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Nurs 405 MS2 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is the major regulator of water supply in the body?

A

ADH (along with thirst mechanism)

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2
Q

Hyper natremia or hypo natremia can both cause what complication with patients?

A

Confusion or altered level of consciousness

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3
Q

With hyper natremia cells ______

A

Shrink

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4
Q

With hypo natremia cells_____

A

Swell

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5
Q

What is the most common cause of SIADH

A

Ectopic hormone production from lung cancer cells, paraneoplastic disorder

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6
Q

How are sodium levels high or low with SIADH

A

Low, delusional. South swell due to fluid shifts into intercellular spaces

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7
Q

And what are the two types of DI

A

Or neurogenic, which can be due to head trauma. Nephrogenic, kidney not responding to a DH in blood

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8
Q

What is the most common cause of drug induced nephrogenic DI

A

Lithium

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9
Q

What will the serum osmolality look like in a patient with SIADH

A

It will be decreased due to increased intravascular fluid volume

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10
Q

What are some clinical manifestations of SIADH

A

Symptoms of hypo natremia such as muscle cramps, shortness of breath, fatigue, confusion, lethargy, impaired taste, anorexia

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11
Q

A priority nursing problems with SIADH

A

No excessive fluid volume, risk for injury, altered mental status,

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12
Q

What has a more abrupt onset, neurogenic or nephrogenic DI

A

neurogenic. Usually self-limiting, but most severe symptoms

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13
Q

Clinical manifestations of diabetes insipidus

A

Polyuria, polydipsia, low specific gravity of urine, low urine osmolality, high serum osmolality due to dehydration and hyponatremia, fatigue, nocturia

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14
Q

Priority nursing problems with diabetes insipidus

A

Fluid volume deficit, risk for injury, altered mental status, hyponatremia

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15
Q

Pharmacotherapy for neurogenic diabetes insipidus

A

Desmopressin/vasopressin. This is a synthetic ADH, given small doses

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16
Q

adrenal cortex secretes what?

A

glucocorticoids (cortisol), mineralocorticoids (aldosterone), sex steroids

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17
Q

Cushing’s syndrome is due to high levels of what?

A

Cortisol

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18
Q

Having a high amount of cortisol for an extended period of time causes many complications, such as

A

Increase glucose availability, protein breakdown, that break down and redistribution, suppression of immune an inflammatory response, CNS excitability

these lead to various manifestations found in S/Sx

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19
Q

Clinical presentation of Cushing syndrome

A

Thin body hair, truncal obesity, moon face, buffalo hump, hirsutism, fitting arms and legs, fragile skin, mental depression or euphoria due to lability, hypertension secondary to salts retaining, hypokalemia, bone demineralization and spontaneous fractures

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20
Q

Priority nursing problems with Cushing’s

A

Infection, impaired skin integrity, risk for injury, waking, ineffective coping, body image concerns, risk for unstable blood glucose, hypokalemia

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21
Q

I treatment options for Cushing’s, related to underlying cause

A

Adrenalectomy if it’s due to adrenal tumor,
removal of tumor is ectopic ACTH secreting tumor is present,
due to prolong steroids gradually get off drugs, reduced dose, conversion of alternate day regimen

22
Q

Nursing care related to Cushing’s

A

I&O, daily weight, fingerstick blood glucose, insulin coverage, monitor vital signs for hypertension, checked skin, urinary track, monitor temp, white blood cell count, for infection. Observed behavior for mood swings and provide emotional support

23
Q

Cushing’s diet

A

Increase protein, potassium, decrease calories, sodium

24
Q

Oh and Addison’s disease there’s a decrease secretion of which hormones?

A

And cortisol, which is our primary stress hormone. Aldosterone, steroid hormone. Antigens, male hormone

25
Q

Clinical manifestations of Addison’s disease

A

I really signs include anorexia, weakness, apathy, electrolyte imbalance, hyperkalemia, hyper pigmentation of skin. Hypotension causes diminished vascular tone, reduce cardiac output. Salt craving due to low serum sodium levels and dehydration. Hypo cortisol ism, hypo glycemia, weakness and fatigue

26
Q

Are primary nursing problems with Addison’s disease

A

Low fluid volume, malnourishment due to nausea and anorexia, activity intolerance due to weakness, and potential complication of addisonian crisis

27
Q

I hormone replacement therapy for Addison’s disease

A

Daily Hydro Cortizone, 2/3 when you wake up, one/3 late afternoon. Follow circadian rhythm.
daily fludrocortisone in the morning
Salt additives, increase doses with stress

28
Q

Teaching for cortisol replacement therapy

A

Follow prescription dosing schedule, never abruptly stop, lifelong, use 3 x 3 rule when stressed, always have emergency supply, where medic alert bracelet

29
Q

What is an addisonian crisis

A

Acute adrenal insufficiency. Medical emergency. Can be caused by insufficiency of serum corticosteroids. Symptoms include sudden penetrating pain in lower back, abdomen or legs. Severe vomiting diarrhea, dehydration, low blood pressure, loss of consciousness. If untreated can be fatal

30
Q

How do you treat and addisonian crisis

A

IV Hydro Cortizone, Celine, and dextrose. Once able to take PO you can decrease the dose until maintenance dose is achieved.

31
Q

What is an Addison’s disease emergency kit

A

Hydro Cortizone hundred milligrams IM, syringes, instructions

32
Q

What kind of environment do we want for a patient with an addisonian crisis, or Addison’s disease in general

A

Stress-free, think about noise lights temperature. Patient is unable to produce corticosteroids to combat stress

33
Q

PHE triad of symptoms for pheochromocytoma

A

Are palpitations, headache, episodic sweating

34
Q

Goiter

A

Enlarged thyroid gland

35
Q

Hyper thyroidism

A

High T3 and T4, low TSH

36
Q

Hypo thyroidism

A

Are low T3 and T4, high TSH

37
Q

toxic goiter

A

Are goiter with hyperthyroidism

38
Q

What is iodine necessary for

A

Synthesis of thyroid hormones. Only the thyroid gland can uptake iodine

39
Q

And what foods can we find iodine in

A

Yogurt, milk, eggs, Iodinized salt

40
Q

Signs and symptoms of hyperthyroidism

A

Tachycardia, murmurs, just with me as, palpitations, angina, tachypnea, dyspnea on exertion, increased appetite, thirst, weight loss, increased peristalsis, diarrhea, memory lapse, short attention span, warm moist and smooth skin, hair loss, palmar erythema, find silky hair, diaphoresis, vitiligo

*Goiter with bruit, exophthalmos, vitiligo,m palmer erythema *

41
Q

Are thyrotoxic crisis, thyroid storm

A

Acute, severe, rare. Usually due to stressors in a patient with pre-existing hyperthyroidism. All hyper thyroidism symptoms are prominent and severe. Patient status post thyroidectomy at risk

42
Q

pharmacotherapy for hyper thyroidism

A

Methimazole, iodine, beta blockers

43
Q

Radioactive iodine therapy

A

Are treatment for chronic hyperthyroidism. Take PO, no need for hospitalization, delayed response. Give anti-thyroid drugs and beta blockers during time it takes to onset. Radioactivity gone in a few days. No direct contact for 2 to 3 days, double flush toilet, separate laundry

44
Q

Oh what is a subtotal thyroidectomy

A

Removing large portion of thyroid gland. Hypothyroidism can occur if too much is taken. Meant for those that are not responsive to anti-thyroid therapy or those with large goiters or those with possibility of malignancy

45
Q

Post-op care for subtotal thyroidectomy

A

Assess for hemorrhage, assess for tracheal compression, semi Fowlers position, avoid flexion or any tension on suture lines, monitor vital signs, Moner serum calcium levels, hoarseness is expected for 3 to 4 days

46
Q

Why do we see low serum calcium levels with a thyroid removal

A

And when removing the thyroid we also remove the parathyroid, which regulates calcium levels. Subsequently hypocalcemia is a common side effect of a thyroid removal. Look for signs of tetany, trousseau’s sign, chvostek’s sign, Tingling, twitching

47
Q

Signs and symptoms of hypothyroidism

A

Weight gain, depression, fatigue, slow mentation speech, somnolence, low exercise tolerance, dyspnea on exertion, anemia, constipation, cold intolerance, hair loss, dry skin, goiter, difficulty swallowing, myxedema

48
Q

Myxedema

A

Oh changes in skin and tissue with prolonged hypothyroidism. Hard swelling, nonpitting. Can be reversed with thyroid hormones

49
Q

Myxedema coma

A

A severe hypothyroidism with very low thyroid levels. Considered a medical emergency. Mental status changes, can lead to unresponsiveness. Caused by heart failure, stroke, infection, or not taking prescribed thyroid medication

50
Q

Oh what thyroid hormone replacement do we use for hypothyroidism

A

Levothyroxine

Nurs 405 MS2 (10 decks)

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