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00NCLEX > Adult Endocrine > Flashcards

Adult Endocrine Flashcards

1
Q

Hypothyroidism (myxedema)

A
  • low T4; high TSH
  • flattened affect
  • constipation
  • weight gain
  • pedal edema
  • low HR and BP
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2
Q

Myxedema coma

A
  • severely low thyroid levels
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3
Q

Hyperthyroidism

A
  • excessive T3 and T4
  • agitation
  • weight loss
  • insomnia
  • HR and BP up
  • heat interlorance
  • injected (red) cojunctiva
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4
Q

Cushing’s disease

A
  • Hypersecretion of ACTH from the pituitary gland
  • excessive corticosterioids
    • causes suppresion of white blood cells
    • immune suppresion
  • thyroid labs not affected
  • osteoporosis
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5
Q

Cushing disease symptoms

A
  • sodium and water retention
  • low hematocrit
  • hypernatremia
  • weight gain
  • fatigue
  • hyperglycemia
  • thirst
  • delayed wound healing
  • sexual dysfunction
  • acne
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6
Q

Cushing disease care

A
  • modify diet to low glycemic and sodium foods
  • increasing potassium rich foods
  • Low impact, weight bearing exercises to increase bone density
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7
Q

Main symptom?

Addison’s disease

A
  • decrease in androgens (sex hormones) and glucocorticoids
  • shock and hypoglycemic**
  • hyper-pigmented (very tan)
  • do not adapt to stress
  • hyponatremia
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8
Q

Adrenal crisis

A
  • abrupt end to steriods (prednisone)
  • severe dehydration (fluid volume deficit)
    • tachycardia
    • hypotension
    • hyponatremia
    • weakness/fatigue
  • henoconcentration (high hematocrit)
  • hyperkalemia
    • peaked T wave
    • give sodium polystyrene
  • adjust dose of steroids if planning serious exercise
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9
Q

Give what?

Addisons Crisis

A
  • Add a SONE (give steroids)
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10
Q

pathophysiology of diabetes mellitus

A

Destruction of pancreatic beta-cells

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11
Q

Pheochromocytoma

A
  • Tumor in adrenal glands
    • too much of epinephrine and norepinephrine
  • diagnose through 24-hour urine test
    • measure catecholamines (stress hormone)
    • elevated = positive
  • classic triad
    • hypertension
    • hyperglycemia
    • headache
  • weight loss
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12
Q

pheochromocytoma high risk for

A
  • hypertensive emergency
  • avoid diet that can raise BP like cheese
  • avoid caffeine, smoking
  • avoid stress
  • cardiac dysrhythmias
  • panic (sweating, headache)
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13
Q

Regular Insulin peak

A
  • IV
    • 15-30 min
  • Sub Q
    • 2-3 hours
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14
Q

Most common cause of hyperthyroidism

A

Grave’s disease

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15
Q

Grave’s disease

A
  • HIGH LEVEL of thyrotropin receptor antibodies (TRAbs)
  • give radioactive iodine
    • UNLESS PREGNANT/BREASTFEEDING
  • exophthalmos/redness
    • no blinking
    • cool compress
    • elevate HOB
    • sunglasses
    • artifical tears
    • stop smoking
  • risk for thyorid storm
  • tachcardia
  • excessive sweating
  • weight loss
  • agitation
  • heat intolerance
  • fatigue
  • shortness of breath
  • muscle tremors
  • thin hair
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16
Q

Myxedema

A
  • severe, non-pitting edema
  • puffy face and periorbital area (around eyes)
  • coarse facial features
  • dry skin and hair (coarse)

hypothyroidism w/ skin involvement

17
Q

Hypophysectomy

A
  • neurosurgical technique for removing pituitary tumors
  • urine output greater than 300 mL/hr is alarming
  • Semi-Fowlers/Fowlers position is appropriate
  • prophylactic nausea vomiting needed
    • Ondansetron!
  • CSF leakage is serious
  • risk for meningitis!
  • increased ICP
  • decreased smell is expected for a few months
  • do not brush teeth = foul-smelling breath
18
Q

severe complication from neurosurgery around the pituitary

A
  • Diabetes insipidus
  • daily weights
  • too much urine output can lead to shock
19
Q

Diabetic nephropathy

A
  • proteinuria > 300 mg
  • kidney fails
  • monitor high BP
20
Q

Hyperglycemia

A
  • glucose over 250
    • if over than check for serum ketones
  • excessive thirst
  • flushed, dry skin
  • abdominal cramping
  • orthotic hypotension
  • hot and dry, your sugars high
21
Q

Jaundice in dark-skin

A
  • examine
    • mucous mebranes
    • hard palate
    • sclera
22
Q

BMI + waist size

A
  • BMI
    • 25-30 = overweight
    • 30+ = obese
  • obese waist size
    • men
      • 40 inches (102 cm) or greater
    • women
      • 35 inches (88 cm) or greater
23
Q

Acanthosis nigricans

A
  • darkening patches in skin folds
  • happens with insulin resistance
  • can indicate diabetes mellitus
24
Q

Thyroid panel test

A
  • given for
    • constipation
    • decreased sex drive
    • reduced activity tolerance
25
Q

PSA test

A
  • test for potential prostate cancer
  • start at age 55
26
Q

Metabolic syndrome

A
  • hypertension
  • hyperglycemia
  • hyperlipidemia
  • obesity
  • precursor to acute coronary syndrome and diabetes type 2
  • pregnant —> significant risk for gestational diabetes
27
Q

Serum cardiac enzymes

A
  • diagnose acute coronary syndrome
  • given with angina
28
Q

C-reactive protein

A
  • diagnose atherosclerosis
29
Q

Water deprivation test

A
  • diagnose diabetes insipidus (DI)
30
Q

Hypoglycemia

A
  • mild
    • less than 70
    • 15g of carbohydrates
  • moderate
    • less than 40
    • 30g of rapidly absorbed carbohydrates
    • UNLESS LETHARGIC AND SLURRED SPEECH = ASPIRATION RISK
  • severe
    • less than 20
    • give glucagon
  • lethargy
  • garbled speech
    • KEEP THEM NPO
    • ASPIRATION RISK
  • hypertension
  • blurred vision
  • can look like stroke
31
Q

Essential hypertension

A

Hypertension without a known cause

32
Q

Metabolic panel

A
  • information about fluid balance
  • electrolytes
    • sodium, potassium
  • how kidneys are working
33
Q

Diabetes insipidus

A
  • lifelong treatment of Desmopressin
    • intranasally or by mouth
    • MAY NEED ADDITIONAL DOSE IF POLYURIA PERSISTS
    • can cause water intoxication
      • risk for water toxicity = EMERGENCY
        • headache, confusion, n/v
  • daily weights at same time
  • monitor intake and output
  • drink equal to amount losing

00NCLEX (30 decks)

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