Endocrine 2

Question 1

broadly describe radioactive iodine therapy

Answer 1

given for hyperthyroid pt
typically given 1 dose (orally)
destroys thyroid cells
WILL cause hypothyroidism (this is expected)

Question 2

education for radioactive iodine therapy

Answer 2

taken at home
radioactive precautions
stay away from babies for a wek

Question 3

what is important to watch for during radioactive iodine therapy

Answer 3

THYROID STORM

Question 4

describe thyroid storm

Answer 4

aka thyrotoxic crisis
*hyperthyroidism multiplied by 100
give them beta blocker and antithyroid
essentially, if a little piece of thyroid is left, it will over produce TH (rebound effect)

Question 5

what are the symptoms of thyroid storm

Answer 5

same as hyperthyroid just magnified

cardiac, fever, hypertension, V/D/N, abdominal pain, anxiety/tremors

Question 6

describe thyroidectomy

Answer 6

leaves enough gland to produce TH
done if hyperthyroidism
total removal=cancer of thyroid
subtotal removal=thyroid is pressing on trachea

Question 7

pre op care of thyroidectomy

Answer 7

decrease function of thyroid
give PU
antithyroid meds to decrease risk of hemorrhage

Question 8

post op care thyroidectomy

Answer 8

• semi fowlers
• support head and neck
• assess hoarseness
• assess pressure at neck
• risk for respiratory distress
• tetany (Ca deficiency)
• elevated head of bed to prevent edema

Question 9

what is most important to watch for in post op thyroidectomy

Answer 9

high risk for HEMORRAHGE

check for bleeding BEHIND head and neck line

Question 10

what does increased hoarseness indicate after thyroidectomy

Answer 10

laryngeal nerve damage

Question 11

why do you check for bleeding behind the head

Answer 11

that is where pooling of blood occurs

bruising**

Question 12

this is one of the most common disorders in the US

Answer 12

hypothyroidism

Question 13

describe hypothyroidism

Answer 13

caused by removal of thyroid gland most often
affects women>men
can be the effect of the antithyroid drug

Question 14

what are the common associations with hypothyroidism

Answer 14

depression

decreased metabolic rate (decreased energy!)

Question 15

removal of a few parathyroids with thyroidectomy will cause…

Answer 15

decreased Ca production
hypocalcemia (assess for signs)
tetany(rigid tight muscles)

Question 16

signs of increased versus decreased Ca

Answer 16

increased= sedated

decreased=less sedated

Question 17

manifestations of hypothyroidism

Answer 17

sleepiness/fatigue
weakness
constipation
cold intolerance
decrease libido
depression
anorexia
amenorea

Question 18

appearance of hypothyroidism

Answer 18

increased wt gain
edema/blank expression
slow movement
coarse features
myxedema
decreased energy and appetite

Question 19

general puffiness, tongue profusion

Answer 19

myxedema

Question 20

lab diagnosis of hypothyroidism

Answer 20

decreased T3 and T4
increased TSH levels
*opposite of hyperthyroidism

Question 21

treatment of hypothyroidism

Answer 21

Levothyroxine (synthoid)

Liothyronine (Cytomel)

Question 22

Levothyroxine (synthoid)

Answer 22

thyroid hormone

force body to turn T4 into T3

Question 23

Liothyronine (Cytomel)

Answer 23

thyroid hormone

gives body T3

Question 24

what are the precautions for thyroid hormone meds

Answer 24

take on empty stomach
start on low dowse, gradually increase
DO NOT want too much pressure on heart (can cause MI)

Question 25

what do you monitor for if on thyroid meds

Answer 25

bruising and bleeding

monitor for coronary insufficiency, chest pain, dyspnea and tachy

Question 26

thyroid pts tend to have _____ d/t _____

Answer 26

Coronary artery disease

increased LDL

Question 27

if on thyroid meds for hypothyroidism…

Answer 27

you will take meds for rest of life

Question 28

describe the function of the adrenal medulla

Answer 28

middle
secretes epi and norepi and catecholamines
helps handle stress

Question 29

hyperstimulation of adrenal medulla caused by ____

Answer 29

tumor (benign, familial)

excessive secretion of catecholamines

Question 30

s/s of hyperstimulation of adrenal medulla

Answer 30

increased BP
increased HR
palpitations
flushed
intermittent side effects

Question 31

lab diagnosis of adrenal medulla hyper stimulation

Answer 31

increased catecholamine levels (epi and norepi)

vanillymadelic (VMA) test-tells if epi/norepi are elevated

Question 32

education for VMA

Answer 32

avoid vanilla for 1 wk
obtained via 24 hr urine sample (look for epi throughout day, not just one sample)
avoid stressful things and smoking

Question 33

treatment for hyper stimulation of adrenal medulla

Answer 33

surgery (remove tumor)
after surgery assess BP
common in women 40-60

Question 34

what are the hormones of the adrenal cortex

Answer 34

SSS (stress, salt, sex) steroids
glucocorticoids, mineralocorticoids, sex hormones
*all have different side effects

Question 35

what do steroids suppress

Answer 35

immune system and inflammatory response

good for arthritis

Question 36

kids on steroids…

Answer 36

may not grow correctly due to the decreased protein

Question 37

action of glucocorticoids

Answer 37

change in mood (unexplainably loopy)
altered defense mechanism (increased risk of infection)
breakdown fats and proteins (provide energy)
inhibit insulin (regulate glucose levels and increase BS

Question 38

why are steroids given

Answer 38

to decrease inflammation

Question 39

what needs to be monitored with glucocorticoids

Answer 39

blood glucose monitoring

Question 40

these diseases are dysfunctions with glucocorticoids and mineralocorticoids

Answer 40

Addison’s and Cushings