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NCLEX > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

Aldosterone does what?

A

Makes you retain sodium and water

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2
Q

ADH does what?

A

Makes you retain water

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3
Q

What two diseases are too much aldosterone?

A

Cushings and hyperaldosteronism

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4
Q

What disease is too little aldosterone

A

Addisons

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5
Q

What disease is too much ADH

A

SIADH

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6
Q

What disease is no enough ADH

A

Diabetes Insipidus

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7
Q

Name 3 Thyroid hormones

A

T3, T4 and calcitonin

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8
Q

What does calcitonin do?

A

It decreases serum calcium levels by taking it out of the blood and pushing it back into the bone

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9
Q

What do we need to make thyroid hormones?

A

Dietary Iodine

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10
Q

Thyroid scan patient teaching…..

A

Discontinue any iodine containing medications 1 week prior to the thyroid scan

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11
Q

Treatment for Hyperthyroidism

A

PTU and methimazole (tapazole); they stop thyroid from making hormones and its used preop to stun the thyroid, We want the client to become; Iodine compounds; beta blockers, radioactive; thyroidectomy

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12
Q

why give iodine compounds to hyperthyroidism

A

decrease the size and vascularity of the gland; give it in milk or juice and use a straw.

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13
Q

Why give beta blockers to hyperthyroid patient

A

to decrease BP, HR and to decrease anxiety.

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14
Q

How do beta blockers work

A

They block the release of epinephrine and norepinephrine

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15
Q

How do you give radioactive iodine

A

Given to hyperthyroid patient. 1 dose ,PO liquid or tablet form, rule out pregnancy first; hypothyroidism is EXPECTED because it destroys thyroid cells. Stay away from babies for 24 hrs; Dont kiss anyone for 24 hrs. Watch for thryoid storm.

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16
Q

Post thyroidectomy nursing care

A

Put personal items close, elevate HOB, check for bleeding behind neck, need more calories pre and postop, assess for laryngeal nerve damage (hoarse, weak voice, eeeee sound), trach at bedside, report any complaints of pressure (assume worst!!)m hypocalcemia; watch swelling, vocal cord paralysis;

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17
Q

Hypothyroidism at birth…

A

cretinism

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18
Q

Treatment for hypothyroidism

A

Levothyroxine (synthroid), thyroglobulin (Proloid), liothyronine (cytomel), take meds forever, tend to have CAD

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19
Q

What does PTH do?

A

Pulls calcium from the bone and places it in the bone, therefore the calcium level goes up.

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20
Q

Too much parathormone….

A

Serum calcium high

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21
Q

What do you monitor post partial parathyroidectomy

A

Monitor for hypocalcemia (be scared the calcium levels drop too low)….watch for tetany, rigid, tight, trosseaus.

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22
Q

Treatment for hypoparathyroidism

A

IV Calcium and phosphate binding drugs like renagel, phoslo or oscal. they bind phosphorus to decrease phosporus and the serum calcium goes up

23
Q

What does adrenal medulla secrete

A

Epinephrine and norepinephrine

24
Q

What is pheochromocytoma

A

Benign tumor that secretes epi and norepi in boluses

25
Q

Diagnose pheochromocytoma

A

VMA (vanillylmandelic acid) test: 24 hr urine specimed done to look for increased levels or epi and norepi. Anything with vanilla in it can cause false highs on test so no vanilla before test for 1 week. Need a calm and stress free enviro when taking test. Throw away first voiding and keep the last voiding.

26
Q

What does adrenal cortex release

A

Steroids (Glucocorticoids, mineralcorticoids, and sex hormones).

27
Q

Glucocorticoids do what 4 things?

A

Change your mood (insomia, depresssed, psychotic, euphoric); alter defense mechanisms (immunosuppression); breakdown fats and proteins (children don’t grow quickly); Inhibits insulin (hyperglycemic so do glucose monitoring).

28
Q

Name the mineralcorticoid & what does it do

A

Aldosterone, retain Na and water, makes you lose K

29
Q

Too much aldosterone means what for K

A

decreased K

30
Q

What is addisons disease

A

Not enough steroids, think shock and high potassium, Low Na, Low water

31
Q

S/sx of addisons disease

A

Initially s/sx are result of hyperkalemia; anorexia, hyperpigmentation, decreased bowel sounds, GI upset, white patchy areas of skin (viltiligo), hypotension, decreased Na, high K, and hypoglycemia

32
Q

Treatment for addisons

A

Increase Na in diet, I&O, daily weights, fluid volume deficit, Give aldosterone fludrocortisone (Florinef), processed fruit juice/broth. Keep the weight within 2-3 lbs of their normal weight. You adjust the meds based on weight. Not on meds the rest of life. Never stop taking steroids abruptly, taper them off. Suddenly stopping can cause addisonian crisis

33
Q

S/sx of cushings disease

A

moon face, buffalo hump, growth arrest, skinny arms and legs, hyperglycemia, psychosis to depression, truncal obesity, oily skin/acne, women with male traits, poor sex drive, high blood pressure, CHF, weight gain, FVE, serum K low, cortisol level high on 24 hr urine

34
Q

Treatment for cushings

A

Diet: increase K, decrease Na, increase protein, increase Calcium; adrenalectomy; avoid infections, quiet environment,

35
Q

How do steroids effect calcium levels

A

They decrease serum calcium levels by excreting it through GI tract. So it can make bones brittle and cause osteoporosis from pulling calcium from bone and putting into blood

36
Q

What can appear in urine of cushing patient

A

glucose bc steroids make BS go up and the kidneys get rid of it; Ketones will also appear bc client is breaking down body fat.

37
Q

Normal Blood glucose level

A

70-110

38
Q

First sign of type 1 DM

A

DKA, appears abruptly

39
Q

Difference between type 1 DM and type 2….

A

not breaking down fats to ketones in type 2.

40
Q

Features of metabolic syndrome

A

insulin resistance, abdominal obestiy, increased triglycerides, decreased HDL, increased BP, and CAD.

41
Q

Screen moms for gestational diabetes when?

A

screen all moms at 24-28 weeks; for risk factors, screen at 1st prental visit.

42
Q

Gestational DM complication to baby…

A

increased BW and hypoglycemia

43
Q

How do oral hypoglycemics work?

A

They stimulate pancreas to make insulin; work to decrease the amount of circulating glucose

44
Q

How is insulin determined and given

A

based on body weight and average dose is 0.4-1.0units/kg/day. Adjusted until the glucose is normal and until there is no more glucose or ketones in urine

45
Q

Rapid acting onset, peak and duration (n

A

Onset 15 min, Peak 1-3 hrs, D-3-5 hrs; never give without food at bedside

46
Q

Regular insulin (hum R, Novolin R)

A

Onset 30 min, peak 2-4, duration 6-8 hrs; only one can give IV

47
Q

NPH (intermediate acting) (Novolin N, Humulin N)

A

Onset is 1.5 hrs, peak 4-12 hr, duration 16-24hrs. It is cloudy insulin.

48
Q

Long acting (Lantus)

A

Onset 2-4 hrs, NO Peak, Duration 24hrs. Dont mix with any other insulin.

49
Q

Name 3 drugs you do not aspirate with

A

Insulin, heparin, lovenox

50
Q

S/sx of hypoglycemia

A

cold, clammy, confused, shaky, headache, nervous, nausea, increased pulse

51
Q

Treatment for DKA

A

Treat cause, hourly blood sugar and K+ levels. (IV insulin can cause hypoglycemia and hypokalemia), EKG, hourly outputs, ABGS, IVF–> start with NS then when get to 300 switch to D5W to prevent throwing into hypoglycemia. Use 2 large bore IV, 1 in each arm. Anticipate the MD will want to add K to the IV solution at some point.

52
Q

What is neurogenic bladder

A

No bladder tone; the bladder doesn’t empty properly, incontinence or retention.

53
Q

What is gastroparesis

A

stomach emptying is delayed; risk of aspiration

NCLEX (10 decks)

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