Term
| Sulfonylureas (most commonly prescribed for diabetes) |
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Definition
↑ Insulin production from pancreas
↓ Chance of prolonged hypoglycemia
10% experience decreased effectiveness after prolonged use
Examples
Glipizide (Glucotrol)
Glimepiride (Amaryl) |
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Term
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Definition
Increase insulin production from pancreas
Taken 30 minutes before each meal up to time of meal
Should not be taken if meal skipped
Examples
Repaglinide (Prandin)
Nateglinide (Starlix) |
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Term
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Definition
Reduce glucose production by liver
Enhance insulin sensitivity at tissues
Improve glucose transport into cells
Do not promote weight gain
Example
Metformin (Glucophage) |
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Term
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Definition
Promotes glucose transport from bloodstream across cell membrane to cytoplasm of cell
Decreases glucose in the bloodstream |
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Term
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Definition
| The tendency of the body to react to extremely low blood sugar (hypoglycemia) by overcompensating, resulting in high blood sugar. |
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Term
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Definition
| When we sleep, hormones are released to help maintain and restore cells within our bodies. These counterregulatory hormones (growth hormone, cortisol and catecholamines) cause the glucose level to rise. For people with diabetes who do not have enough circulating insulin to keep this increase of glucose under control, the end result is a high glucose reading in the morning. |
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Term
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Definition
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Term
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Definition
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Term
Balance
Regular meals
Five portions of fruit/vegetables
Spread fruit throughout the day |
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Definition
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Term
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Definition
| Term used to describe rise in blood glucose levels after consuming carbohydrate-containing food |
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Term
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Definition
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Term
Confusion, diaphoresis, hunger, visual disturbances, irritability
May be confused with intoxication or mental illness
Seizures, coma and death |
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Definition
| common manifestations of diabetes |
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Term
| Diabetic Ketoacidosis (DKA) |
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Definition
Blood glucose ≥ 250 mg/dL
Ketosis
Ketonuria/ketonemia
Metabolic acidosis
↓pH, PCO2, HCO3
Dehydration
Electrolyte imbalances
↓ Na, ↓/↑K, Cl, PO4 |
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Term
| Hyperosmolar hyperglycemic non-ketotic syndrome |
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Definition
Blood glucose ≥ 600 mg/dL
Dry mouth
Extreme thirst
Raised temperature over 101F
More common in type II diabetes |
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Term
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Definition
Excessive thirst
Blurred vision
Weakness
Headache
Acetone breath
*Kussmaul respirations
Deep, non-labored, rapid
Orthostatic hypotension
Weak, rapid pulse
Dehydration*
GI symptoms
Anorexia, N & V, *vomiting & abdominal pain |
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Term
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Definition
disorders of the blood vessels
Large vessels (macrovascular) – Heart Dz, stroke
Greater frequency and earlier onset for those with Diabetes |
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Definition
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Term
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Definition
| Accelerates the development of HTN |
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Term
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Definition
Sensory
Paresthesias of the hands &/or feet
Autonomic
Gastroparesis, bowel incontinence, & diarrhea, heart burn, constipation
Urinary retention
Sexual dysfunction
Decrease in vaginal lubrication, libido
Silent MI |
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Term
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Definition
results from excess secretion of growth hormone (GH), very rare
Bone and soft tissue overgrowth (bones increase in thickness and width but not length)
Manifestations:
Enlargement of hands/feet
Thickening/enlargement of face/head
Sleep apnea
Signs of:
DM , Cardiomegaly, HTN
Treatment:
Returning GH levels to normal
Surgery
Radiation
Drug Therapy
Combination |
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Term
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Definition
rare, decrease in one or more of the pituitary hormones:
The anterior pituitary gland secretes:
adrenocorticotrophic hormone (ACTH)
thyroid-stimulating hormone (TSH)
follicle-stimulating hormone (FSH)
luteinizing hormone (LH), GH
prolactin
The posterior pituitary gland secretes:
ADH
Oxytocin
Most deficiencies involve GH and gonadotropins (e.g., LH, FSH) due to a pituitary tumor |
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Term
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Definition
results from an overproduction or oversecretion of ADH
fluid retention
serum hypoosmolality
dilutional hyponatremia
Hypochloremia
concentrated urine in presence of normal or increased intravascular volume
normal renal function
Most common cause - lung cancer
Treatment
directed at underlying cause
goal to restore normal fluid volume and osmolality
Fluid restriction results in gradual, daily weight reductions, progressive rise in serum sodium concentration and osmolality, and symptomatic improvement |
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Term
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Definition
| defciency of production or secretion of ADH or decreased renal response to ADH causing fluid and electrolyte imbalances due to increased urinary output and increased plasma osmolality -May be transient or chronic |
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Term
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Definition
| Thyroid gland hyperactivity with sustained increase in synthesis and release of thyroid hormones |
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Term
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Definition
autoimmune disease marked by thyroid enlargement and excessive thyroid hormone secretion
classic finding - exophthalmos, a protrusion of eyeballs from the orbits
Treatment
antithyroid medications
radioactive iodine therapy
subtotal thyroidectomy – causes hypothyroidism (on replacement thyroid hormone medication for life) |
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Term
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Definition
| (related to destruction of thyroid tissue or defective hormone synthesis) |
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Term
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Definition
| (related to pituitary disease with decreased TSH secretion or hypothalamic dysfunction with decreased thyrotropin-releasing hormone [TRH] secretion) |
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Term
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Definition
| related to thyroiditis or from a discontinuation of thyroid hormone therapy |
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Term
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Definition
Manifestations:
fatigue, lethargy, personality and mental changes, decreased cardiac output, anemia, and constipation.
myxedema, an accumulation of hydrophilic mucopolysaccharides in dermis and other tissues. This mucinous edema causes characteristic facies of hypothyroidism (i.e., puffiness, periorbital edema, and masklike affect)
Treatment :
Restoration of euthyroid state as safely and rapidly as possible with hormone replacement therapy
Levothyroxine (Synthroid) drug of choice |
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Term
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Definition
Increased secretion of parathyroid hormone (PTH) - leads to hypercalcemia and hypophosphatemia
Manifestations:
weakness, loss of appetite, constipation, emotional disorders, and shortened attention span
Major signs:
Osteoporosis, fractures, and kidney stones
Neuromuscular abnormalities:
muscle weakness in proximal muscles of lower extremities |
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Term
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Definition
Rare, results from inadequate circulating PTH resulting in hypocalcemia
Most common cause is iatrogenic
accidental removal of parathyroid glands or damage to these glands during neck surgery
Manifestations
Tetany - tingling of lips, fingertips, ncreased muscle tension with paresthesias and stiffness
Painful tonic spasms of smooth and skeletal muscles (extremities and face)
Laryngospasms
Positive Chvostek/Trousseau sign are usually present |
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Term
| Cushing Syndrome (dysfunction of adrenal cortex) |
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Definition
Caused by excessive corticosteroids, particularly glucocorticoids
Most common cause - iatrogenic administration of exogenous corticosteroids (e.g., prednisone)
Manifestations:
centripedal or generalized obesity, “moon facies” (fullness of face), purplish red striae below the skin surface, hirsutism in women, hypertension, and unexplained hypokalemia
Treatment:
Surgery
Drug therapy |
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Term
| Addison's Disease (adreno-cortical insufficiency) |
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Definition
all three classes of adrenal corticosteroids (glucocorticoids, mineralocorticoids, and androgens) are reduced – usually autoimmune
Manifestations:
Slow onset: weakness, weight loss, anorexia
Skin hyperpigmentation in sun-exposed areas of body, at pressure points, over joints, in palmar creases
Treatment :
Replacement therapy (Hydrocortisone most commonly used) has both glucocorticoid and mineralocorticoid properties
During times of stress, dosage is increased to prevent addisonian crisis |
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Term
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Definition
Characterized by excessive aldosterone secretion commonly caused by small solitary adrenocortical adenoma
Main effects:
Sodium retention and potassium and hydrogen ion excretion
Key sign of this disease:
hypertension with hypokalemic alkalosis
Treatment:
Mostly surgical removal of adenoma (adrenalectomy)
Patients with bilateral adrenal hyperplasia are treated with drugs. Calcium channel blockers may be used to control BP
Patients are taught to monitor own BP and need for monitoring |
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Term
| Pheochromocytoma (Disorders of the adrenal medulla) |
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Definition
Rare, characterized by an adrenal mostly benign medulla tumor that produces excessive catecholamines (epinephrine, norepinephrine)
Secretion of excessive catecholamines results in severe HTN
Undiagnosed and untreated, may lead to diabetes mellitus, cardiomyopathy, and death
Manifestations:
severe, episodic hypertension accompanied by classic triad of (1) severe, pounding headache, (2) tachycardia with palpitations and profuse sweating, and (3) unexplained abdominal or chest pain
Attacks may be provoked by many medications, including antihypertensives, opioids, radiologic contrast media, and tricyclic antidepressants
Treatment:
Surgical removal of tumor |
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Term
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Definition
onset: 30 minutes to 1 hour
peak: 2-3 hours
duration: 3-6 hours |
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Term
| Intermediate/NPH/Cloudy/Lente |
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Definition
onset: 2-4 hours
Peak: 4-10 hours
Duration: 10-16 hours |
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Term
| long-acting/ultralente (cloudy) |
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Definition
onset: 1-2 hours
Peak: no pronounced peak
Duration: 24+ hours |
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Term
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Definition
| c. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism.\ |
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Term
| a. phentolamine (Regitine). |
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Definition
| A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer: |
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Term
| Rapid-acting: lispro, aspart, glulisine |
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Definition
Onset: 15 minutes
Peak: 60-90 minutes
Duration: 3-4 hours |
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