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21 Cards in this Set
- Front
- Back
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Interview Qs for Thyroid
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Hypo:
fatigue? dry skin? weight gain? cold intolerance? constipation? Hyper: weight loss? heat intolerance? diarrhea? Both: past thyroid prob? changes in meds? |
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Thyroid Physical Assess---1
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Vital signs: BP; HR
Evaluate deep tendon reflexes Hyper: incr reflex response Hypo: slower response Hyper: incr HR; irregular rhythm Hypo: decr. HR; bradycardia |
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Thyroid Physical Assess---2
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Inspect neck for thyroid gland; palpate thyroid gland: stand behind pt; place fingers on cricoid cartilage, tilt head back and swallow.
Indicate size, shape, nodules. NOT always possible to palpate |
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Thyroid Physical Assess--3
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Inspect eyes -- if attached of eyelid --> hyperthyroid
Inspect: hypo skin: dry, scaly, cold, rough hair: dry coarse brittle nails: oncholysis (nail moves away from nail bed) |
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Normal TSH
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Used to monitor pt
Normal: 0.3-0.6mU/L hypo: increased hyper: decreased |
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Thyroid labs & test
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RAIU, TRH, Antithyroid Ab (grave's hashimoto), thyroid scans, ECGs, FLP (fasting lipid panel)
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Action of Insulin
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Decr. blood glucose --> decr insulin/ incr glucagon and gluconeogenesis --> incr blood glucose branches off to:
incr insulin release --> removal of glucose from blood --> decr blood glucose decr. glucagon release --> decr hepatic glucose production --> decr blood glucose |
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DM - interview
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Polyuria? nocturia? polydipsia? polyphagia? fatigue? blurry vision? weight loss?
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DM - Phys Assess
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Vital signs: BP; HR
Examine feet: peripheral neuropathy |
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DM Foot exam inspection
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Inspect for:
Ulcers, toenails (too long, in grown), calluses, corns, deformities, redness, swelling, weakness in feet or ankle. |
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DM - foot exam palpate for?
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Dorsalis Pedal pulse --- on both feet
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Diagnostic test & Lab test; GDM
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Diagnostic: C-peptide
Lab test: Oral glucose tolerance test (OGTT) normal: <140 GDM: 2 or more elevated BG levels |
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HgA1c
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measures amt of glucose bound to hemoglobin
avg blood glucose over past 3 months normal: 4-6% Goal DM: <7% NOT for diagnosis! |
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Fructosamine
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measures glycosylated proteins (ie albumin)
correlates w/ glucose control over 2-3weeks |
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DML lab test 2
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Urine:
glucose ketones albumin: Cr ratio |
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IFG IGT DM for FPG
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FPG: for:
IFG: 100 - 125 IGT: 70 - 100 DM: >126 |
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Self monitoring blood glucose (SMBG) Goals
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Fasting (in AM): 70 - 130
2h postprandial: <180 |
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How to use a glucometer
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check exp date of control solution; do this w/ every new box of test strips, improper storage, suspect meter is damaged
Prepare lancet Turn on meter; insert test strip (check exp date); rub/massage area to be punctured; wash hands in warm water. Puncture skin, apply droplet to test strip. |
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How often to test blood glucose via glucometer? When?
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1-8x/day depends on drug therapy
Test before breakfast/1st meal and 2hr after meal. |
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Alt site testing (arm etc)
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not available in all meters; can be less painful. However it is less accurate for measuring rapid changes in blood sugar.
Only recommend to pt testing multiple times per day; or for fasting levels only. Need to learn proper technique. |
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Selecting meter based on?
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insurance/cost
size of disply; dexterity; portability; smaple size; calibration; memory capabilities |
