Nursing Tips: Endocrine

Patients taking corticosteroids (e.g., prednisone, hydrocortisone) are at increased risk of infection. Monitor for signs of infection, and educate patients taking these medications to avoid crowded areas and perform frequent hand hygiene.

Because of the unpleasant GI side effects of metformin, educate patients to take this medication with a meal.

When caring for a child with pheochromocytoma, be sure not to palpate the abdomen. Palpation can cause a sudden release of catecholamines, triggering severe hypertension!

A patient taking a strong iodine solution to treat hyperthyroidism or thyrotoxicosis in preparation for thyroidectomy should be educated as to the symptoms of iodism (e.g., metallic taste, stomatitis, severe GI upset).

A negative feedback loop governs most endocrine hormones. In this type of feedback, when the body senses there is not enough of a hormone circulating in the blood, changes are initiated to increase production of that hormone. Once the body senses there is too much of that hormone, changes are initiated to decrease production of that hormone.

A child with Growth Hormone Deficiency would have an average birth weight/length, but show delayed growth through childhood.

Antidiuretic hormones (ex: vasopressin and desmopressin) are used to treat Diabetes Insipidus.

When mixing insulin, remember CLEAR before CLOUDY. Inject air in the longer-acting insulin (NPH), then inject air in the shorter-acting insulin (regular). Without withdrawing needle, draw up shorter-acting insulin, then draw up longer-acting insulin.

Diabetic foot care teaching: Inspect feet; Apply moisturizer; Wear cotton socks; Cut nails straight across; Don't use OTC products or use heating pads on feet.

With Diabetes InSIPidus, you will want to SIP a lot of water. Diabetes Insipidus causes the patient to urinate large quantities of dilute urine, leaving the patient dehydrated and thirsty!

Syndrome of Inappropriate ADH (SIADH) causes the excess water to be reabsorbed by the kidneys, resulting in hypervolemia.

NPH is an intermediate-acting insulin. Onset is 1-2 hours, peak is 4-12 hours, and duration is 18-24 hours.

HINT: Neil Patrick Harris (NPH) is a hard-working actor of intermediate height. If you call him, he will be "on set" in 1-2 hours and he will stay there for up to 24 hours.

Glipizide and glyburide are Sulfonylureas used to treat type 2 Diabetes.

HINT: Think of riding down a slide, as your blood sugar comes down with this medication. Key side effect = hypoglycemia.

Acarbose is an alpha glucosidase inhibitor used to treat type 2 Diabetes. It works by inhibiting glucose absorption in the GI tract.

HINT: A = "NO" + CARBS. So "No carbs" absorbed in the GI tract with acarbose.

Propylthiouracil (PTU) is used for Grave's disease (and in preparation for a thyroidectomy). HINT: PTU will Prevent Thyroid from being Up too high.

If your patient has hypoglycemia (blood glucose level under 70 mg/dL), provide a 10-20g carbohydrate. This could be a 4 oz juice or regular soda.

For patients with Diabetes, the goal is to keep their HgbA1C under 7!

Pioglitazone is an oral antidiabetic medication. Key side effects include fluid retention and elevated LDL levels. HINT: Pioglitazone kind of looks like "pig zone", which can help you remember these side effects.

Glucagon is a hyperglycemic agent used to treat severe hypoglycemia wihen a patient is unable to take oral glucose (ex: unconscious patient). HINT: When the glucose is all GONE, take glucagon.