endocrine Flashcards
SIADH priority concepts
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
SIADH symptoms
BLOATED
Bloating (weight gain without edema)
Low urinary output
Overproduction of ADH
Anorexia
Tachycardia
Electrolyte imbalance (hyponatremia)
Disorientation, decreased LOC, decreased reflexes
SIADH treatement
treat underlying malignanct and correct the imalance (fluid restriction, oral salt tabletsm isotonic saline)
furosemide initially
demeclocycline for stronger
monitor sodium level
diabetes insipidus
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
diabetes insipidus symptoms
HE PEES
hypotension
excess diluted urine
poor skin turgor
excess thirst
extra dry mucous membranes
weight loSSS
diabetes insipidus treatment
give iv fluids
electrolyte replacement
desmopressin (synthetic vasopressin)
addisons
adrenocortical insufficiency
adrenal suppression by exogenous steroid use
addisons s&s
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
Addisonian crisis
profound fatigue
dehydration
vascular collapse (hypotension)
renal shutdown
decreased serum sodium
increased serum potassium
addisons diagnosis tests
adrenocortical hormone levels
acth levels (Adrenocorticotropic hormone anterior pituitary)
acth stimumlation test
addisons assessment
not any illness or stressors that may precipitate problems
fluid and electrolyte status
vital signs and orthostatics
weight changes muscle weakness fatigue
medications
addisons interventions
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
cushings
excessive adrenocortical or corticosteroid medications
cushings s&s
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!
cushings diagnostic test
dexamethasone suppression test
cushings assessment
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
corticosteroid theapy
suppress inflammation and autoimmune response
control allergic reactions
reduce transplant rejection
medications
take as prescribed don’t taper or DC abruptly
overactive sympathetic system s&s
heart rhythm issues (arrythmias)
constipation
dizziness or passing out when standing up
eyelid droop (ptosis)
fast heart rate at rest
sexual dysfunction
overactive parasympathetic system s&s
constipation
fast heart rate at rest
heart rhythm issues (a fib)
sexual dysfunction
trouble digesting food including gastroparesis
surgery for hyperthyroidism
subtotal thyroidectomy- treatment of choice for thyroid cancer
modified or radical neck dissection
post op care for hyperparathyroidism
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
pituitary tumor treatment
surgery (craniotomy, transsphenoidal) to remove without radiation
drug therapy to stop the tumor from making hormones
chemoh
adrenal crisis signs and symptoms
profound fatigue
dehydration
vascular collapse
renal shutdown
hyponatremia
hyperkalemia
