NCLEX Diabetes and Endocrine Master Set

DM vs DI vs SIADH (Core Concept)

DM is sugar problem; DI is water leaving; SIADH is water staying.

Memory trick for DM, DI, and SIADH

DM = Maple Syrup. DI = Desert Inside. SIADH = Sponge Syndrome.

Fluid Volume Deficit conditions

DM, DI, DKA, and HHS.

Fluid Volume Excess condition

SIADH.

NCLEX Priority Assessment for fluid balance

Assess blood pressure, heart rate, mental status, and urine output.

What are the 3 Ps of Diabetes Mellitus?

Polyuria, polydipsia, and polyphagia.

Cause of the 3 Ps in Diabetes Mellitus

Glucose remains in bloodstream while cells are starving.

Type 1 Diabetes (Core Concept)

Autoimmune destruction of beta cells; little to no insulin production.

Type 2 Diabetes (Core Concept)

Insulin resistance and progressive loss of insulin production.

Memory trick for Type 1 vs Type 2 Diabetes

Type 1 = No insulin factory. Type 2 = Factory workers ignore insulin.

Type 2 Diabetes first-line medication

Metformin.

Metformin side effects and contraindications and use

GI upset, diarrhea, rare lactic acidosis; hold for severe kidney dysfunction. decreases insulin liver production in type 2

SGLT2 Inhibitors suffix and mechanism

Ending: -flozin. Mechanism: Flush sugar through the urine. type 2

SGLT2 Inhibitors risks

UTI, genital fungal infections, and dehydration.

GLP-1 Receptor Agonists suffix and memory trick

Ending: -tide. Memory: Get Lean Patients (promotes weight loss). type 2

NCLEX rule for Rapid Acting Insulin

Give with meals. Hold if meal tray is delayed.

Regular Insulin key fact and memory trick

Can be given IV. Memory: Regular Runs IV.

NPH Insulin key facts

Intermediate acting, cloudy suspension, cannot be given IV.

Long Acting Insulin rule

Glargine, Detemir, Degludec. Do not mix Glargine with other insulins.

Insulin mixing order

Clear before cloudy. Draw up Regular before NPH (RN).

Peak Insulin Action risk

Hypoglycemia is most likely to occur during insulin peak.

Hypoglycemia symptoms memory trick

Cold and clammy needs candy (sweating, tremors, confusion, tachycardia).

Hypoglycemia Treatment (Conscious Patient)

15-15 Rule: 15 g rapid carbohydrates, recheck in 15 minutes.

Hypoglycemia Treatment (Unconscious Patient)

Glucagon IM/SQ (no IV access) or Dextrose IV (IV access available).

Hyperglycemia symptoms memory trick

Hot and dry needs fluids (dehydration, polyuria, polydipsia).

Exercise effect on insulin

Increases insulin sensitivity; acts like a free insulin shot.

Diabetes Sick Day Rules

Continue insulin, check glucose frequently, drink fluids, monitor ketones.

DKA description and memory trick

Burning furniture for heat (burning fat for energy, producing ketones).

Hallmark findings of DKA

Dehydration, ketones, acidosis, Kussmaul respirations, fruity breath, abdominal pain.

Mnemonic for Kussmaul respirations

Blowing out the fire (blowing off acid rapidly).

DKA Treatment Priority

Fill the tank then fix the engine (IV fluids first, then IV insulin).

HHS description and priority treatment

Sahara Desert Syndrome (extreme dehydration). Priority: Aggressive fluid replacement.

DKA vs HHS comparison

DKA: Type 1, ketones, acidosis. HHS: Type 2, no ketones, higher mortality.

Diabetic Foot Care key rule

LOOK Before You WALK. Inspect daily, wear shoes, never go barefoot.

A1C Benchmarks

Normal: <5.7%. Prediabetes: 5.7-6.4%. Diabetes: 6.5% or greater.

NCLEX Priority Rule: Glucose vs Acidosis

Low sugar kills faster than high sugar.

Rapid insulin think:

LAG, Lispro, Aspart, Glusimine

Rapid insulin (timing)

LAG, onset:15 peak1hr duration 3hrs

Short regular insulin think

R. Novolin R, Atropid R, Humulin R

Short (reg) insulin timing

R. onset: 30 min, peak:2-4hr, duration:6hrs

Intermediate think

N. NPH, Novalin N, Humulin N

intermediate timing

N. onset: 60 min, peak:4-8hrs, duration: 12hrs

Long acting think

GlaDe (glargine, detemir, degludec) L. Levemir, Lantus, Lente

Long acting timing

L. onset:120min, Peak: NONE, duration: 24hrs