Endocrine Flashcards
What 3 hormones are secreted by the thyroid gland?
- Thyroxine (T4)
- Triiodothyronine (T3)
- Calcitonin
Thyroxine (T4) is converted to ______ peripherally
Triiodothyronine (T3)
The thyroid gland is responsible for ______
BMR
Are the following manifestations of hypothyroidism or hyperthyroidism?
- Bradycardia
- Constipation
- Weight gain
Hypothyroidism
What are the manifestations of hypothyroidism? (3)
- Facial edema
- Fatigue
- Intolerance to cold
Patients with hypothyroidism are lacking ______
T3 and T4
Describe the mechanism of action of synthroid (3)
- Increases metabolic rate –> converts T4 to T3
- Increases catecholamine sensitivity –> increases cardiac output
- Increases renal blood flow / GFR –> diuretic effect
What are the side effects of synthroid? (2)
- Diaphoresis
- Weight loss
What are the adverse effects of synthroid? (2)
- Osteoporosis
- Seizures
Tube feedings ______ absorption of synthroid
Decrease
Describe the nursing considerations of synthroid (2)
- Long half-life - single dose per day
- Stop tube feed before and after administration
Describe the administration of synthroid (3)
- In the morning
- 30 - 60 minutes prior to food
- With full glass of water
When does the maximum therapeutic effect of synthroid occur?
4 - 6 weeks
What are the routes of synthroid? (2)
- PO
- IV
IV synthroid is rarely used and should be ______ of oral dose
50%
Are the following manifestations of hypothyroidism or hyperthyroidism?
- Tachycardia
- Diarrhea
- Weight loss
Hyperthyroidism
What are the manifestations of hyperthyroidism? (4)
- Bulging eyes
- Facial flushing
- Finger clubbing
- Intolerance to heat
Describe the treatment of hyperthyroidism (3)
- Destruction of thyroid gland
- Thyroidectomy
- Antithyroid drugs
What are some examples of antithyroid drugs? (3)
- Tapazole
- PTU
- Iodine-131
Describe the mechanism of action of tapazole
Inhibits synthesis of T3 / T4
Tapazole cannot inactivate already formed ______
Thyroid hormone
What is the primary side effect of tapazole?
Agranulocytosis
Describe the nursing considerations of tapazole (2)
- Not safe during pregnancy / lactation
- Monitor CBC - pancytopenia (low platelets)
When does the maximum therapeutic effect of tapazole occur?
12 weeks
Describe the mechanism of action of PTU
Inhibits synthesis of T3 / T4
What is the primary concern of PTU?
Liver function
Describe the primary nursing consideration of PTU
Requires multiple doses per day
Describe the mechanism of action of iodine-131
Thyroid gland destruction
Describe the nursing considerations of iodine-131 (2)
- Not safe during pregnancy / lactation
- Causes life-long hypothyroidism
When does the maximum therapeutic effect of iodine-131 occur?
8 - 12 weeks
Describe the nursing considerations of antithyroid medications (4)
- Avoid food high in iodine
- Better tolerated with food
- Combine to maintain blood levels
- Do not stop abruptly
What is the primary adverse effect of thyroid drugs?
Dysrhythmias
What is the primary adverse effect of anti-thyroid drugs?
Leukopenia
______ is a growth hormone drug
Genotropin
Genotropin targets the ______
Anterior pituitary
What are the indications of genotropin? (2)
- Hypopituitary dwarfism
- Wasting / cachexia from HIV
What are the routes of genotropin? (2)
- SQ
- IM
Genotropin dosing is ______
Weight based
Describe the mechanism of action of desmopressin (DDAVP)
Mimics ADH —> retains water
What are the indications of desmopressin (DDAVP)? (3)
- Acute bleeding disorders
- Diabetes insipidus
- Nocturnal enuresis
What are the side effects of desmopressin (DDAVP)? (2)
- Hyponatremia
- Water intoxication
Describe the nursing implications of desmopressin (DDAVP) (2)
- Daily weights
- Monitor renal function
Genotropin should increase ______ in children
Growth
Desmopressin (DDVAP) should reduce ______ and decrease urinary output
Thirst
Steroids differ in what factors related to sodium and fluid retention? (3)
- Duration
- Extent
- Potency
The primary purpose of corticosteroids is to …
Decrease inflammation
Prednisone is an intermediate acting ______
Glucocorticoid
______ is the most commonly used oral glucocorticoid for anti-inflammatory / immunosuppressant purposes
Prednisone
What is prednisone used to treat?
Exacerbations of chronic respiratory illnesses
Hydrocortisone is a short-acting ______
Glucocorticoid
20 mg of hydrocortisone = ______ of prednisone
5 mg
What is the primary side effect of hydrocortisone?
Sodium / water retention
What is hydrocortisone used to treat?
Chronic adrenal insufficiency
Which route of hydrocortisone has the lowest potency?
Topical
______ is the most commonly used injectable glucocorticoid drug
Solu-medrol
What is the route of solu-medrol?
IV
Injectable formulations containing benzyl alcohol cannot be given to children under ______
28 days of age
Describe the nursing considerations of corticosteroids (3)
- Monitor for edema
- Monitor electrolytes
- Do not take with alcohol, aspirin, or NSAIDs
Describe the administration of oral corticosteroids
Given with food
What can occur as a result of sudden discontinuation of corticosteroid drugs?
Drop in serum levels / cortisone
What are the routes of corticosteroids? (4)
- PO
- IV
- IM
- Rectal
Fludrocortisone acetate is a ______
Mineralocorticoid
Describe the mechanism of action of fludrocortisone acetate (2)
- Sodium retention
- Potassium excretion
What is the primary indication of fludrocortisone acetate?
Adrenocortical insufficiency (Addison’s disease)
What is the primary side effect of fludrocortisone acetate?
Hypokalemia - monitor cardiac changes (U waves)
What are the adverse effects of fludrocortisone acetate? (2)
- Intracranial pressure
- Seizures
