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NCLEX Mark K > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

Thyroid does…

A

Regulates metabolism

Tip.

When you see THYROIDISM think METABOLISM

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2
Q

Hyperthyroidism = Hypermetabolism

S / S Everything (Goes Up / Goes Down)

What disease is this associated with

A

Everything goes up (except weight)
High HR, BP, irritation, heat intolerance, cold tolerance, Exophthalmos (bulging eyes)

Graves disease

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3
Q

Graves disease (Hyperthyroidism)

(3) treatments

A

Radioactive Iodine

PTU (propylthiouracil) Puts Thyroid Under - Cancer Drug

Thyroidectomy (most common)

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4
Q

Radioactive Iodine treatment for Graves disease (Hyperthyroidism)

Has (2) precautions

A
  1. No visitors for 24 hrs
  2. Flush urine 3x
    If urine is spilled, call hazmat team
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5
Q

PTU for Graves Disease (Hyperthyroidism) which lab do you monitor

A

WBC- it’s an immune suppressant

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6
Q

Most important question to ask regarding Thyroidectomy

A

Is it Total (complete) or Subtotal (partial

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7
Q

Total Thyroidectomy
Risks

Subtotal
Risk

A

Life long hormone replacement

At risk Hypocalcemia
(Parathyroid controls Ca level -> Positive Trousseau & Chvostek)

Subtotal
Hormone replacement not needed
Risk for: Thyroid Storm / Crisis Thyroid storm

heart rate, blood pressure, and body temperature can soar to dangerously high levels.

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8
Q

Name the 4 S & S that correlate with a Thyroid Storm (SubTotal Thyroidectomy)

A

Super high Temps >105
Extremely High BP 210/ 180 (Stroke)
Severe Tachycardia 180 - 200
Psychotic Delirium- can cause brain damage while frying brain to death

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9
Q

Super high Temps >105
Extremely High BP 210/ 180 (Stroke)
Severe Tachycardia 180 - 200
Psychotic Delirium- can cause brain damage while frying brain to death

Thyroid Storm

What are the Interventions

Immediate intervention

(Reduce Temperature) how?
First way
Best way

Type of medication not to use

Oxygen at

When do you leave patient

A

Immediate; Temp down & Oxygen up

First way: Ice Packs
Best way: Cooling Blanket

Don’t use Tylenol- won’t work due to it affects the Hypothalamus

Oxygen @ 10L

Never, ever leave Patient

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10
Q

When treating a thyroid storm your priority is to Reduce Body Temp & Increase Oxygen

Put these interventions in order of which you do first

Ice pack
Oxygen
Cooling Blanket

A

Oxygen
Ice pack
Cooling Blanket

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11
Q

Post op risk: Thyroidectomy

1st 12 hours: priority =

A

Airway & hemorrhage

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12
Q

Post op Risk Thyroidectomy

12 - 48 hrs after Total & SUBTOTAL

A

Total: Tetany (muscular spasms in larynx, can cut off airway Due to Low Calcium)

Subtotal: Thyroid Storm
Releases large amount of Thyroid Hormone

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13
Q

Post op Risk Thyroidectomy

> 48 hours

A

Infection

Tip
Never choose Infection as a Priority in the first 72 hours for anything

Only chose it AFTER 72 HRS

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14
Q

Tetany vs Tinnitus

A

Tetany

symptom Involuntary muscle contractions and overstimulatedperipheral nerves

It’s usually caused bylow blood calciumlevels

Tinnitus = Ringing in the ears

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15
Q

Hypothyroidism / Hypometabolism

S/S
Skinny / fat
Cold / hot
BP / HR

Treatment

A

Fat
Cold
Low BP / HR = Myxedema

Treatment; Synthroid (levothyroxine)

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16
Q

Hypothyroidism / Hypometabolism

Sedation medication can have this affect on them.

Would you question am ambien HS before surgery?

If paitent is NPO what precaution would you take

A

Put them in a coma

Yes, this can put them in a coma

NPO, call Dr and confirm that they don’t need their Synthroid

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17
Q

Never hold what pill before surgery without Expressed orders to do so

A

Synthroid

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18
Q

Adrenocortex disease

A

Cushing, Conns, Addisons

All start with A / C

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19
Q

Addisons is (under / over) secretion of adrenal cortex

A

Under

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20
Q

S / S

Hyperpigmented (Tan)

No stress response (Get put into shock)

A

Addisons

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21
Q

Body responses to stress

Glucose & BP

A

Glucose Raises
BP Raises

22
Q

Treatment for Addisons

A

Glucocortidicoids
Steroids; all end in “sone” ex: prednisone dexamethasone& hydrocortisone

TIP.

Addisons = ADD a SONE

23
Q

Addisons disease is

(Over / Under) secretion of cortisol & sometimes aldostrone

Treatment (Add / Take Away) Cortisol/ Aldostrone

A

Under secretion of cortisol & sometimes aldostrone

Add

24
Q

Crushings syndrome
( Depletion/ Excess) of cortical steroids production

S & S (Same as side effects of Steroid Medications)

A

S & S
Moon face (Puffy face & Neck)
Beard (Hirsutism)
Big Body (Certal Obesity)
Retains Sodium & Water (Loses K)
Straie (Stretch Marks)
HIGH GLUCOSE
Bruises
“IM Mad I have an Infection”

25
Q

Cushings
Over production of Cortisol

Treatment

A

Adrenalectomy

26
Q

Children’s Toy / Play Activy

  1. Is it safe (3)
  2. Age appropriate
  3. Feasible
A

1.
No small toys under 4
No metal (die-cast)toys if oxygen is in use
Beware of fomites
Which are safer (Teddy bears or GI joes) - Gi Joe’s, can be clean

27
Q

Children’s Toy / Play Activy

Age appropriate

0 - 6 months:

A

Musical Mobile or Soft & Large

28
Q

Age appropriate toy for

6 - 9 months:

A

Cover uncover toy/ Large Harder( Plastic, Wood, Metal)

29
Q

Age appropriate

Object Perminamce (ability to know an object is there when they can’t see it. Ie. Object is hidden under a blanket)

A

6 - 9 months

30
Q

Age Appropriate

9 - 12 Months

A

Vocalization
Talking Toys. See & Say, Pull String

31
Q

Never pick answers with the following words in them in the child is under ___ months

(Build, Sort, Stack, Make, Construct)

A

9

(Build, Sort, Stack, Make, Construct)
9 months is when they start purposeful play

32
Q

Age appropriate

1 - 3 year old

A

Push / Toys
Wagon, Stroller, Lawn Mower

33
Q

Do Toddlers have finger dexterity ie. Use of scissors, color pencils, crayons

A

No

34
Q

Parallel Play play along side but not with

Which age group

A

Toddlers

35
Q

Preschoolers Work on these skills

Which type of play style

A

Fine motor / balance.

Characterized by Cooperative play. Pretend Play

36
Q

School Age type of play

A

Creative: Allow them to create
Collective:
Competitive:

37
Q

Adolescentes: Type of “Play”

A

Peer Group Association

38
Q

LamenLaminectomy is

Why is it done?

A

Remove part or all of the vertebral bone (lamina).

Ease pressure on the spinal cord or the nerve roots

Caused by injury, herniated disk, narrowing of the canal (spinal stenosis), or tumors.

39
Q

S & S of nerve route compression

(3)

A

Pain
Paresthesia
paresis

40
Q

Most important part of any Neuro question

A

Location

Cervical Neck
Thoracic Upper Back
Lumbar Lower Back

41
Q

What is the most important pre-op assessment for a Cervical Lamenectomy?

A

1.Breathing
2. Arm & Hand function

Cervical Intervates Diaphragm & Arms

42
Q

What is the most important pre-op assessment for a Thoracic Lamenectomy?

A
  1. Assess Cough
  2. Bowel function
43
Q

What is the most important pre-op assessment for a Lumbar Lamenectomy?

A

When was the last time they voided
Function of Legs

Intervates Bladder & Legs

44
Q

1 post op answer after Lamenectomy is…

A

Log roll

45
Q

3 rules for post op Spine Surgery

A
  1. Don’t dangle (Onside of bed) keep it minimal.
  2. Don’t sit for longer than 30 mins
  3. They may walk, stand, lay down without restrictions
46
Q

Post op Complications for Cervical Lamenectomy

A
  1. Pneumonia
47
Q

Post op Complications for Thoracic Lamenectomy

A
  1. Pneumonia
  2. Bowles don’t work
48
Q

Post op Complications for Lumbar Lamenectomy

A

Urinary retention
Leg problems

49
Q

Which Lamenectomy will have a chest tube

A

Anterior thoracic

50
Q

Lamenectomy with Fusion taking a bone graft from ____

A

Illiac crest

51
Q

Lamenectomy with Fusion will have 2 incision points which will

hurt more
Blood more
Reject more

A

The Illiac crest / Hip
Illiac crest
Spine

52
Q

Discharge teaching Lamenectomy
4 Temp
3 Perm Restrictions

A
  1. No sitting longer 30 mins. (6 weeks)
  2. Lie flat and log roll for (6 weeks)
  3. No driving for (6 weeks)
  4. Don’t lift over 5 lbs (6 weeks)

Perm
1. Can’t lift by bend at waist. Lift with knee
2. Cervical lams cannot lift anything over head
3. No mountain biking, circus rides, cosas asi

NCLEX Mark K (9 decks)

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