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Exam 3 Endocrine 219 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What are symptoms of acromegaly?

A

Visual disturbances
Thickening of tounge /dysphasia
Deepening of voice
Enlarged organs

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2
Q

What diagnostic studies are used for acromegaly?

A

MRI and CT
Eye exam
Glucose tolerance test

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3
Q

What is the treatment for acromegaly?

A

Hypophysectomy
Radiation

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4
Q

What medication treats acromegaly?

A

Octreotide (Sandostatin)

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5
Q

What does Octreotide (Sandostatin) do?

A

Reduces growth hormone levels

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6
Q

What is given for GH replacements and what does it do?

A

Somatropin

Increases energy, body mass, week-being, and body image

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7
Q

What medication is used to treat hypopituitarism?

A

Somatropin (Genotropin)

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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

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9
Q

What can ACTH deficiencies lead to?

A

Acute adrenal insuffiency
Hypovolemic shock

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10
Q

What does increases serum osmolity mean?

A

Hypernatremia

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11
Q

What does the posterior pituitary gland store?

A

Oxytocin
ADH

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12
Q

What is SIADH caused from?

A

Malignancies in the lungs or pancreas

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13
Q

What does a pt with SIADH have?

A

Low serum osmolity
Hyponatremia
Concentrated urine

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14
Q

What are signs and symptoms of SIADH?

A

Fluid volume overload
LOC/seizures
Weight gain
Low urine output
HTN and Tachycardia

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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

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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

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17
Q

What level of sodium can you give a loop diuretic to a pt with SIADH?

A

Sodium greater than 125

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18
Q

What sodium level do you give a pt hypertonic solutions (3% NaCL) with SIADH?

A

Sodium less than 120

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19
Q

What medication treats SIADH?

A

Democlocycline

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20
Q

What is central DI
What is it caused by?

A

Low ADH
Brain tumors, head injuries, brain surgery or CNS infection

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21
Q

What is nephrogenic DI?
What is it caused by?

A

Kidneys don’t respond to ADH
Medications, lithium, renal damage

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22
Q

What is primary DI?
What is it caused by?

A

Excessive water intake
Lesions in the thirst center

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23
Q

What are the symptoms of DI?

A

Polyuria (Peeing a lot)
Polydipsia (thirsty)
Hypernatremia
Weakness from nocturia
Dehydration

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24
Q

What much does a pt urinate with DI?

A

2-20L/day

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25
Q

What are the diagnostic levels for DI?

A

Dilute urine 200ml/hour or more
Urine gravity less than 1.005
Water deprivation test

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26
Q

What is normal results for a water deprivation test?

A

Small amounts of concentrated urine

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27
Q

What does results of a water deprivation show for a pt with DI?

A

Large amounts of dilute urine

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28
Q

How does the nurse know it is central DI after a water deprivation test?

A

Urine osmolity is increased (100-600)
Decrease in urine output
Concentrated urine

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29
Q

How does the nurse know it is nephrogenic DI after a water deprivation test?

A

Urine osmolity is low (less than 300)
Urinate in large amounts
Urine is diluted

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30
Q

What 3 medications can you give to a patient with central DI?

A

DDAVP
Vasssopresssion
Carbamazepine

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31
Q

What does Carbamazepine do?

A

Decreases thirst and urine output

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32
Q

What do thiazide diuretics do for a pt with nephrogenic DI?

A

Decrease flow of ADH

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33
Q

What can desmopressin acetate (DDAVP) lead to?

A

Hyponatremia

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34
Q

What do you teach the pt taking DDAVP about the symptoms?

A

Cold-like symptoms
Dry mouth
Swelling
Vision changes
Stroke symptoms

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35
Q

If goiter is caused by under active thyroid hormones which medications are given?

A

Synthroid

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36
Q

If goiter is caused by overactive thyroid hormones what medications are given?

A

Mathimazole (Tapazole)
Propylthiouracil

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37
Q

When is radioactive Iodine used?

A

When the thyroid is overactive

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38
Q

What happens to a pt weight with hyperthyroidism?

A

It will decrease

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39
Q

What are the t4, T3, and TSH levels with thyroiditis?

A

T4 and T3 LOW
TSH HIGH

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40
Q

What is Hashimotos thyroditis?

A

Not enough thyroid hormones

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41
Q

What are the symptoms of Hashitmotos thyroiditis?

A

Goiter
Weight Gain
Muscle weakness

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42
Q

What is a common cause of hyperthyroidism?

A

Graves’ disease

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43
Q

What happens to a pt metabolism with hyperthyroidism?

A

Increase causing underweight appearance

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44
Q

What are the signs and symptoms of hyperthyroidism?

A

Weight loss
Goiter
Anxiety/twitching
Difficulty sleeping
Thirst
Red palms

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45
Q

What 3 medications are given to a pt with hyperthyroidism?

A

Tapazole
PTU
Beta-blocker

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46
Q

What interventions does the nurse provide for a pt with hyperthyroidism?

A

Rest
Cool/quiet room
D. Weights
Increase calories

47
Q

What does the medication PTU do?

A

Prevents production of thyroid hormones

48
Q

What are adverse affects of PTU and Tapazole?

A

Decreased WBC
Alopecia
Loss of taste

49
Q

What are the priorities post-op thyroidectomy?

A

Hypocalcemia
Airway
Hemorrhage
Damage to laryngeal nerve

50
Q

What are the signs and symptoms of Graves’ disease?

A

Bruits
Heat intolerance
Smooth soft skin and hair
Palpatations
Protruding eyeballs

51
Q

What are the diagnostic studies for Graves’ disease?

A

T4 HIGH
TSH LOW
RAIU

52
Q

What can thyroid storm lead to?

A

Starvation

53
Q

What are the signs and symptoms of thyroid storm?

A

Fever
Systolic HTN
N/V/D
Anxiety, tachycardia

54
Q

What is primary hypothyroidism?

A

Dysfunction of the thyroid gland

55
Q

What scan do you use for hypothyroidism?

A

Echo
For cardiac enlargement

56
Q

What are the signs and symptoms of hypothyroidism?

A

Tired, brain fog
Paresthesia
Intolerance to cold
Dry skin, loss of body hair
Constipation
Menstrual disturbances

57
Q

What is the most common drug for hypothyroidism?

A

Levothyroxine (Synthroid)

58
Q

What do you assess in a pt with hypothyroidism?

A

Constipation

59
Q

What does the nurse do for a patient with hypothyroidism?

A

Monitor VS HR and rythem
Low calorie, cholesterol and fat diet
Daily exercise
Provide warm environment

60
Q

What does Levothyroxine (Synthroid) do?

A

Increases metabolism

61
Q

When do you take Levothyroxine (Synthroid)?

A

In the morning on an empty stomach

62
Q

What causes Myxedema?

A

Untreated Hypothyroism
(Missing a dose of meds)

63
Q

What are the signs and symptoms of myxedema?

A

Dry course hair
Periorbital Edema
Puffy, dull face with dry skin

64
Q

What can hyperparathyroidism cause?

A

Decreases bone density
Renal calculi

65
Q

What is primary Hyperparathyroidism?

A

Parathyroid secretes to much PTH

66
Q

What is secondary hyperparathyroidism?

A

Response to hypocalcemia

67
Q

What is tertiary Hyperparathyroidism?

A

Enlargement of PT glands

68
Q

What are the signs and symptoms of hyperparathyroidism?

A

Skeletal pain
Bone deformation
Epigastric pain
Weight loss/Constipation
HTN, Dysrhythmias
Renal stones

69
Q

what do calcimemetics do for hyperparathyroidism?

A

Decrease PTH

70
Q

What medication do you use for hyperparathyroidism?

A

Alendronate (Fosamax)

71
Q

What does alendronate (Fosamax) do?

A

Prevents osteoporosis

72
Q

What disease can put a patient at risk for tertiary hyperparathyroidism?

A

Kidney transplant after long period of dialysis

73
Q

What are causes of hypoparathyroidism?

A

Tumors
Heavy Metal Poising

74
Q

What condition do you have with hypoparathyroidism?

A

Hypocalcemia

75
Q

What are the signs and symptoms of hypoparathyroidism?

A

Numbness/tingling in face
Cramping
Positive Cvostek and trousseau
Hypotension
Anxiety

76
Q

What are signs of overt tetany?

A

Bronchospasms
Laryngeal spasms
Dysphasia
Dysrhythmias
Photophobia

77
Q

What do you teach your patient with hypoparathyroidism about their diet?

A

High calcium low phosphorus diet
Avoid spinach

78
Q

What can calcium medications for hypoparathyroidism cause?

A

Prolonged QT Intervals
Inverted T wave

79
Q

What is a glucocorticoid?
What does it do?

A

Cortisol
Increases glucose

80
Q

What is a mineralocorticoid?
What does it do?

A

Aldosterone
Regulates sodium and potassium

81
Q

What does cortisol inhibit?

A

Inflammatory response
(Considered an anti inflammatory)

82
Q

What does Aldosterone do?

A

Reabsorbs sodium
Excretes potassium

83
Q

What will lab levels look like in Cushing syndrome?

A

Increased BS and sodium
Decreased potassium and calcium

84
Q

What are the 3 ways to check cortisol levels for Cushing?

A

Saliva Night
24 hour urine
Dexamethasone supression test

85
Q

What is a low dose dexamethasone suppression test?

A

Steroid should supress the real ease of cortisol

86
Q

If cortisol is not suppressed in a dexamethasone suppression test what will be diagnosed?

A

Cushing

87
Q

What are the interventions for Cushing syndrome?

A

Protect against thromboembolism

88
Q

What medication do you give to a pt for hyperglycemia but have Cushing disease and type 2 diabetes?

A

Mifepristone (Korlym)

89
Q

What 2 medications help a pt with Cushing disease but prevent Addisons?

A

Hydrocortisone
prednisone

90
Q

What is the main medication for Cushing syndrome?

A

Ketoconazole (Nizoral)

91
Q

What do you take Ketoconazol (Nizoral) with and why?

A

Coffee,tea, or juice
to increase acidity in stomach

92
Q

If both of the adrenal glands are removed what will the pt need?

A

Lifelong cortisol and aldosterone replacement

93
Q

What do you administer post-op adrenalectomy?

A

High dose IV steroids

94
Q

What can low aldosterone levels lead to?

A

Dehydration
Hypotension
Hyponatremia
Hyperkalemia

95
Q

What is secondary adrenal insufficiency?

A

Not enough ACTH from pituitary

96
Q

What do the lab values with Addisons look like?

A

Decreased BS and sodium
Increased potassium and calcium

97
Q

What are the signs and symptoms of Addison’s disease?

A

Lethargy
N/V
Weight loss
Hyperpigmentation

98
Q

What test are used to diagnose Addison’s disease?

A

ACTH stimulation test
CRH stimulation test
EKG
MRI or CT

99
Q

What is ACTH stimulation test?

A

Take first thing in morning
Baseline cortisol levels
Give ACTH
Recheck labs
If cortisol didn’t increase then it indicates Addisons

100
Q

What does a pt with Addisons diseases EKG show?

A

Tall peaked T waves

101
Q

What do you administer to a pt with Addison’s disease?

A

Hydrocortisone- 2 in morning, 1 at nighttime
Fludrocortisone-morning
Salt
DHEA in women

102
Q

What medication is used for Addison’s disease?

A

Hydrocortisone

103
Q

What can hydrocortisone cause?

A

Weight gain
Vertigo
Shock
Osteoporosis

104
Q

What are the administration instructions for hydrocortisone?

A

every morning at the same time with food

105
Q

What mineralcorticoid is used to treat Addison’s disease?

A

Fludrocortisone

106
Q

What is the administration instructions for fludrocortisone?

A

Take with a cortisol med
Stored airtight and light protected
59-86 degrees F

107
Q

What is hyperaldosterinism characterized with?

A

Hypertension
Hypokalemic alkalosis

108
Q

What do labs look like with hyperaldosteronism?

A

Increased aldosterone and sodium
Decreased potassium

109
Q

What are the signs and symptoms of hyperaldosteronism?

A

Dysrhythmias
Paresthesia
Tetany
Visual changes
Glucose intolerance

110
Q

If hyperplasia is the cause of hyperaldosteronism, what is the treatment?

A

Dexamethasone
Spirolactione
CCB for HTN

111
Q

What are the signs and symptoms of pheochromocytoma?

A

Pounding HA
Sever HTN
Palpatations
Profuse sweating

112
Q

What is pheochromocytoma?

A

Excess catecholamines
(Epinephrine,norepinephrine, dospamine)

113
Q

What is an important intervention for pheochromocytoma?

A

Change positions slowly due to severe HTN

Exam 3 Endocrine 219 (2 decks)

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