AHII Endocrine Flashcards
hypocalcemia
watch for laryngospasm--> stridor lack of PTH CATS (convulsions, arrhythmias, tingling and tetany, stridor and spasms) Ca gluconate Ca chloride
patient reports tightness in throat following thyroidectomy
suspect hematoma-need suture removal tray and sterile 4X4’s, PRBC’s and be ready to send back to OR
changes in volume, quality and tone following a thyroidectomy
indicate possible laryngeal nerve damage
thyroid storm (due to thyroid getting squeezed like a sponge)
TH release
hypermetabolism
increased O2 needs
SNS overdrive
tachycardia/palpitations afib elevated temp, flushing O2 hunger, chest pain tremors, hyperhidrosis (excessive sweating) agitation watch for hypoglycemia!!
thyroid storm
pheochromocytoma
EPI, NE secreting tumor
happens spontaneously lasts minutes to hours
PHE (Palpitations, HA, hyperglycemia, hypertension, Excessive sweating)
ONLY REGULAR INSULIN IV
Remove adrenal gland is primary tx.
treating thyroid storm
maintain airway and support o2 status
circulation and metabolic needs: treat dehydration, DEXTROSE fluids (D5W NOT Glucagon!!) Propanolol, Digoxin (body may have used up all of glycogen stores, making Glucagon ineffective)
cooling blanket, ice packs, NO ASA, protect the skin, NSAIDS
block conversion of T4 to T3: PTU monitor CBC, fever, chills, sore throat, agranulocytosis, rigors
hyponatremia, hypotonic blood, concentrated urine, no edema
suspect SIADH-implement seizure precautions!-cells will swell bc they are hypertonic to the blood-this includes the brain
What might cause SIADH?
Cancer, CNS disorder, meds, pulmonary issues, CYCLOPHOSPHAMIDE
Hyponatremia
think neuro changes: disorientation, restlessness, lethargy, unresponsive, coma, seizures
large urine output, hypernatremia, increased serum osmolality, decreased urine osmolality and specific gravity, dehydration (dry MM, tenting skin, sunken eyes, insatiable thirst)
diabetes insipidus; treat with 1/2 NS, push PO fluids, vasopressin in neurogenic, if nephrogenic, ADH (Vasopressin) wont work bc kidney tubules cannot response, so remove the source with LITHIUM, give NSAIDS to reduce polyuria, encourage a low salt, low protein diet to reduce urine output, and give Thiazide diuretics (thiazide diuretics slow the GFR to decrease urine output)
neugenic: result of hyposecretion of ADH
Nephrogenic: kidney tubules fail to reabsorb water in response to ADH
buffalo hump, moon face, purple striae on abd
cushings
solu-cortef
IV hydrocortisone: doesnt fit if patient has Cushings which is too much glucocorticoids-why would you give IV Steriords?
confusion, weakness, pale, palpitations
acute adrenal insufficiency from stopping steriods abruptly
hyponatremia, hyperkalemia, hypotension
cushings
what do endocrine glands do?
maintenance and regulation of vital functions
response to stress and injury
growth and development
energy metabolism
reproduction
fluid, electrolyte, and acid-base balance
hypothalamus
body temp, sleep, appetite (activates, controls and integrates ANS)
pituitary gland
growth of body tissues, influences water absorption by the kidney, and controls sexual development and function
adrenal gland
sodium and electrolyte balance, affects carb, fat, and protein metabolism, influences developemnt of sexual characteristics, sustains fight or flight response
adrenal cortex
outer shell; synthesizes glucocorticoids and mineralocorticoids and secretes small amounts of sex hormones
adrenal medulla
inner core; SNS-produces NE, EPI
thyroid gland
metabolism and growth
makes T4, T3 and thyrocalcitonin
parathyroid glands
controls calcium and phosphorus metabolism, produces PTH
pancreas
influences carb metabolism, indirectly influences fat and protein metabolism, produces insulin and glucagon