Endocrine and Metabolic Crises Flashcards
7 cards from real CCRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Endocrine and Metabolic Crises flashcards as text
A patient in diabetic ketoacidosis (DKA) has a serum potassium of 5.8 mEq/L on admission. What is the priority nursing consideration regarding potassium?
Answer: Total body potassium is depleted despite the elevated serum level
In DKA, acidosis shifts potassium extracellularly, so a normal or high serum level masks a significant total-body deficit that worsens once insulin drives potassium back into cells.
Which laboratory finding best distinguishes hyperosmolar hyperglycemic state (HHS) from DKA?
Answer: Profound hyperglycemia with minimal ketosis and near-normal pH
HHS is characterized by extreme hyperglycemia and high osmolality but little or no ketosis because residual insulin prevents lipolysis.
A patient with DKA is started on an insulin infusion. The glucose drops from 600 to 250 mg/dL. What is the appropriate next step?
Answer: Add dextrose to the IV fluids while continuing the insulin infusion
Once glucose reaches about 200-250 mg/dL, dextrose is added so insulin can continue clearing ketones without causing hypoglycemia.
Which assessment finding is most consistent with myxedema coma?
Answer: Hypothermia, bradycardia, and altered mental status
Myxedema coma is severe hypothyroidism presenting with hypothermia, bradycardia, hypoventilation, and decreased consciousness.
A patient in thyroid storm has a temperature of 105.8°F and heart rate of 160. Which medication is given to block peripheral conversion of T4 to T3 and reduce thyroid output?
Answer: Propylthiouracil (PTU)
PTU both inhibits thyroid hormone synthesis and blocks peripheral conversion of T4 to the more active T3.
Why is aspirin contraindicated for fever control in thyroid storm?
Answer: It displaces thyroid hormone from binding proteins, raising free hormone levels
Salicylates displace thyroid hormone from thyroid-binding globulin, increasing free hormone and worsening the storm.
A patient with adrenal (Addisonian) crisis presents with hypotension unresponsive to fluids. What is the priority pharmacologic treatment?
Answer: IV hydrocortisone
Addisonian crisis is acute cortisol deficiency, so IV hydrocortisone is the lifesaving treatment along with fluids and glucose.