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Endocrine Flashcards

1
Q

Trousseau sign is to determine presence of

A

Assessment to determine for hypocalcemia before
and after thyroidectomy.

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2
Q

Symptoms of hepatic coma (Select all apply)

A

Impaired memory, attention, oncentration
hallucination, and dapcing tremor upon dorsiflexion of
hand.

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3
Q

Signs of Laennec’s cirrhosis due to alcohol abuse

A

Abdominal distention, protruding umbilicus, icteric
sclera

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4
Q

Esophageal varices (food to avoid)

A

Eating raw vegetables and food must be chewed well
and to eat slowly, No alcohol ingestion.

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5
Q

For liver biopsy which is significant assessment to the site,

A

Ecchymosis - bruising

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6
Q

A common complaints of patient who had laparoscopic
cholecystectomy

A

Right shoulder pain (due to irritation to the diaphragm
after carbon dioxide insufflation)

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7
Q

Hepatic Encephalopathy - On Lactulose to decrease
ammonia level so expect for diarrhea

A

On Lactulose (Duphalac) to decrease ammonia level
so expect for diarrhea.

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8
Q

Sengstaken Blakemore tube, nurse to keep at the bedside

A

A pair of scissors

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9
Q

Trousseau bedside application before surgery as baseline
after to determine?

A

Check serum level of Calcium (hypocalcemia)

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10
Q

Positive sign for hypocalcemia?

A

(+) Trousseau and Chvostek’s signs

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11
Q

Positive sign for hypomagnesemia?

A

(+) Trousseau and Chvostek’s signs

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12
Q

Predisposing factor associated with Type 2diabetes

A

Obesity

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13
Q

What would be the effect to a diabetic client of taking
alcohol when on Sulfonylurea

A

Disulfiram (Antabuse) like symptoms
(flushing, vertigo, tachycardia, and palpitations)

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14
Q

Insulin glargine (Lantus) is administered at what time?

A

At bedtime and is indicated for Type Il diabetes
mellitus.

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15
Q

Lispro (Humalog) insulin teaching when to start eating?

A

Eat within 5-15 minutes of Lispro administration

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16
Q

Signs and symptoms of hypoglycemia.

A

Cold clammy skin, diaphoresis, tremors, tachycardia
palpitation, and lethargy.

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17
Q

What to administer to reverse acidosis in Diabetic
Ketoacidosis (DKA)?

A

potassium shift back into intracellular compartments.
Nurse alert: oral hypoglycemic medication is
contraindicated in Diabetic Ketoacidosis.

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18
Q

Normal value of Glycosylated hemoglobin HbA1c

A

Less than 7% for diabetic
Less than 6% for non-diabetic *
Greater than 8% is considered poorly controlled

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19
Q

Effect of insulin and alcohol, may cause fast reaction in

A

Hypoglycemia

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20
Q

In DKA, potassium level is initially high or low?

A

High
Hyperkalemia

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21
Q

Client teaching on client with DKA when activity is being
planned.

A

Avoid exercise, rest and take plenty of fluids.

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22
Q

When a ketone is check?

A

When blood sugar is 250mg/dl or when acetone
breath is present.

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23
Q

Nursing intervention when the bedside glucose monitoring
is read as critically high or critically low.

A

Obtain a stat venous blood draw. Most agencies
May have a protocol order in this case.

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24
Q

Nursing alert for Protamine Zinc

A

Long acting, check insulin reaction early in the
morning, and give milk or carbohydrate foods at
bedtime

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25
Q

Denver shunt is inserted to client with cases of

A

Cirrhosis - to divert ascetic fluid from the abdomen
into the jugular vein or to the vena cava

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26
Q

Chronic idiopathic jaundice with pigments in the liver

A

Dubin-Johnson syndrome

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27
Q

Amount of ascitic fluid drawn during paracentesis

A

Slow removal of 2 to 3 liters to relieve acute symptoms.

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28
Q

Electrolyte imbalance resulting in patient with DKA

A

Hyperkalemia

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29
Q

Medication used to sterilize the bowel by reducing the
number of bacteria in the GIT (as in cirrhosis of the liver)

A

Neomycin

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30
Q

It lowers the pH and traps ammonia in the colon; diarrhea is
a common side effect. It is also used for constipation.

A

Lactulose (is a synthetic sugar), used as a cathartic.

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31
Q

Used to reduce ammonia level (hepatic encephalopathy).

A

Lactulose (a laxative-osmotic effect).

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32
Q

Drug of choice for pancreatic, gallbladder pain

A

Demerol (meperidine)

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33
Q

Reason for taking Neomycin among clients with cirrhosis of
the liver.

A

To reduce ammonia level by enteric bacteria.

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34
Q

Nursing intervention when pt is eating with a T tube post
cholecystectomy

A

Clamp the tube during meal hours to assist in fat
digestion.

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35
Q

An autoimmune disorder where body’s own antibodies
attack the cells of the body. Most common cause of
hypothyroidism.

A

Hashimoto’s thyroiditis

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36
Q

Thyroid Storm or Thyroid Crisis

A

Extreme form of hyperthyroidism, fever spikes to 106.

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37
Q

How to administer SSK1 (Saturated Solution of Potassium
lodide)

A

Dilute well with milk, water, carbonated drinks or
water to disguise the bitter taste. KKSl is taken with a
straw to avoid staining to the teeth.

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38
Q

It helps to control the amount of calcium in the blood.
Normal calcium levels help maintains muscle control and
the blood’s ability to clot.

A

Parathyroid gland

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39
Q

Patient teaching undergoing
parathyroidectomy avoid:

A

Milk, seafood, green fruits, green leafy vegetable,
turkey or chicken. Answer: Milk or milk products.

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40
Q

Signs of Addisonian “crisis”

What is the Diagnostic test for Addison crisis?

A

Decreased urine output, hypotension, dry skin, dry
mucous membrane, altered LOC.

ACTH stimulation test .

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41
Q

SIADH is defined as.

A

Excessive release of antidiuretic hormone or
vasopressin from posterior pituitary gland.

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42
Q

Signs and symptoms of SIADH

A
  1. Hyponatremia, fluid overload
    (not causing edema and hypertension)
  2. Fluid retention
  3. Decreased urinary output
  4. Decreased LOC (due to cerebral edema and
    increased intracranial pressure)
  5. Normal or increased plasma volume
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43
Q

Treatment for SIADH

A

Fluid restriction
Diuretic (Lasix-furosemide), a loop diuretic
Sodium replacement

44
Q

What is diabetes Insipidus?

A

Profound deficiency of an antidiuretic hormone
(ADH), causing excessive diuresis,

45
Q

Treatment for Diabetes insipidus

A

Desmopressin

46
Q

Treatment for nephrogenic diabetis insipidus

A

Thiazides ( diuretics) for paradoxical effect

47
Q

What do you seen on Anterior and Posterior gland?

A

Anterior Pituitary gland:
ACTH
FSH, LH, prolactin
Growth hormones
TSH

Posterior gland:
Vasopressin (ADH)
Oxytocin

48
Q

The endocrine system is made of glands, hormones, & organs.
Billary-Tree

_______ is the largest gland/ internal organ.
It produces two (2) pints of bile (digestive enzyme) daily.
_____ stores and concentrates bile.
_______releases pancreatic juices, enzymes, and secretes insulin.

A

Liver
Gall bladder
Pancreas

49
Q

Ammonia

A
50
Q

Cirrhosis of the liver what electrolyte imbalance

Hypo or hyper?
Natremia

What do you reduced?
Complications?

A

Cirrhosis. at the Uver is a chronic liver disease secondary to destruction of hepatic cells from chronic alcoholism but It is only one of the causes.
May progress to liver failure and obstruction of portal circulation,
Signs and symptoms:
Early symptoms: fatigue, anorexia, and weight loss, to edema, elevated liver enzymes, electrolyte imbalance primarily hyponatremia.
Reduced albumin causing edema and ascites,
Complications: fluid retention, esophageal varices, and upper Gl bleeding.

51
Q

Paracentesis: Nursing alert : May require “ albumin”

A
52
Q

Paracentesis

A

What

53
Q

Liver biopsy
Patient Teaching
Pre liver biopsy

A
54
Q

Post liver biopsy care

A
55
Q

Pancreas

A
56
Q

Gland hormone action

A
57
Q

Pancreatitis
Signs
Cullen and Grey turner

A

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216450/

58
Q

Gall bladder - stores and concentrates bile to digest fast and oils.

Chole - Gall bladder

____ is inflammation of the gallbladder (acute or chronic). Primarily affecting obese female.
______ is the presence of one or more calculi (gallstones) in the gallbladder.
_____ cholecystitis is a sudden inflammation of the galibladder that causes severe abdominal pain.
_____ cholecystitis is long-standing swelling and irritation of the gallbladder.

A
59
Q

Diagnostic procedures for Chole cyctography

A
60
Q

Cholesintigraphy or HIDA (Hydroxy. Imino Diacetic Acid).-

A

is a study of gallbladder through imaging to detect: Biliary obstruction
(gallbladder stone or cancer).,
HIDA Scan determines any blockage

If there is an obstruction, the radioactive tracer will not be able to reach the gallbladder coming from the liver.
Preparation: NP0 after midnight lor the procedure and resume to low fat meal.

61
Q
A
62
Q

____ is a useful tool in establishing the diagnosis of cholecystitis, Confirmation of the diagnosis depends on a
combination of physical findings by palpation and ultrasound,

A

Murphy’s sign

63
Q

Client complaint after laparoscopic cholecystectomy:

A

irritate the diaphragm and cause referred shoulder pain.

Pain last for 24-48 hours or may take several days.

64
Q

Diabetes Mellitus

A
65
Q

Type 1 and Type 2

A
66
Q

Hyper glycemic Vs Hypo glycemia

A
67
Q

Optic click insulin Pen

Lantus is for?what type of diatebetes?
How many times a day?

What is levemir for?

A
68
Q
A
69
Q

_____ Normal or elevate blood glucose at bedtime, a decrease of
glucose level between “2-3 am” to hypoglycemic levels,
and a subsequent rise of the sugar due to the production of
counter- regulatory hormones,

A

Somogyi effect
Nursing teaching:
Decrease evening dose (pre-dinner or bedtime) of
intermediate-acting insulin or increased bed time snack,

70
Q

Injection

A
71
Q

DKA vs HHNK

A
72
Q

____ an uncommon initial manifestation in patients with diabetic ketoacidosis.
Aggressive potassium repletion to correct other metabolic abnormalities, including hyperglycemia and hyperosmolality.

A

Profound hypokalemia ( DKA) Initial

73
Q

Potassium loss is caused by a shift of ____ from the _______ to the extra cellular space exchange with hydrogen ions that
accumulate extracellularly in acidosis. Much of the shifted extracellular potassium is lost in urine because of osmotic diuresis.

A

Potassium
Intracellular

74
Q

What is hemoconcentration?
What is hemodilution?
BUN?
Creatinine?

A
75
Q

Peripheral Neuropathy

A
76
Q

Mixing insulins

A
77
Q

D/S x Q

A
78
Q

Metformin : Side Effects

Metallic taste, abdominal discomfort, diarrhea, anorexia, nausea or vomiting.

Monitor for : Hypo or Hypperglycemia?

Contraindicated?

When lasix and metformin? Whats gonna happen?

A
79
Q

/Oral Drug Combinations to treat Type 2 Diabetes & Non-insulin injections

A
80
Q

Glucagon - used for hypoglycemia and administered IM, IV, subcutaneous. Usual dose 1-2 mg.
Do not administer anything orally when patient is lethargic or ALOC..

> Diagnostic test for Pheochromocytoma (will induce increased BP)
but contraindicated in known Pheochromocytoma.

A
81
Q

Hemoglobin A1c
Diabetic Foot care

A
82
Q

Insulin onset test:

A
83
Q

DI VS SIADH

A
84
Q

DI and SIADH treatment and Nursing alert

A
85
Q

Addison and Cushing Syndrome

A
86
Q

Addison and Cushing Syndrome

A
87
Q

Addisonian Crisis (Adrenal Crisis)

A
88
Q

Pheochromocytoma

A
89
Q

Side Effects of Steroids

A
90
Q

Thyroid Gland

A
91
Q

Thyroid Diagnostic Test

Thyroid Ultrasound
Thyroid Scan
Serum Thyroid Panel

A
92
Q

Hyperthyroidism and Hypothyroidism

A
93
Q

Hyperthyroidism/Hypothyroidism
Treatment
Nursing Action

A
94
Q

Chvostek’s Sign and Trousseau Signs
(+*) for hypocalcemia and hypomagnesemia

A
95
Q

Thyroid Levels Interpretation

T3 T4 Low TSH High - Hypothyroidism

T3 T4 High TSH Low - Hyperthyroidism

A
96
Q

Hyperthyroidism also known as ________.

A

Grave’s Disease ( toxic goiter)

97
Q

Radioactive Iodine Teaching And Administration:

A
98
Q

Thyroidectomy

Available at the bedside prior to receiving client from PACU:

Thyroidectomy set, suction machine
Oxygen inhalation, Calcium chloride IV

A

Post thyroidectomy Care :
Semi-Fowler’$ position or 2-3 pillows.
Avoid hyperextending the neck, head in neutral position.
No Aspirin or NSAIDs within 10 days,
No lifting 20 pounds within 10 days after surgery.
Follow up with the surgeon after a week,

99
Q

Para thyroid gland

A
100
Q

Hypo para thyroidism and Hyper parathyroidism
Treatment
See pictures:

A
101
Q

Hypo physectomy - Removal of pituitary gland to treat Cushing Syndrome or tumor.

A
102
Q

Client Teaching to decrease Addisonian crisis:

Most important is “ Steriod in Addison crisis”

A
103
Q

Acgromegaly

Treatment : Sando”statin”

A
104
Q

Hepa B -

Vertical Transmission

When is the vaccine treatment?

A

0,1 and 6 months

105
Q

Hepatitis D

(Delta Hepatitis)

Transmission?

A

Bloody fluids, excretion of infected person or maybe acquired from infected HBV.

106
Q

AIDS and HIV

A
107
Q

Hepatitis A

Post Exposure: Gamma globulin injection

_______ - Presence of a virus in the bloodstream

A

Viremia

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