Endocrine Flashcards
what is the fnxn of the thyroid
- regulates metabolism
hyperthyroidism leads to…
- hypermetabolism
what are S&S of hyperthyroidism
- weight loss
- increased P
- increased BP
- irritable
- heat intolernce (they run hot)
- cold tolerance (bc they’re hot)
- exopthalamus (bulging eyes)
- graves disease
(think of what youd see if someone had a high metabolism)
what is treatment for hyperthyroidism (3)
- radioactive iodine
- PTU (Propylthiouracil, think: Put Thyroid Under)
- thyroidectomy (surgical removal)
what is included in teaching for pts on radioactive iodine
- must isolate for the 1st 24 hrs
- caution with urine –> flush 3 times, if spills need to call hospital hazmat urine, etc.
what is the primary use of Propylthiouracil
- cancer
- special use = hyperthyroidism
what is a risk associated with Propylthiouracil? what needs to be monitored?
- immunosuppression
= monitor WBCs
what are 2 types of thyroidectomy
- total/complete
- sub total/partial
what is included in care after a total thyroidectomy
- will require lifelong hormone replacement
- risk of hypocalcemia (so look for S&S of hypocalcemia)
what is included in care after a subtotal thyroidectomy
- no lifelong replacement, maybe temporary
- less risk of hypocalcemia
- risk of thyroid storm/crisis (medical emergency)
what are S&S of thyroid storm (4)
- ++ increased temp
- ++ increased BP (stroke category)
- ++ HR
- psychic delirium
what risk is associated with thyroid storm
- permanent brain damage
what is treatment of thyroid storm
self-limiting, will eventually stop = goal: spare brain
- decrease temp
- increase O2 (O2 mask)
how should you decrease a temp with thyroid storm
- ice bath (first)
- cooling blanket (best)
what post-op risk is greatest within the first 24 hours after any type of thyroidectomy
1: risk of edema = airway compression
#2: hemorrhage
what post-op risk is the greatest in the first 12-48 hours after a total thyroidectomy
- low Ca = tetany = risk of airway obstruction
what post-op risk is the greatest in the first 12-48 hours after a partial thyroidectomy
- thyroid storm
what post-op risk is the greatest after 48 hours after a total thyroidectomy
- infection
(exam tip: do not pick infection if question asks about the greatest concern before 48-72h postop)
what impact does hypothyroidism have on metabolism
- low metabolism
what are S&S of hypothyroidism
- obese
- lethargic
- flat, dull
- cold intol
- heat tolerance
- low P
- low BP
- slow
- myxedema
what is treatment for hypothyroidism
- thyroid hormones
ex. levothyroxine/synthroid
what is a general rule regarding sedation and a pt with hypothyroidism
- DO NOT sedate (they are already lethargic)
what 2 diseases have to do with the adrenal cortex
- addison’s
- cushings
what is addison’s disease
- adrenal insufficiency
what are S&S of addison’s disease
- hyperpigmentation (tan)
- unable to adapt to stress
when a pt with addison’s disease experiences stress, what can happen?
- drop in BG
- drop in BP (shock)
= risk of decreased perfusion to brain
what is treatment for addison’s
- steroids (glucocorticoids)
(think: need to ADD steroids)
glucocorticoids end in
____asone
what is cushing’s disease
- excess adrenal
what are S&S of cushing’s disease? (and therefore side effects of glucocorticoids)
- irritable
- moon face
- hirsituism (increased body hair)
- buffalo hump
- gynecomastia
- skinny arms & legs (d/t atrophy)
- trunkal/central obesity
- straie
- bruises
- water & Na retention
- decreased K+
- increased BG
- immunosuppression
what is treatment for cushing’s disease
- adrenalectomy
what risk is associated with bilat adrenalectomy
- risk of addison’s disease = give steroids
