Endocrine Flashcards

1
Q

What 3 hormones are secreted by the thyroid gland?

A
  • Thyroxine (T4)
  • Triiodothyronine (T3)
  • Calcitonin
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2
Q

Thyroxine (T4) is converted to ______ peripherally

A

Triiodothyronine (T3)

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3
Q

The thyroid gland is responsible for ______

A

BMR

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4
Q

Are the following manifestations of hypothyroidism or hyperthyroidism?

  • Bradycardia
  • Constipation
  • Weight gain
A

Hypothyroidism

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5
Q

What are the manifestations of hypothyroidism? (3)

A
  • Facial edema
  • Fatigue
  • Intolerance to cold
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6
Q

Patients with hypothyroidism are lacking ______

A

T3 and T4

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7
Q

Describe the mechanism of action of synthroid (3)

A
  • Increases metabolic rate –> converts T4 to T3
  • Increases catecholamine sensitivity –> increases cardiac output
  • Increases renal blood flow / GFR –> diuretic effect
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8
Q

What are the side effects of synthroid? (2)

A
  • Diaphoresis
  • Weight loss
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9
Q

What are the adverse effects of synthroid? (2)

A
  • Osteoporosis
  • Seizures
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10
Q

Tube feedings ______ absorption of synthroid

A

Decrease

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11
Q

Describe the nursing considerations of synthroid (2)

A
  • Long half-life - single dose per day
  • Stop tube feed before and after administration
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12
Q

Describe the administration of synthroid (3)

A
  • In the morning
  • 30 - 60 minutes prior to food
  • With full glass of water
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13
Q

When does the maximum therapeutic effect of synthroid occur?

A

4 - 6 weeks

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14
Q

What are the routes of synthroid? (2)

A
  • PO
  • IV
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15
Q

IV synthroid is rarely used and should be ______ of oral dose

A

50%

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16
Q

Are the following manifestations of hypothyroidism or hyperthyroidism?

  • Tachycardia
  • Diarrhea
  • Weight loss
A

Hyperthyroidism

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17
Q

What are the manifestations of hyperthyroidism? (4)

A
  • Bulging eyes
  • Facial flushing
  • Finger clubbing
  • Intolerance to heat
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18
Q

Describe the treatment of hyperthyroidism (3)

A
  • Destruction of thyroid gland
  • Thyroidectomy
  • Antithyroid drugs
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19
Q

What are some examples of antithyroid drugs? (3)

A
  • Tapazole
  • PTU
  • Iodine-131
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20
Q

Describe the mechanism of action of tapazole

A

Inhibits synthesis of T3 / T4

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21
Q

Tapazole cannot inactivate already formed ______

A

Thyroid hormone

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22
Q

What is the primary side effect of tapazole?

A

Agranulocytosis

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23
Q

Describe the nursing considerations of tapazole (2)

A
  • Not safe during pregnancy / lactation
  • Monitor CBC - pancytopenia (low platelets)
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24
Q

When does the maximum therapeutic effect of tapazole occur?

A

12 weeks

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25
Q

Describe the mechanism of action of PTU

A

Inhibits synthesis of T3 / T4

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26
Q

What is the primary concern of PTU?

A

Liver function

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27
Q

Describe the primary nursing consideration of PTU

A

Requires multiple doses per day

28
Q

Describe the mechanism of action of iodine-131

A

Thyroid gland destruction

29
Q

Describe the nursing considerations of iodine-131 (2)

A
  • Not safe during pregnancy / lactation
  • Causes life-long hypothyroidism
30
Q

When does the maximum therapeutic effect of iodine-131 occur?

A

8 - 12 weeks

31
Q

Describe the nursing considerations of antithyroid medications (4)

A
  • Avoid food high in iodine
  • Better tolerated with food
  • Combine to maintain blood levels
  • Do not stop abruptly
32
Q

What is the primary adverse effect of thyroid drugs?

A

Dysrhythmias

33
Q

What is the primary adverse effect of anti-thyroid drugs?

A

Leukopenia

34
Q

______ is a growth hormone drug

A

Genotropin

35
Q

Genotropin targets the ______

A

Anterior pituitary

36
Q

What are the indications of genotropin? (2)

A
  • Hypopituitary dwarfism
  • Wasting / cachexia from HIV
37
Q

What are the routes of genotropin? (2)

A
  • SQ
  • IM
38
Q

Genotropin dosing is ______

A

Weight based

39
Q

Describe the mechanism of action of desmopressin (DDAVP)

A

Mimics ADH —> retains water

40
Q

What are the indications of desmopressin (DDAVP)? (3)

A
  • Acute bleeding disorders
  • Diabetes insipidus
  • Nocturnal enuresis
41
Q

What are the side effects of desmopressin (DDAVP)? (2)

A
  • Hyponatremia
  • Water intoxication
42
Q

Describe the nursing implications of desmopressin (DDAVP) (2)

A
  • Daily weights
  • Monitor renal function
43
Q

Genotropin should increase ______ in children

A

Growth

44
Q

Desmopressin (DDVAP) should reduce ______ and decrease urinary output

A

Thirst

45
Q

Steroids differ in what factors related to sodium and fluid retention? (3)

A
  • Duration
  • Extent
  • Potency
46
Q

The primary purpose of corticosteroids is to …

A

Decrease inflammation

47
Q

Prednisone is an intermediate acting ______

A

Glucocorticoid

48
Q

______ is the most commonly used oral glucocorticoid for anti-inflammatory / immunosuppressant purposes

A

Prednisone

49
Q

What is prednisone used to treat?

A

Exacerbations of chronic respiratory illnesses

50
Q

Hydrocortisone is a short-acting ______

A

Glucocorticoid

51
Q

20 mg of hydrocortisone = ______ of prednisone

A

5 mg

52
Q

What is the primary side effect of hydrocortisone?

A

Sodium / water retention

53
Q

What is hydrocortisone used to treat?

A

Chronic adrenal insufficiency

54
Q

Which route of hydrocortisone has the lowest potency?

A

Topical

55
Q

______ is the most commonly used injectable glucocorticoid drug

A

Solu-medrol

56
Q

What is the route of solu-medrol?

A

IV

57
Q

Injectable formulations containing benzyl alcohol cannot be given to children under ______

A

28 days of age

58
Q

Describe the nursing considerations of corticosteroids (3)

A
  • Monitor for edema
  • Monitor electrolytes
  • Do not take with alcohol, aspirin, or NSAIDs
59
Q

Describe the administration of oral corticosteroids

A

Given with food

60
Q

What can occur as a result of sudden discontinuation of corticosteroid drugs?

A

Drop in serum levels / cortisone

61
Q

What are the routes of corticosteroids? (4)

A
  • PO
  • IV
  • IM
  • Rectal
62
Q

Fludrocortisone acetate is a ______

A

Mineralocorticoid

63
Q

Describe the mechanism of action of fludrocortisone acetate (2)

A
  • Sodium retention
  • Potassium excretion
64
Q

What is the primary indication of fludrocortisone acetate?

A

Adrenocortical insufficiency (Addison’s disease)

65
Q

What is the primary side effect of fludrocortisone acetate?

A

Hypokalemia - monitor cardiac changes (U waves)

66
Q

What are the adverse effects of fludrocortisone acetate? (2)

A
  • Intracranial pressure
  • Seizures