Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Patients with anorexia nervosa may exhibit severe emaciation and may complain of cold intolerance or constipation. Amenorrhea is almost always present. Bradycardia, hypotension and hypothermia may be present in severe cases.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Although there are no clear triglyceride levels that predict pancreatitis, most clinicians treat fasting levels above 500 mg/dL. The risk of pancreatitis may be more related to the triglyceride level following consumption of a fatty meal.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Patients with very high levels of serum triglycerides (greater than 1000 mg/dL) are at risk for pancreatitis. The pathophysiology is not certain, since pancreatitis never develops in some patients with very high triglyceride levels.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Ezetimibe is a lipid-lowering drug that inhibits the intestinal absorption of dietary and biliary cholesterol by blocking passage across the intestinal wall by inhibiting a cholesterol transporter.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Niacin causes a prostaglandin-mediated flushing that patients may describe as “hot flashes” or pruritus and that can be decreased with aspirin (81-325 mg/ day) or other nonsteroidal anti-inflammatory agents taken during the same day.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Niacin reduces the production of VLDL particles, with secondary reduction in LDL and increases in HDL cholesterol levels. The average effect is a 15-25% reduction in LDL cholesterol and a 25-35% increase in HDL cholesterol.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Fasting patients taking noncardioselective beta-blockers can have an exaggerated hypoglycemic response to starvation. The beta-blockade inhibits fatty acids and gluconeogenesis substrate release and reduces plasma glucagon response.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The fluoroquinolones, particularly gatifloxacin, have been associated with both hypoglycemia and hyperglycemia. It is thought that the drug acts on the ATP sensitive potassium channels in the beta cell.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
A number of medications apart from the sulfonylureas can occasionally cause hypoglycemia. Common offenders include the fluoroquinolones such as gatifloxacin and levofloxacin, ACE inhibitors and beta-adrenergic blocking agents.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Patients with autoimmune hypoglycemia have early postprandial hyperglycemia followed by hypoglycemia 3-4 hours later. The hypoglycemia is attributed to a dissociation of insulin-antibody immune complexes, releasing free insulin.

Nursing Tip of the Day! - Fundamentals

 Category: Fundamentals 
Hypoglycemia sometimes develops in patients who have undergone gastric surgery (gastrectomy, pyloroplasty, gastrojejunostomy, Bilroth II procedure and Roux-en-Y), especially when they consume high levels of carbohydrates.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The treatment of choice for insulin-secreting tumors is surgical resection. While waiting for surgery, patients should be given oral diazoxide. Side effects include edema due to sodium retention, gastric irritation and mild hirsutism.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The so-called Whipple triad is characteristic of hypoglycemia. It consists of (1) a history of hypoglycemic symptoms, (2) an associated fasting blood glucose of 45 mg/ dL or less and (3) immediate recovery upon administration of glucose.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Alcohol-related hypoglycemia is due to hepatic glycogen depletion combined with inhibition of gluconeogenesis. It is common in malnourished alcohol abusers but can occur in anyone who is unable to ingest food after an acute alcoholic episode.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Postprandial (reactive) hypoglycemia may be seen after gastrointestinal surgery and is particularly associated with the dumping syndrome after gastrectomy and Roux-en-Y gastric bypass surgery.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Fasting hypoglycemia may occur in certain endocrine disorders, such as hypopituitarism, Addison disease, or myxedema, and in disorders related to liver malfunction, such as acute alcoholism or liver failure.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Lactic acidosis is not uncommon in any severely ill patient suffering from cardiac decompensation, respiratory or hepatic failure, septicemia, or infarction of bowel or extremities. The main clinical feature of lactic acidosis is marked hyperventilation.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Lactic acidosis is characterized by the accumulation of excess lactic acid in the blood. Normally, the principal sources of this acid are the erythrocytes (which lack enzymes for aerobic oxidation), skeletal muscle, skin and brain. 

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
In diabetic ketoacidosis, when blood glucose falls to 250 mg/dL, the fluids should be changed to a 5% glucose-containing solution. This will prevent the development of hypoglycemia and will also reduce the likelihood of cerebral edema.