Download Chapter 23 Endocrine Emergencies Case PowerPoint Answers

Nancy Caroline’s Emergency Care in the Streets, Seventh Edition
Chapter 23: Endocrine Emergencies
Chapter 23
Endocrine Emergencies
Case PowerPoint Answers
1. What is your differential diagnosis?
Answer: On the basis of the signs and symptoms, your patient’s potential differential
diagnosis can include hypotension, drug overdose, arrhythmias, and hypoglycemia.
2. When do symptoms of hypoglycemia occur?
Answer: Signs and symptoms of hypoglycemia usually occur once the blood glucose
level falls below 60 mg/dL. However, if the drop in glucose levels is rapid, they can be
seen at higher levels.
3. What are some of the causes of hypoglycemia?
Answer: The causes of hypoglycemia are many. The more common causes of
hypoglycemia in patients with diabetes are taking too much insulin or oral hypoglycemic
medications, not eating enough, and unusual or extreme exercise without adequate food
intake. Hypoglycemia may also be found in patients who are chronic alcoholics, suffer
from malnutrition, or have pancreatic disorders, liver disease, hypothermia, cancer, or
sepsis. Be on the lookout for intentional overdoses on insulin and oral hypoglycemic
medications. People with a history of eating disorders may take insulin to burn off the
“extra calories” of desserts or other foods that may be considered high calorie.
4. How may a person with hypoglycemia present?
Answer: Signs and symptoms of hypoglycemia include hunger, irritability, shakiness, or
headache to name a few. Others include changes in mental status, appearance of
intoxication, seizures, and coma. Vital sign changes will include a weak, rapid pulse and
pale, cool, diaphoretic skin.
5. Which medications besides insulin can be used to control diabetes?
Answer: Patients with type 2 diabetes may be prescribed oral hypoglycemic agents to
help regulate their glucose levels. Type 2 diabetics are able to use these medications
because they work with the body’s own insulin (they have working beta cells). Examples
of commonly prescribed oral hypoglycemic agents include chlorpropamide, tolazide,
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Nancy Caroline’s Emergency Care in the Streets, Seventh Edition
Chapter 23: Endocrine Emergencies
tolbutamide, glipizide, and glyburide. Two newer medications include pioglitizone and
metformin.
6. Does diabetes affect other organ systems?
Answer: Unfortunately, the answer to this question is yes. Diabetic patients are at risk for
developing blindness, kidney disease, peripheral neuropathy, hypertension,
atherosclerosis, heart disease, and peripheral vascular disease.
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