exam 2 endocrine, maintenance of homeostasis

fat soluble vitamins

A, D, E, K

Vitamin A function

vision, immune system, skin

vitamin A toxicity

liver damage, birth defects

vitamin A foods

carrots, sweet potatoes, leafy greens

vitamin D function

calcium absorption, bone health

Vitamin D deficiency

rickets (kids), osteomalacia (adults)

vitamin D toxicity

hypercalcemia (confusion, weakness)

vitamin d foods

fortified milk, sunlight, fatty fish

Vitamin E function

antioxidant, skin health

vitamin E deficiency

neuropathy, muscle weakenss

vitamin E toxicity

bleeding risk

vitamin E food

nuts, seeds, vegetable oils

vitamin K function

blood clotting

vitamin K deficiency

bleeding/bruising

warfarin overdose antidote

vitamin K

vitamin K foods

leafy green veggies

water soluble vitamins

C, B1 (thiamine), B6 (pyridoxine), B12 (cyanocobalamin), B9 (folate)

vitamin C, ascorbic acid function

wound healing, iron absorption, immune support

vitamin C deficiency

scurvy (bleeding gums, bruising)

vitamin C foods

citrus fruits, peppers, strawberries

B1 (thiamine) function

nerve function

often given IV to alcohol-dependent patients

B1 thiamine deficiency

Wernicke Korsakoff syndrome in alcoholics (confusion, ataxia)

B1 thiamine food

whole grain, pork, legumes

B6 (pyridoxine) function

nerve and protein metabolism

B6 deficiency

irritability, neuropathy

B6 food

bananas, meats, whole grains

B12 (cyanocobalamin) function

RBC production, neuro health

B9 (folate) function

cell growth, neural tube development

B9 (folate) deficiency

spina bifida in fetus, megaloblastic anemia

pregnant women need increase

B9 folate foods

leafy greens, beans, fortified grains

calcium function

bones, muscle contraction, nerve function

calcium deficiency

tetany, Chvostek (face), trousseau (hands/fingers)

what vitamin do you need to absorb calcium

vitamin D

take these meds separately with calcium

iron and thyroid meds

iron function

hemoglobin formation

iron deficiency

anemia

iron increases absorption with

vitamin C (take on an empty stomach)

avoid milk/antacids

what is a normal side effect with iron

black stools

magnesium function

nerve/muscle function, cardiac rhythm

magnesium deficiency

seizure, tremor, arrhythmias

magnesium toxicity and antidote

respiratory depression

calcium gluconate

potassium function

cardiac/muscle function

potassium administration

never IV push

IV infusion max rate 10 mEq/hr

oral given with food

hyperkalemia and how to correct it

peaked t waves, risk of cardiac arrest

sodium polystyrene, dextrose and insulin IV

hypokalemia

muscle cramps, arrhythmias

sodium function

fluid balance, nerve transmission

hyponatremia

seizures, confusion

hypernatremia

dehydration, thirst

isotonic fluids

no shifting into/out of cell, same osmolarity

used for: fluid volume replacement, dehydration, shock, burns, surgery

types of isotonic fluids

0.9% normal saline

lactated ringers

D5W (in bag its isotonic, but becomes hypotonic in the body)

hypotonic fluids

lower osmolarity than blood, water moves into cells→ causes cells to swell

used for cellular dehydration: DKA, rehydrating cells

types of hypotonic fluids

0.45%, 0.33% normal saline

D5W

hypertonic fluids

higher osmolarity than blood, water moves out of cells into bloodstream→ cells shrink

used for hyponatremia, cerebral edema, post op patient (reduce swelling)

levothyroxine

hypothyroid

levothyroxine administration

oral: on an empty stomach in morning

not with calcium, iron, iodine containing foods

levothyroxine dosing

hypothyroidism= dose increase

hyperthyroidism= dose decrease

methimazole

hyperthyroidism

propylthiouracil

hyperthyroidism

desmopressin, vasopressin (-pressins)

synthetic ADH (Synthetic antidiuretic hormone) diabetes insipidus (hypernatremia)

how do you know synthetic ADH work

urine output decreases, specific gravity increases

demeclocycline

for SIADH (excess antidiuretic hormone)

conivaptan, tolvaptan (-vaptan)

for SIADH (excess antidiuretic hormone)

predisone

glucocorticoids

methylprednisolone

glucocorticoids

dexamethasone

glucocorticoids

hydrocortisone

glucocorticoids

glucocorticoids

steroid hormones and prescription medications that reduce inflammation, suppress the immune system, and regulate carbohydrate, protein, and fat metabolism

side effects of glucocorticoids

increased appetite, weight gain, sodium and fluid retention, buffalo hump, mood face, long term cushings

glucocorticoids education

never stop abruptly, must wean (adrenal crisis)

mineralcorticoids

produced by the adrenal cortex that manage the body's salt, water, and electrolyte balance

fludrocortisone

mineralcorticoids

lispro, aspart

rapid insulin

15 min onset

food need to be in front of patient when giving

regular

short insulin

30 min onset

NPH

Intermediate insulin

glargine, detemir, degludec

long insulin

do not mix with any other insulin

mixing up insulin

draw up clear before cloudy

glucagon, dextrose

hypoglycemia

metformin

oral antidiabetic: managing type 2 diabetes, primarily working to lower blood sugar levels by improving insulin sensitivity and reducing glucose production in the liver.

hold 48 hours before contrast dye

glipizide, glyburide

sulfonylureas: lower blood glucose by stimulating pancreatic beta‑cells to release insulin.

given daily with breakfast

liraglutide, semaglutide (-glutides)

GLP 1s: antidiabetic

delay gastric emptying

empagliflozin, dapagliflozin, canagliflozin (-gliflozin)

SGLT2 inhibitors: oral antidiabetics

somatotropin

replace growth hormone

bone epiphyses must be open

octreotide

suppress growth hormone

bromocriptine

suppress growth hormone