- Diagnosis
- Decreased TSH with Elevated Free T4
- Radioactive Iodine Uptake (RAIU)
2 mins
Hyperthyroidism Interventions
- Drug Therapy
- Propylthiouracil (PTU)
- Methimazole (Tapazole)
- Iodine
- Beta Blockers
- Other Therapies
- Radioiodine Ablation
- Thyroidectomy
- Complications
- Thyrotoxicosis
- Post-Surgery Hypocalcemia
2 mins
Propylthiouracil (PTU) and Methimazole (MMI)
- Indications
- Hyperthyroidism
- Mechanism
- Inhibits Thyroid Peroxidase
- PTU Blocks Peripheral Conversion of T4 to T3
- Side Effects
- Agranulocytosis
- Skin Rash
- Hepatotoxicity (PTU)
- Teratogen (MMI)
1 min
Hypothyroidism Assessment
- Assessment
- Weight Gain - Edema
- Lethargy
- Cold Intolerance
- Bradycardia
- Hypertension
- Brittle Nails and Dry Skin
- Constipation
- Goiter
- Prolonged Menses
- Slowed Thinking
- Diagnostic Tests
- Decreased Free T4
- Increased TSH
2 mins
Hypothyroidism Intervention
- Medications
- Levothyroxine (Synthroid)
- Liothyronine (Cytomel)
- Complication
- Myxedema Coma
- Nursing Considerations
- Lifelong Replacement Hormone
- Monitor Vital Signs
- Fluids and Fiber
- Low Calorie, Low Fat Diet
- Medication Education
- No Switching Brands
2 mins
Levothyroxine (Synthroid)
- Mechanism
- Synthetic T4
- Indications
- Hypothyroidism
- Side Effects
- Thyrotoxicosis
- Tremors
- Heat Intolerance
- Insomnia
- Tachycardia
- Considerations
- Do Not Use for Obesity
- TSH Monitoring
2 mins
Phenylketonuria (PKU)
- Cause
- Autosomal Recessive Genetic Disorder
- Enzyme Deficiency
- Assessment
- Failure to Thrive
- Irritability
- Musty or Mousy Odor
- Cognitive Impairment
- Interventions
- Low Phenylalanine Diet
- Low Protein Foods (Diet)
- Avoid Aspartame
- Sapropterin (Kuvan)
- Considerations
- Guthrie Blood Test
2 mins
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