NSG 320 Topic 1 Study Guide & Ticket to Class

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Feb 20, 2024

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NSG-320 Adult Health1 Participation Points / Study Guide Topic 1 – Endocrine Diseases As your participation points for class: Choose one of the following activities to complete prior to class. (study questions, key terms, ThinkNotes, Drug List, a Case Study, or Study Sheets). Please have it available during our classroom discussion. Suggestion: Approach this activity as if you need to explain the terms to a client or family who has no medical background in a way they will understand. (Successful completion of participation activities for class does count toward your weekly participation grade.) Submission Required: Reply to “Question to Instructor” Forum Study Questions – Complete 5 questions to receive points Based on your readings and any other credible source of information, provide answers, in your own words , to the following study questions: 1. What is the difference between type 1 and type 2 Diabetes? Type 1 diabetes is a disease that people are born with, where their body either does not create insulin, or it doesn’t create enough of it. This results in high blood glucose, since insulin is the hormone that allows glucose to enter the cells. This is known as “insulin- dependent” diabetes because people with Type 1 diabetes will need to take insulin for the entirety of their lives. Type 2 diabetes, or “adult-onset”, is developed later in life. It occurs when a person has high blood sugar for prolonged periods of time, resulting in insulin receptor resistance. This means that your body has to create more insulin in order for your cells to respond to it. Over time, your body isn’t able to continue creating enough insulin, so blood glucose levels rise. 2. What is glucagon and when is it used? 3. What groups have a higher risk of developing diabetes? 4. What does post-prandial glucose mean and why is it important? 5. What chronic complications can diabetes cause? 6. What is diabetic neuropathy? How is it treated medically? What nursing interventions are appropriate to help decrease the client’s pain? 7. What is the cultural significance for those with diabetes? 8. What is the expected laboratory profile of diabetes? 9. How can injury related to hyperglycemia be prevented? 10. What oral drugs are used to treat diabetes? 11. Why does metformin need to be used with caution in the patient with renal disease? It can result is lactic acidosis, a rare complication of metformin accumulation. 12. What is the onset, peak and duration of the different types of insulin? 13. What do clients who are monitoring their own blood glucose levels need to be taught? Revised: 07/2020

NSG-320 Adult Health1 Participation Points / Study Guide 14. How can hypoglycemia be prevented? 15. What does the client need to be taught regarding exercise, diet, and medications? 16. Name at least 5 gerontological considerations that you as the nurse will add to a care plan for a client with diabetes. 17. What needs to be taught to the diabetic patient regarding foot care? 18. What are the symptoms of both hyperglycemia and hypoglycemia? How are they different? 19. How does infection play a role in the disease process of acute or chronic diabetes? 20. How can kidney damage and visual issues be reduced in the diabetic patient? 21. How is hypoglycemia treated? 22. What do all patients who have diabetes need to be taught? 23. What are the sick-day rules? 24. Explain the pathophysiology, clinical manifestations, interprofessional care, and nursing management of clients diagnosed with thyroid dysfunction. 25. The nurse is caring for a patient recently started on levothyroxine for hypothyroidism. What information reported by the patient requires immediate action and why? a. Weight gain or weight loss b. Chest pain and palpitations c. Muscle weakness and fatigue d. Decreased appetite and constipation Key Terms – Complete all to receive points Upon completion of Topic 1, you should be able to briefly define these terms, in your own words.  Basal bolus plan - Multiple daily insulin injections or an insulin pump used together with frequent BGM or CGM. Goal is to achieve a glucose level as close to normal as possible, as much of the time as possible.  Combination insulin therapy - Rapid-acting insulin is mixed with intermediate-acting insulin in the same syringe, to decrease the number of daily injections.  Dawn phenomena - Hyperglycemia that is present on awakening. May be caused by the increased excretion of GH and cortisol in the early morning hours.  Diabetes mellitus type I - 5-10% of DM, insulin is not created in sufficient quantities by the body. Insulin is required.  Diabetes mellitus type II - 90-95% of DM. Primary defect is insulin resistance, decreased insulin production over time, and changes in adipokines production.  Diabetes-related nephropathy - Damage to the small blood vessels that supply the glomeruli of the kidney. It is the leading cause of ESRD in the US and is seen in 20-40% of people with DM. Glucose is a large molecule, which is difficult for the kidneys to filter.  Diabetes-related neuropathy Revised: 07/2020

NSG-320 Adult Health1 Participation Points / Study Guide - Nerve damage that occurs from the metabolic imbalances associated with DM.  Diabetes-related retinopathy - Microvascular damage to the retina because of chronic hyperglycemia, nephropathy, and hypertension.  Exophthalmos - Protrusion of the eyeball beyond its normal position, caused by hyperthyroidism.  Glucometer - Device used to check blood glucose.  Goiter - Generalized enlargement of the thyroid gland, due to hyperthyroidism, hypothyroidism, or iodine deficiency.  Hyperthyroidism - Hyperactivity of the thyroid gland with sustained increase in synthesis and release of thyroid hormones.  Hypothyroidism - Deficiency of thyroid hormone that causes a general slowing of the metabolic rate.  Impaired fasting glucose - Fasting glucose levels are 100 to 125 mg/dL.  Impaired glucose tolerance - 2-hour oral glucose tolerance test values are 140 to 199 mg/dL.  Inhaled insulin - Ex. Afrezza. Rapid-acting inhaled insulin, given at the beginning of a meal or within 20 minutes of starting a meal. Should be used in combination with long acting insulin.  Insulin Resistance - Body tissues do not respond to the action of insulin because insulin receptors are not responsive.  Long – or intermediate acting (basal) background insulin - Used to maintain glucose levels in between meals and overnight. Released steadily and continuously, usually given once daily.  Mealtime insulin (bolus) - Rapid-acting insulin, such as lispro, have an onset of 15 minutes and should be injected within 15 minutes of eating.  Metabolic syndrome - A group of metabolic risk factors that increase a person’s chance of developing CVD, stroke, and diabetes.  Prediabetes - The stage in between normal glucose levels and diabetes.  Self-monitoring of blood glucose - Obtaining current glucose levels to allow a patient to make decisions about food intake, activity patterns, and drug dosages.  Somogyi effect - A high dose of insulin causes a decline in glucose levels during the night. As a result, counterregulatory hormones are released that can cause rebound hyperglycemia. Revised: 07/2020

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