chapter 20 Endocrine and Hematology

What is the endocrine system

A communication system that controls functions inside the body

What are the secret messenger hormones?

Endocrine glands

If a gland isn’t functioning normally, this leads to hypersecretion or hyposecretion. A gland may be functioning correctly , but the organ may not be responding. What is this referred to as?

Endocrine Disorders

What does the pancreas produce to unlock the semipermeable walls of cells?

Insulin

If there isn’t a proper balance of hormones, what happens ?

Cells do not get fed

In a person without diabetes, what does the pancreas store and secrete to the level of glucose in the blood?

Insulin and glucagon

What stimulates liver and skeletal muscles to release glycogen, leading to glycogen converting back to glucose for use as cellular fuel?

Glucagon

A diabetic patient might be suffering from what two things ?

Impaired insulin production or not enough functional receptors for the insulin to bind to.

What are the three types of diabetes ?

Diabetes Mellitus type 1

Diabetes Mellitus Type 2

Pregnancy Induced Geststional Diabetes

What symptoms are seen in both Diabetes Mellitus types 1 and 2?

Hyperglycemia and hypoglycemia

What patients are more likely to have a depressed level of consciousness than patients with hyperglycemia?

Patients with hypoglycemia

Because altered mental status mimics intoxication, what should you do when you have an intoxicated patient ?

Be thorough and check a fingerstick glucose level

what should you always inquire about in patients with type 1 diabetes ?

The presence of an insulin pump

Polyuria (frequent urination), Polydipsia (increase in fluid consumption), polyphagia (severe hunger and increased food intake), weight loss and fatigue are seen in what patients ?

Patients with new onset type 1

breathing faster and deeper as a back up system is referred to as?

Kussmaul Respirations

Abdominal pain, body aches, nausea, vomiting, severe altered mental status or unconsciousness if referred are symptoms of ?

DKA (Diabetic ketoacidosis)

If a patient has DKA, what should you ask the patients family and friends for ?

The patients history and presentation

Which is the glucose level of a patient who MOST likely has DKA?

400 mg/DL

When blood glucose levels rise and don’t respond when the pancreas secretes insulin, this resistance of insulin is called ?

Type 2 diabetes

Patients with symptomatic hyperglycemia show signs and symptoms of

frequent urination, increased thirst, blurred vision, and fatigue

Hyperosmolarity (dark and concentrated urine) is seen in patients with fluid imbalance referred to as ?

HHNS (hyperosmolar hyperglycemic nonketotic syndrome)

Patients who inject insulin or use oral medications are prone to ?

Symptomatic hypoglycemia

If You arrive to a scene to find a patient with pale, clammy skin, dizziness, rapid pulse, lethargic mental status, or weakness on one side of the body; this patient most likely has ?

Hypoglycemia

When arriving on scene of a diabetic patient, what are possible hazards you need to look out for ?

Syringes or used needles

Paleness is harder to detect in patients with darker skin. What do you check for instead ?

Pale mucous membranes inside the inner lower eyelid or slow capillary refill

What determines when you transport your patient after checking the ABCs?

The patients level of consciousness and ability to swallow

Which condition of a patient is more critical and causes more permanent problems, symptomatic hypoglycemia or DKA?

Symptomatic Hypoglycemia because untreated this results in loss of consciousness and can quickly cause significant brain damage or death

What are the three types of oral glucose?

Rapidly dissolving gel, large chewable tablet, a liquid formulation

patients with decreased level of consciousness and diabetic history, you should always

Administer glucose gel if authorized

What are contraindications to oral glucose ?

Inability to swallow, unconsciousness (aspiration can occur)

In children seizures may be caused by?

Fever or epilepsy

Treatment of seizures includes

Ensure a patent airway and place the patient on their side

Until proven otherwise, what must you always suspect in a patient with altered mental status ?

Hypoglycemia

Patients with difficulty to awaken may not have a gag reflex meaning

Their tongues will often relax and obstruct their airway

What are the four disorders of hematology

Sickle cell (hemoglobin S)

Hemophilia

Thrombophillia

Anemia

What are the Four components of blood

Erythrocytes, leukoctyes, platelets, and plasma

Normal blood sugar ranges from

80-120

Erythrocytes make up

42% to 47% of your blood

Leukocytes make up

.1% to .2%

Platelets make up

4% to 7%

Sicke cell is

An inherited blood disease to protect from malaria

People with sickle cell can experience

Hypoxia or vasooclusive crisis

Anemia, jaundice, gallstones, and splenic dysfunction or complications of?

Sickle cell disease

Patients with hemophilia A have an extended and inability to what ?

Extended bleed time and inability to clot

Complications of hemophilia A are

Long-term joint problems

Bleeding in the brain

Thrombosis

Thrombophilia is

The inability to maintain the viscosity and smooth flow of blood through venous and arterial systems (blood clogging or clotting more easily

DVT is worrisome for patients who

have had joint replacement surgery

Anemia is

An abnormally low number of RBCs

When anemia is present, what happens to the tissues?

They may become hypoxic because the blood is unable to deliver adequate amounts of oxygen

Proper procedure for administering oral glucose to a patient includes al of the following except:

Assessing the patients mental status, checking the medications expiration date, ensuring the absence of a gag reflex, requesting permission from medical control

Ensuring the absence of a gag reflex

When obtaining a SAMPLE history from a patient with diabetes who has an altered mental status, it would be MOST important to determine:

A)approximately how much water the patient drank that day

B)if he or she has had any recent illnesses or excessive stress

C)if there is a family history of diabetes or related conditions

D)the name of the physician who prescribed his or her insulin

B) if he or she has had any recent illnesses or excessive stress