endocrine

Question 1

SIADH priority concepts

Answer 1

complication of cancer
hypopituitary
increased secretion of adh
volume overload
diminished output, electrolytes are diluted
fluid restriction less than 800 mL a day
Abnormal or sustained production
Cancer cells manufacture, store, and release ADH
Many chemotherapeutic agents stimulate release

Question 2

SIADH symptoms

Answer 2

BLOATED
Bloating (weight gain without edema)
Low urinary output
Overproduction of ADH
Anorexia
Tachycardia
Electrolyte imbalance (hyponatremia)
Disorientation, decreased LOC, decreased reflexes

Question 3

SIADH treatement

Answer 3

treat underlying malignanct and correct the imalance (fluid restriction, oral salt tabletsm isotonic saline)
furosemide initially
demeclocycline for stronger
monitor sodium level

Question 4

diabetes insipidus

Answer 4

condition in which abnormally large columes of dilute urine are excreted as a result of a deficient level of vasopressin
decreased secretion of ADH leading to excessive urine output
decreased urine osmolality
hypopituitary

Question 5

diabetes insipidus symptoms

Answer 5

HE PEES
hypotension
excess diluted urine
poor skin turgor
excess thirst
extra dry mucous membranes
weight loSSS

Question 6

diabetes insipidus treatment

Answer 6

give iv fluids
electrolyte replacement
desmopressin (synthetic vasopressin)

Question 7

addisons

Answer 7

adrenocortical insufficiency
adrenal suppression by exogenous steroid use

Question 8

addisons s&s

Answer 8

muscle weakness
anorexia
GI symptoms
fatigue
dark pigmentation of skin and mucosa (bronze), hypotension, low blood glucose, low serum sodium, high serum potassium, apathy, emotional lability, confusion, changes in distribution of body hair

AADDSS
Added tan
Added potassium
Decreased weight
Decreased BP, hair, sugar, and energy
Sodium loss
Salt cravings

Question 9

Addisonian crisis

Answer 9

profound fatigue
dehydration
vascular collapse (hypotension)
renal shutdown
decreased serum sodium
increased serum potassium

Question 10

addisons diagnosis tests

Answer 10

adrenocortical hormone levels
acth levels (Adrenocorticotropic hormone anterior pituitary)
acth stimumlation test

Question 11

addisons assessment

Answer 11

not any illness or stressors that may precipitate problems
fluid and electrolyte status
vital signs and orthostatics
weight changes muscle weakness fatigue
medications

Question 12

addisons interventions

Answer 12

risk for fluid deficit - monitor for signs and symptoms of fluid volume deficit, encourage fluid and foods select foods high in sodium administer hormone replacement as prescribed

activity intolerance- avoid stress and activity till stable, perform all activities for patient when in crisis, maintain a quiet, non stressful enviornment, measures to reduce anxiety

patient education

Question 13

cushings

Answer 13

excessive adrenocortical or corticosteroid medications

Question 14

cushings s&s

Answer 14

hyperglycemia
moon face
buffalo hump
heavy trunk and thin extremities
fragile thin skin
straie
weakness
hypertension
acne
infection
loss of libido
mood changes
increased sodium decreased potassium
virtualization in women (male qualities)

SARAH IS SALTY
Sugar high
Androgen hormone increase (masculine traits)
Resistance to infection is low (slow healing)
Apple-shape
HTN
Intense mood swings
Sodium increase
Serum calcium increased
A buffalo hump
Looks like a moon (and lassitude)
Thin and fragile skin (with striations)
Yes, they are obese in the trunk!

Question 15

cushings diagnostic test

Answer 15

dexamethasone suppression test

Question 16

cushings assessment

Answer 16

activity level and ability to carry out self care
skin assessment
changes in physical appearance and responses to these changes
mental function
emotional status
medications

Question 17

corticosteroid theapy

Answer 17

suppress inflammation and autoimmune response
control allergic reactions
reduce transplant rejection
medications
take as prescribed don’t taper or DC abruptly

Question 18

overactive sympathetic system s&s

Answer 18

heart rhythm issues (arrythmias)
constipation
dizziness or passing out when standing up
eyelid droop (ptosis)
fast heart rate at rest
sexual dysfunction

Question 19

overactive parasympathetic system s&s

Answer 19

constipation
fast heart rate at rest
heart rhythm issues (a fib)
sexual dysfunction
trouble digesting food including gastroparesis

Question 20

surgery for hyperthyroidism

Answer 20

subtotal thyroidectomy- treatment of choice for thyroid cancer
modified or radical neck dissection

Question 21

post op care for hyperparathyroidism

Answer 21

hormone replacement therapy
monitor respirstions
monitor bleeding and hematoma formation
assess pain and provide pain relief measures
semi fowler position support head and neck
assess voice discourage talking
potential hypoglycemia r/t injury or removal of parathyroid gland

Question 22

pituitary tumor treatment

Answer 22

surgery (craniotomy, transsphenoidal) to remove without radiation
drug therapy to stop the tumor from making hormones
chemoh

Question 23

adrenal crisis signs and symptoms

Answer 23

profound fatigue
dehydration
vascular collapse
renal shutdown
hyponatremia
hyperkalemia