Endocrine Flashcards
1
Q
What are symptoms of acromegaly?
A
Visual disturbances
Thickening of tounge /dysphasia
Deepening of voice
Enlarged organs
2
Q
What diagnostic studies are used for acromegaly?
A
MRI and CT
Eye exam
Glucose tolerance test
3
Q
What is the treatment for acromegaly?
A
Hypophysectomy
Radiation
4
Q
What medication treats acromegaly?
A
Octreotide (Sandostatin)
5
Q
What does Octreotide (Sandostatin) do?
A
Reduces growth hormone levels
6
Q
What is given for GH replacements and what does it do?
A
Somatropin
Increases energy, body mass, week-being, and body image
7
Q
What medication is used to treat hypopituitarism?
A
Somatropin (Genotropin)
8
Q
What does the nurse teach the patient taking Somatropin (Genotropin) ?
A
It can cause swelling in the feet and hands
Myalgias
Joint pain
HA
9
Q
What can ACTH deficiencies lead to?
A
Acute adrenal insuffiency
Hypovolemic shock
10
Q
What does increases serum osmolity mean?
A
Hypernatremia
11
Q
What does the posterior pituitary gland store?
A
Oxytocin
ADH
12
Q
What is SIADH caused from?
A
Malignancies in the lungs or pancreas
13
Q
What does a pt with SIADH have?
A
Low serum osmolity
Hyponatremia
Concentrated urine
14
Q
What are signs and symptoms of SIADH?
A
Fluid volume overload
LOC/seizures
Weight gain
Low urine output
HTN and Tachycardia
15
Q
What are the diagnostic levels for SIADH?
A
Sodium less than 134
Serum osmolity less than 280
Urine gravity greater then 1.025
16
Q
What actions does the nurse do for a patient with SIADH?
A
Put pt on fluid restrictions (800-1000ml/day)
heart and lung sounds
Daily weights
I/O, LOC, Vitals
17
Q
What level of sodium can you give a loop diuretic to a pt with SIADH?
A
Sodium greater than 125
18
Q
What sodium level do you give a pt hypertonic solutions (3% NaCL) with SIADH?
A
Sodium less than 120
19
Q
What medication treats SIADH?
A
Democlocycline
20
Q
What is central DI
What is it caused by?
A
Low ADH
Brain tumors, head injuries, brain surgery or CNS infection
21
Q
What is nephrogenic DI?
What is it caused by?
A
Kidneys don’t respond to ADH
Medications, lithium, renal damage
22
Q
What is primary DI?
What is it caused by?
A
Excessive water intake
Lesions in the thirst center
23
Q
What are the symptoms of DI?
A
Polyuria (Peeing a lot)
Polydipsia (thirsty)
Hypernatremia
Weakness from nocturia
Dehydration
24
Q
What much does a pt urinate with DI?
A
2-20L/day
25
What are the diagnostic levels for DI?
Dilute urine 200ml/hour or more
Urine gravity less than 1.005
Water deprivation test
26
What is normal results for a water deprivation test?
Small amounts of concentrated urine
27
What does results of a water deprivation show for a pt with DI?
Large amounts of dilute urine
28
How does the nurse know it is central DI after a water deprivation test?
Urine osmolity is increased (100-600)
Decrease in urine output
Concentrated urine
29
How does the nurse know it is nephrogenic DI after a water deprivation test?
Urine osmolity is low (less than 300)
Urinate in large amounts
Urine is diluted
30
What 3 medications can you give to a patient with central DI?
DDAVP
Vasssopresssion
Carbamazepine
31
What does Carbamazepine do?
Decreases thirst and urine output
32
What do thiazide diuretics do for a pt with nephrogenic DI?
Decrease flow of ADH
33
What can desmopressin acetate (DDAVP) lead to?
Hyponatremia
34
What do you teach the pt taking DDAVP about the symptoms?
Cold-like symptoms
Dry mouth
Swelling
Vision changes
Stroke symptoms
35
If goiter is caused by under active thyroid hormones which medications are given?
Synthroid
36
If goiter is caused by overactive thyroid hormones what medications are given?
Mathimazole (Tapazole)
Propylthiouracil
37
When is radioactive Iodine used?
When the thyroid is overactive
38
What happens to a pt weight with hyperthyroidism?
It will decrease
39
What are the t4, T3, and TSH levels with thyroiditis?
T4 and T3 LOW
TSH HIGH
40
What is Hashimotos thyroditis?
Not enough thyroid hormones
41
What are the symptoms of Hashitmotos thyroiditis?
Goiter
Weight Gain
Muscle weakness
42
What is a common cause of hyperthyroidism?
Graves’ disease
43
What happens to a pt metabolism with hyperthyroidism?
Increase causing underweight appearance
44
What are the signs and symptoms of hyperthyroidism?
Weight loss
Goiter
Anxiety/twitching
Difficulty sleeping
Thirst
Red palms
45
What 3 medications are given to a pt with hyperthyroidism?
Tapazole
PTU
Beta-blocker
46
What interventions does the nurse provide for a pt with hyperthyroidism?
Rest
Cool/quiet room
D. Weights
Increase calories
47
What does the medication PTU do?
Prevents production of thyroid hormones
48
What are adverse affects of PTU and Tapazole?
Decreased WBC
Alopecia
Loss of taste
49
What are the priorities post-op thyroidectomy?
Hypocalcemia
Airway
Hemorrhage
Damage to laryngeal nerve
50
What are the signs and symptoms of Graves’ disease?
Bruits
Heat intolerance
Smooth soft skin and hair
Palpatations
Protruding eyeballs
51
What are the diagnostic studies for Graves’ disease?
T4 HIGH
TSH LOW
RAIU
52
What can thyroid storm lead to?
Starvation
53
What are the signs and symptoms of thyroid storm?
Fever
Systolic HTN
N/V/D
Anxiety, tachycardia
54
What is primary hypothyroidism?
Dysfunction of the thyroid gland
55
What scan do you use for hypothyroidism?
Echo
For cardiac enlargement
56
What are the signs and symptoms of hypothyroidism?
Tired, brain fog
Paresthesia
Intolerance to cold
Dry skin, loss of body hair
Constipation
Menstrual disturbances
57
What is the most common drug for hypothyroidism?
Levothyroxine (Synthroid)
58
What do you assess in a pt with hypothyroidism?
Constipation
59
What does the nurse do for a patient with hypothyroidism?
Monitor VS HR and rythem
Low calorie, cholesterol and fat diet
Daily exercise
Provide warm environment
60
What does Levothyroxine (Synthroid) do?
Increases metabolism
61
When do you take Levothyroxine (Synthroid)?
In the morning on an empty stomach
62
What causes Myxedema?
Untreated Hypothyroism
(Missing a dose of meds)
63
What are the signs and symptoms of myxedema?
Dry course hair
Periorbital Edema
Puffy, dull face with dry skin
64
What can hyperparathyroidism cause?
Decreases bone density
Renal calculi
65
What is primary Hyperparathyroidism?
Parathyroid secretes to much PTH
66
What is secondary hyperparathyroidism?
Response to hypocalcemia
67
What is tertiary Hyperparathyroidism?
Enlargement of PT glands
68
What are the signs and symptoms of hyperparathyroidism?
Skeletal pain
Bone deformation
Epigastric pain
Weight loss/Constipation
HTN, Dysrhythmias
Renal stones
69
what do calcimemetics do for hyperparathyroidism?
Decrease PTH
70
What medication do you use for hyperparathyroidism?
Alendronate (Fosamax)
71
What does alendronate (Fosamax) do?
Prevents osteoporosis
72
What disease can put a patient at risk for tertiary hyperparathyroidism?
Kidney transplant after long period of dialysis
73
What are causes of hypoparathyroidism?
Tumors
Heavy Metal Poising
74
What condition do you have with hypoparathyroidism?
Hypocalcemia
75
What are the signs and symptoms of hypoparathyroidism?
Numbness/tingling in face
Cramping
Positive Cvostek and trousseau
Hypotension
Anxiety
76
What are signs of overt tetany?
Bronchospasms
Laryngeal spasms
Dysphasia
Dysrhythmias
Photophobia
77
What do you teach your patient with hypoparathyroidism about their diet?
High calcium low phosphorus diet
Avoid spinach
78
What can calcium medications for hypoparathyroidism cause?
Prolonged QT Intervals
Inverted T wave
79
What is a glucocorticoid?
What does it do?
Cortisol
Increases glucose
80
What is a mineralocorticoid?
What does it do?
Aldosterone
Regulates sodium and potassium
81
What does cortisol inhibit?
Inflammatory response
(Considered an anti inflammatory)
82
What does Aldosterone do?
Reabsorbs sodium
Excretes potassium
83
What will lab levels look like in Cushing syndrome?
Increased BS and sodium
Decreased potassium and calcium
84
What are the 3 ways to check cortisol levels for Cushing?
Saliva Night
24 hour urine
Dexamethasone supression test
85
What is a low dose dexamethasone suppression test?
Steroid should supress the real ease of cortisol
86
If cortisol is not suppressed in a dexamethasone suppression test what will be diagnosed?
Cushing
87
What are the interventions for Cushing syndrome?
Protect against thromboembolism
88
What medication do you give to a pt for hyperglycemia but have Cushing disease and type 2 diabetes?
Mifepristone (Korlym)
89
What 2 medications help a pt with Cushing disease but prevent Addisons?
Hydrocortisone
prednisone
90
What is the main medication for Cushing syndrome?
Ketoconazole (Nizoral)
91
What do you take Ketoconazol (Nizoral) with and why?
Coffee,tea, or juice
to increase acidity in stomach
92
If both of the adrenal glands are removed what will the pt need?
Lifelong cortisol and aldosterone replacement
93
What do you administer post-op adrenalectomy?
High dose IV steroids
94
What can low aldosterone levels lead to?
Dehydration
Hypotension
Hyponatremia
Hyperkalemia
95
What is secondary adrenal insufficiency?
Not enough ACTH from pituitary
96
What do the lab values with Addisons look like?
Decreased BS and sodium
Increased potassium and calcium
97
What are the signs and symptoms of Addison’s disease?
Lethargy
N/V
Weight loss
Hyperpigmentation
98
What test are used to diagnose Addison’s disease?
ACTH stimulation test
CRH stimulation test
EKG
MRI or CT
99
What is ACTH stimulation test?
Take first thing in morning
Baseline cortisol levels
Give ACTH
Recheck labs
If cortisol didn’t increase then it indicates Addisons
100
What does a pt with Addisons diseases EKG show?
Tall peaked T waves
101
What do you administer to a pt with Addison’s disease?
Hydrocortisone- 2 in morning, 1 at nighttime
Fludrocortisone-morning
Salt
DHEA in women
102
What medication is used for Addison’s disease?
Hydrocortisone
103
What can hydrocortisone cause?
Weight gain
Vertigo
Shock
Osteoporosis
104
What are the administration instructions for hydrocortisone?
every morning at the same time with food
105
What mineralcorticoid is used to treat Addison’s disease?
Fludrocortisone
106
What is the administration instructions for fludrocortisone?
Take with a cortisol med
Stored airtight and light protected
59-86 degrees F
107
What is hyperaldosterinism characterized with?
Hypertension
Hypokalemic alkalosis
108
What do labs look like with hyperaldosteronism?
Increased aldosterone and sodium
Decreased potassium
109
What are the signs and symptoms of hyperaldosteronism?
Dysrhythmias
Paresthesia
Tetany
Visual changes
Glucose intolerance
110
If hyperplasia is the cause of hyperaldosteronism, what is the treatment?
Dexamethasone
Spirolactione
CCB for HTN
111
What are the signs and symptoms of pheochromocytoma?
Pounding HA
Sever HTN
Palpatations
Profuse sweating
112
What is pheochromocytoma?
Excess catecholamines
(Epinephrine,norepinephrine, dospamine)
113
What is an important intervention for pheochromocytoma?
Change positions slowly due to severe HTN
