Diabetic foot care

Apply lotion to dry areas of feet avoiding between toes

Glargine and Regular Insulin administration

Do NOT mix Glargine with any other insulin in same syringe
- draw up insulin glargine and regular insulin into separate
syringes

Thyroidectomy - S/S of HYPOCALEMIA

Tingling and numbness of hands and feet (Paresthesias)

AE of Corticosteroids
Osteoporosis, moon-shaped face, increased risk of infection

Type I DM and illness

Call Dr if BG is >250 mg/dL; check BG q4hr; check urine for
ketones if >240; continue to take insulin

Adrenal Insufficiency
HYPERcalemia; weight LOSS; HYPOnatremia

Hypergylcemic-Hyperosmolar State (HHS)

Produces enough insulin to prevent KETOSIS, but not
enough to prevent hypergylcemia; pH is NORMAL; BG >800

Thyroidectomy and taking thyroid hormone replacement

Take on EMPTY STOMACH - NPO for 30-60 min AFTER taking
it

Adrenocorticotropic Hormone (ACTH) Stimulation Test

For Addison's - response is absent/very decreased in those
with adrenal insufficiency

SIADH
Report hyponatremia

DI - taking Desmopressin nasal spray

Blow nose gently prior to using spray - avoid dilution of
medications by nasal secretions or improper absorption
due to nasal blockage

Therapeutic outcome of insulin therapy

Fasting BG of 96 mg/dL - NORMAL

Cushing's Disease
HYPERGLYCEMIA; HYPOcalcemia; HYPOKALEMIA; low
lymphocyte count

Total Thyroidectomy
Report LARYNGEAL STRIDOR

Diabetic Ketoacidosis (DKA)

BG >300 mg/dL

Hypoglycemia S/S
Cool, clamy skin; anxiety; nervousness; tachycardia;
confusion

Hyperglycemia S/S
Rapid, deep respiration; abdominal cramping; dehydration
= ortho hypotension

Propranolol IV for THYROID STORM

reduces effects of thyroid hormone of the heart

Hyperthyroidism
Tremors; diaphoresis; insomnia

DM and alcohol consumption

Ingest alcohol with meals to reduce alcohol-induced
hypoglycemia - alcohol prevents liver production of glucose

Proplythiouracil (PTU)
SUPPRESSES production of thyroid hormone (for
Hyperthyroidism) - allows for weight GAIN

DKA
pH 7.32 (ACIDIC), PaCo2 36 (normal), HCO3 -14 (LOW)

Cushing's Disease
HIRSUTISM (increased androgen production)

Hypothyroidism taking lifelong hormone replacement

therapy but has not been taking regularly
Expect HYPOTENSION - S/S of HYPOthyroidism

DI - receiving Desmopressin
Occurance of NOCTURIA indicates need for dosage
adjustment - initial dose is admin in evening; provider will
increase dosage until client no longer has nocturia

Post-op and experiencing Acute Adrenal Insufficiency

Admin IV HYDROCORTISONE SODIUM SUCCINATE - to
replace CORTISOL deficiency

Peripheral Neuropathy with DM

Monitor temperature of bath water with a thermometer prevents injuries to feet

Pheochromocytoma - Vanillylmandelic Acid Test

Restrict COFFEE, TEA, BANANAS, CHOCOLATE, VANILLA 2-3
days prior to test

DI
LOW SG; INCREASED Hct; INCREASED HR; INCREASED BUN

SIADH
HIGH SG

HbA1c Test
Good indicator of average BG levels

Pheochromocytoma (Cathecholamines)
AVOID PALPATING ABDOMEN - risk for HYPERTENSIVE
CRISIS - palpating abdomen causes sudden release of
CATHECHOLAMINES which can cause hypertensive crisis