Endocrine

Question 1

thyroid glands

Answer 1

-produces three hormones (T3, T4, & calcitonin)
-need iodine to make hormones

Question 2

calcitonin

Answer 2

-decreases serum calcium levels by taking calcium out of the blood and pushing it back to the bone

Question 3

hyperthyroid (Grave’s disease) signs and symptoms

Answer 3

-nervous
-irritable
-attention span decreases
-increased appetite
-decreased weight
-sweaty/hot
-exophthalmos
-GI fast
-increased BP and pulse (increased workload on the heart)
-arrhythmias/palpitations
-thyroid size enlarges
-

Question 4

diagnosis of hyperthyroidism

Answer 4

-increased T4 level
-decreased TSH
-thyroid scan
-pt must d/c any iodine containing meds 1 week prior to scan and must wait 6 weeks to restart meds
-US/MRI/CT

Question 5

amiodarone

Answer 5

-antiarrhythmic drug containing high levels of iodine and may affect thyroid function

Question 6

hyperthyroidism treatment

Answer 6

-anti-thyroids
-iodine compounds
-beta blockers
-radioactive iodine therapy
-thyroidectomy (partial or complete)

Question 7

anti-thyroids

Answer 7

methimazole, propylthiouracil

-methimazole is a single daily dose with less side effects
-used pre-op to stun the thyroid

Question 8

iodine compounds

Answer 8

potassium iodine
-decrease the size and the vascularity of the gland
-all endocrine glands are VERY VASCULAR
-decrease the likelihood of bleeding & hemorrhage

*give in milk or juice, & use a straw because it stains the teeth

Question 9

beta blockers

Answer 9

Propranolol (supportive therapy)
-decreases myocardial contractility
-decrease cardiac output (decrease brain perfusion)
-decreases HR, BP
-decrease anxiety
-do not give to diabetics or asthmatics

Question 10

radioactive iodine therapy

Answer 10

-one dose
-give PO
-rule out pregnancy first!!
-destroys thyroid cells–> hypothyroidism
-follow radioactive precautions: stay away from babies for 1 week, don’t kiss anyone for 1 week

-watch for thyroid storm (thyrotoxicosis and thyrotoxic crisis), could be a rebound effect post-radioactive iodine

Question 11

thyroidectomy

Answer 11

-done when client has a large goiter, thyroid cancer, or did not respond to anti-thyroid therapy

Question 12

post op thyroidectomy

Answer 12

-report feeling of pressure
-check for bleeding at incision site and at the back of the neck (pooling)
-assess for recurrent laryngeal nerve damage by listening for hoarseness
-could lead to vocal cord paralysis
-if there is paralysis in both cords, airway obstruction will occur requiring immediate trach

-keep trach at bedside:
swelling
recurrent laryngeal nerve damage (vocal cord paralysis)
-hypocalcemia (assess for parathyroid removal)–> not sedated
-teach how to support neck (pillows)
-HOB elevated to decrease edema
-client needs more calories

Question 13

hypothyroidism signs and symptoms

Answer 13

• no energy
  -fatigue
  -no expression
  -speech slowed and slurred
  -increased weight
  -GI tract slows down
  -cold
  -amenorrhea

Question 14

hypothyroidism diagnosis

Answer 14

-thyroxine (T4) decreased
-increased TSH

Question 15

hypothyroidism treatment

Answer 15

levothyroxine, liothyronine

-take on an empty stomach
-clients with hypothyroidism tend to have CV disease and CAD
-take meds for life
-increased energy levels

Question 16

parathyroid

Answer 16

-secretes PTH
-pulls calcium out of the bones to the blood and increases serum calcium
-too much PTH= hypercalcemia
-not enough PTH= hypocalcemia

Question 17

sings and symptoms of hyperparathyroidism

Answer 17

-hypercalcemia
-hypophosphatemia
-too much PTH
-sedated

Question 18

treatment of hyperparathyroidism

Answer 18

-partial thyroidectomy (remove two parathyroid), decrease PTH secretion

monitor for hypocalcemia post op (tight, rigid muscles)

Question 19

signs and symptoms of hypoparathyroidism

Answer 19

-hypocalcemia
-hyperphosphatemia
-not enough PTH
-not sedated

Question 20

treatment for hypoparathyroidism

Answer 20

-IV calcium
-phosphorus binding drugs (calcium acetate)
binds with phosphorus to decreased serum phosphate and increase serum calcium

Question 21

pheochromocytoma

Answer 21

benign tumors that secrete epi and norepi in boluses
-tend to be familial so screen the family