Chapter54 Flashcards
Identify the following test
A stimulus may be provided to determine whether the endocrine gland is capable of normal production. Measured amount of hormones or substances are minister to stimulate the target gland to produce its hormone . Then these hormones are measured.
Stimulation test is performed on a client with suspected under activity of the endocrine gland.
Figure of almost levels to increase with a stimulation test indicates what?
Hypo function. Example hypothyroidism
What test is used when hormone that was or high or in the upper range of normal? Agents that deplete activity of hormone production or ministered to determine if there’s normal negative feedback.
Suppression test
Fater of hormone production to be suppress during standardized testing when performing a suppression test indicates what?
Hyperfunction. Example hyperthyroidism secrets too many hormones
Identify the following diagnostic test.
Measures the absorption of iodine isotope to see how about thyroid gland is function
Radioactive iodine uptake
Radioactive iodine uptake
Once the radioactive iodine is introduced the amount of radioactivity is measured in how many hours and then again at how many hours
2 to 4 hours and again at 24 hours
The thyroid function test measures the absorption of iodine. What are the normal values in how many hours
3% to 10% at 2 to 4 hours and 5% to 30% in 24 hours anything below that or over that is abnormal function
In a radioactive iodine uptake test any values about 10% in a span of 24 hours or above 30% in the span of 24 hours indicates what?
hyperthyroidism, decrease iodine intake, increase iodine excretion
Describe the following body system
Maintenance and regulation of vital functions response to stress an injury to inflammatory response growth and development energy metabolism reproduction food electrolyte an acid base balance
Endocrine system
Identify the following test.
Used when hormone levels are high or in the upper range of normal, an agent is introduced to the body to suppress response and determine whether there is normal negative feedback. when chemicals are introduced and there is a failure of hormone production suppression, that would indicate a hyperfunction.
Suppression test
When you have a decrease in radioactive iodine Uptake this will indicate
Hypothyroidism and low T4 level use of anti-thyroid medication thyroiditis myxedema
Myxedema -
nounMEDICINE
swelling of the skin and underlying tissues giving a waxy consistency, typical of patients with underactive thyroid glands.
the more general condition associated with hypothyroidism, including weight gain, mental dullness, and sensitivity to cold.
T3 and T4 resin uptake test
What does it diagnose What do these forms T3 T4 regulate? What are the normal values for T3 - T4 - Thyroxine, free (FT4)-
They are blood test that diagnosed disorders with the thyroid
They regulate thyroid stimulating hormone TSH
T3 - 8o to 230
T4 - 5-12
Thyroxine, free (FT4)-0.8 - 2.4
Which hormone elevates with hyperthyroidism decreases with the aging process and maybe decreased with hypothyroidism?
Which hormone is increased with hyperthyroidism and decrease with hypothyroidism?
T3
T4
Which blood test is used to differentiate the diagnosis of primary hypothyroidism?
What are the normal values?
What do elevated values indicate and what to decrease values indicate?
Thyroid stimulating hormone TSH
0.2 to 5.4
Elevated values indicate primary hypothyroidism
Decrease values indicate hyperthyroidism or secondary hypothyroidism.
Identify the following procedure and what do you reassure the client
Performed to identify not to support role in the thyroid a radio isotope of iodine or technetium is administered.
What would invalidate the exam?
Regarding medication what are you check with the healthcare provider?
Thyroid scan
Reassure that radioactive medication is not dangerous to self or others
If patient has received contrast agents within the past three months
If you have the greenlight to discontinue Iodine medications for 14 days before test
Thyroid scan
How long does the patient maintain NPO ?
If iodine Will be used the client will fast for an additional ———– minutes after ingestion of the oral isotope and the scan will be done in ——— hours after that
45 minutes and 24 hours
Thyroid scan
If technetium is used it will be administered what route and how many minutes before
IV
30 minutes before the scan
This test does not get performed on pregnant women
This examination is done for cytological examination of the thyroid there’s no preparation necessary and after procedure you apply like pressure to the site
Needle aspiration of thyroid tissue
Glucose tolerance test
What is this test performed?
How is it conducted and when is it positive?
Is it a reliable test?
Diabetes mellitus
You give the patient and injection or ingestion of glucose you wait 2 hours and if it’s over 200 mg/dL are you will confirm diabetes mellitus
It is not the most reliable many things alter it
Client preparation : for glucose tolerance test
The patient Must maintain a diet of at least ———- grams of carbohydrates for ——— days before the test
36 hours before what you avoid consuming
How long do you fast before the test
Sure you do exercise before the test?
Why is an initial sample drawn before the test begins?
How will blood be drawn during the exam? (Time intervals)
Do you withhold insulin or oral hypoglycemic medication for my client who has diabetes mellitus
150 g of carbohydrates for three days
Alcohol smoking coffee
10 to 12 hours fasting before the test
For eight hours before and after the test avoid strenuous exercise
A blood sample is drawn to determine fasting blood glucose
Blood will be drawn at 30 minutes intervals for a minimum of two hours
Yes withhold insulin before test
Give the name for the blood glucose bound to hemoglobin also how do you abbreviate it?
These levels will indicate how will the blood glucose has been controlled over the past _________ to ____________ months.
Glycosylated hemoglobin A1c (HbA1c)
3 to 4 months
What is the usual cause of an increase in HbA1c value? (Glycosylated hemoglobin A1c)
Hyperglycemia in a client with diabetes mellitus
What should be the goal values in HbA1c value? (Glycosylated hemoglobin A1c)
Is fasting required?
Clients with diabetes mellitus below 7% plans without diabetes mellitus the normal range is 4% to 6%
No. Fasting required
The following disorders are they dealing with anterior pituitary or posterior pituitary?
Hyperpituatarism and hypopituitarism
Anterior pituitary
The following disorders are they dealing with anterior pituitary or posterior pituitary?
Diabetes insipidus and syndrome of inappropriate antidiuretic hormone secretion (SIADH)
These disorders can be caused by damage to the posterior pituitary or hypothalamus
Hypopituitarism
What is this condition caused by
What are the hormones most often affected? their six
Tumors trauma encephalitis autoimmunity or stroke
Growth hormone go needle tropic hormone thyroid stimulating hormone
ACTH adrenal corticotropic hormone
ADH. Anti diuretic hormone
Hypopituitarism- describe the effects of the hypoproduction of the following hormones. GH/TSH GH AND ADH GONADOTROPIN AND ACTH TSH, ADH, ACTH,GH TUMORS ON PITUATARY
GH/TSH- mild to moderate obesity
GH AND ADH- reduced cardiac output
GONADOTROPIN AND ACTH- infertility sexual dysfunction
TSH, ADH, ACTH,GH- fatigue low blood pressure
TUMORS ON PITUATARY- headaches
Nursing interventions for hypopituitarism
What type of support you provide the client and family
Due to the low production of hormones with a client need?
What will you need to teach the client?
Emotional support
Hormone replacement therapy.
Teach the client regarding signs and symptoms of hypo function and hyper function related to insufficient or excess hormone replacement
What do you have when you have hypersecretion of growth hormone by the anterior pituitary gland in an adult caused primarily by pituitary tumors?
Hypopituitarism
Hyperpituitary causes what conditions? Name 2
Cushing disease and acromegaly
The giant
There once was a big giant with large hands and feet he had a big job is super old hands were full of arthritis and pain in his joints he couldn’t see right and he was always smelly with diaphoresis his skin was nasty and oil very dick and rub his organs were huge due to organomegaly, his voice was very deep but he was hypertensive and he couldn’t eat people because he had dysphagia. This giant at the signs and symptoms of what gland disorder?
hyperpituitary
Joint pain intervention frequent skincare emotional support radiation for pituitary he prescribed repair the client for hypophysectomy if planned.
These interventions are for what
Hypopituitary
Identify the following procedure.
Removal of pituitary tumor be a craniotomy or transphenoidal (endoscopic transnasal). A latter approach is preferred.
Hypophysectomy (PITUATARY adenoectomy, transphenoidal PITUATARY surgery)
Listen it’s not good if you get this procedure you may have increased intracranial pressure, bleeding or you can get meningitis or hypopituitarism those are serious risk
These complications are associated with what procedure?
Craniotomy
Listen I know you have a hyperpituitary and you want a hypophysectomy by performing a ________________ surgery but know that this surgery may have complications or you may reverse back to hypopituitary.
transsphenoidal surgery
transsphenoidal surgery: post procedure interventions
What do you do to the patient’s head?
What two things do you monitor for?
What should the patient avoid at all cost?
Temporarily the patient may get symptoms of what to pathologies?
What meds would you administer?
What can we say about mouth care?
Elevate the head of the bed
Monitor vital signs neurologic status in level of consciousness but the two things you must monitor for complications is increased cranial pressure and bleeding
Avoid sneezing coughing and blowing nose
Temporarily the patient may suffer from diabetes insipidus or syndrome of inappropriate antidiuretic hormone secretion resulting from ADH disturbances
Antibiotics and Antidiuretic anti-pyretic
Clean mouth with mouth rinse patient must brush teeth with ultra soft toothbrush two weeks following surgery
transsphenoidal surgery: post procedure interventions
Following the surgery what do you have to monitor which may indicate leakage of CSF and what exactly are you checking for within the CSF ?
Nasal drainage or postnasal drip and your checking for drainage of glucose
Identify the following conditions.
I know secretion of ADH due to a stroke or drama causing the kidney tubules to fail to reabsorb or water
Diabetes insipidus
Identify the condition of the dragon.
There once was a dragon that when he flew urinated large amounts of diluted urine (polydipsia.) over the town. he was always dehydrated because of this you can tell due to his skin turgor and dry mucous membranes he had an inability to concentrate his urine. He Peed so much that he had a low specific urine gravity of 1.006 and even lower at times. This Dragon was good for nothing he was always fatigued his big wings had muscle pains and weakness he had a constant headache because he was dehydrated and when he would stand up to scare people he would fall flat on his face because he asked postural hypotension causing vascular collapse. Because of this dehydration his heart was 1 million a mile with tachycardia.
This Dragon had diabetes insipidus.
