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 with severe hypoglycemia (glucose 38 mg/dL) is unconscious without IV access. What is the appropriate intervention?
Answer: Administer intramuscular glucagon
When IV access is unavailable in an unconscious hypoglycemic patient, IM glucagon mobilizes hepatic glucose stores.
Which fluid is typically given first in the initial resuscitation of DKA?
Answer: 0.9% normal saline
Isotonic normal saline is started first to restore intravascular volume before transitioning to hypotonic fluids and adding dextrose.
A patient with myxedema coma requires thyroid hormone replacement plus which additional therapy before or with levothyroxine?
Answer: IV corticosteroids to cover possible adrenal insufficiency
Corticosteroids are given in myxedema coma because coexisting adrenal insufficiency can be unmasked when thyroid hormone is replaced.
Which sign in a critically ill patient most strongly suggests hypoglycemia rather than another cause of altered mentation?
Answer: Diaphoresis, tremor, and confusion that resolves with glucose
Adrenergic and neuroglycopenic symptoms such as sweating, tremor, and confusion that reverse with glucose are hallmark hypoglycemia findings.
When managing DKA, why must phosphate and magnesium be monitored?
Answer: Insulin therapy and acidosis correction can cause significant depletion of these electrolytes
As insulin drives glucose into cells, phosphate and magnesium shift intracellularly and can become depleted, requiring monitoring and replacement.
A patient with thyroid storm should be managed in which sequence of medications when iodine is needed?
Answer: Give an antithyroid drug (PTU) before iodine to prevent new hormone synthesis
Antithyroid drugs are given before iodine so iodine does not provide substrate for additional hormone synthesis (Wolff-Chaikoff effect is intended).
Which intervention is most important when caring for a comatose patient in myxedema coma with hypoventilation?
Answer: Provide ventilatory support and passive rewarming
Airway and ventilatory support plus gradual passive rewarming are priorities because hypoventilation and hypothermia are life-threatening in myxedema coma.