****** Endocrine system ****
**Important points for exam :—–
- Primary goal of treatment in hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is to rehydrate the patient to restore fluid volume.
- In diabetic Keto acidosis (DKA) fluid replacement is also given initially.
- External insulin pump provides small continuous dose of short acting insulin subcutaneously throughout day and night.
- In DKA, pH is lower than 7.35 , plasma bicarbonate is lower than 15 meq/l, blood glucose level is higher than 250 mg/dl and Ketone are present in blood and urine.
- In DKA, , patient will have polyuria and Kussmaul respiration (Deep and rapid breathing) .
- Shakiness, palpitation ,lightheadedness are signs of hypoglycemia.
- Instruct patient to notify physician when the Glucose level is higher than 250 mg/dl.
- Classic symptoms of hyperglycemia are polydipsia (excessive thrust, polyuria, polyphagia ( excessive hunger )
- Patient with diabetes mellitus who is experiencing hyperglycemia should be given highest priority on fluid replacement because high Glucose level will excrete glucose in the urine which can lead to dehydration.
- After hypophysectomy check for nasal drainage and test it for glucose bcz it may be CSF leakage .
- Polydipsia and polyuria are the classical symptom of diabetes insipidus.
- Patient diagnosed with myxoedema coma initial action will be to maintain a patent Airway.
- In DKA, the priorities should be on administration of short acting insulin IV because insulin is absolute lack in DKA and followed by fluid replacement.
- NPH insulin peaks between 4 to 12 hours therefore no exercise should be done between 4 to 12 hours it can lead to hypoglycemia after taking NPH insulin.
- Hypercalcemia is Hallmark of hyperparathyroidism elevated serum calcium level produce osmotic diuresis and thus polyuria.
- After post operative parathyroidectomy the clients should be observed for any laryngeal strydor or difficulty in breathing it should be reported to the physician immediately
- Pheochromocytoma is a catecholamine producing tumor and causing secretion of excess amount of epinephrine and norepinephrine
- In pheochromocytoma, heart rate lower than 90 is a potential complication associated with this disorder.
- Cushing’s disease results from increased pituitary scretion of adrenocorticotropic hormone.
- In pheochromocytoma, after adrenalectomy vital sign should be observed because hypertension is Hallmark of pheochromocytoma .
- Diaphoresis and confusion are signs of moderate hypoglycemia.
- Thyroid storm is an acute and life-threatening condition that occurs in a client with uncontrollable hyperthyroidism.
- Symptoms of Thyroid storm include elevated temperature ,systolic hypertension,nausea, and tremors.
- Aspirin is avoided in thyroid Storm to reduce fever.
- Hypertensive crisis can occur as a complication of pheochromocytoma
- In hypothyroidism provide low calorie low cholesterol and low saturated fat diet
- In hyperthyroidism provide a high calorie diet.
- Weight loss is common in diabetes type 1 and less in diabetes type 2.
- Polyuria, polydipsia polyphagia are common in diabetes mellitus.
- To prevent a serious reaction inform the client taking sulphonylurea to avoid consuming alcohol
- Metabolic syndrome is also known as syndrome x