Endocrine Flashcards
Hyperthyroidism medical Tx
3 types
Propylthiouracil:
Stops thyroid form making T3
Used Preoperational oto stun thyroid
Iodine compounds:
Gastric upset, give with milk/food. Stains teeth, everything
Radioactive iodine:
Cannot kiss anyone for 24 hours and stay away from a babies for 24 hours
1 dose only
Calcitonin function
Released by thyroid gland
Puts Ca+ into bones.
Requires iodine
Thyroidectomy
HOB elevated, support neck
Bleeding worries
**Can lead to airway obstruction, keep trach handy. Watch for vocal chord paralysis
Parathyroid scan be taken out, worry about hypocalcemia.
Hyperparathyroidism
Equals HYPERcalcemia, HYPOphosphatemia.
Sedation
Pheochromocytoma-
Dx
Tumors that produce epi/norepi
Increased BP, HR, Pulse.
Flushed, diaphoretic
Dx-
Vanillylmandelic acid test- 24 hour urine collection to look for epi/norepi.
With any 24 hour collection, throw out first void, keep last
Adrenal cortex-
3 hormones
Glucocorticoids
Mineralcorticoids
Sex hormones
Adrenal cortex-
Glucocorticoids
Acute mood changes
Immunosuppression
Breaks down fats and protiens
Adrenal cortex-
Mineralcorticoids
Aldosterone- fluid management. Causes retention of Na+ and H2O loss of K+.
Adrenal cortex-
Complications
Addison’s - not enough adrenal hormones.
Lose Na+ and H2O, retain K+, fluid loss
Tx- add Na+ to diet! I/O/daily weight (fluid loss), fludrocortisone (nurse can increase or hold if weight is out of 2-3 lb of normal weight.
Cushings- Too many adrenal hormones. Too much aldosterone=HYPOkalemia. Tx= adrenalectomy. to prep for this, prepare for loss of all those adrenal hormones- increase protien, K+, Ca+, decrease Na+.
Patho of DMI
No insulin means glucose builds up in vascular space–>hypertonic blood–>kidneys push out extra glucose and fluids(polydipsia/uria)–> cells starve and begin to break down fats/protiens–> keytones build up–> metabolic acidosis.
Gestational Diabetes-
Complications for baby
Hypoglycemia undue to baby having to compensate for mom’s huge glucose level. Baby produces more insulin which then isn’t needed directly after birth.
Oral hypoglycemics-
Action
Stimulate pancreas to make more insulin
Decreases glucogenesis in liver
Increase insulin receptivity in tissues
Insulin types
Regular- clear
NPH- time released. Particles make it cloudy.
Clear, then cloudy
Glucagon
Long acting. Lasts the day, but need to use short acting at meals for that food bolus.
Snacks are not required.
A1C levels?
4-6%
>6.5% = diabetes
Illness and diabetes-
Illness is an added stress, which can cause glucose levels to increase, with insulin deficient people, this will lead to DKA.
A pt. With DM is unconscious, do you treat them for hypo or hyperglycemia?
Hypoglycemia
D50W or injectable glucagon
Hypoglycemia
Sx
Tx
Cold/clammy, shaky, nervous, <70 bs
Eat, when BG is up, then eat complex carbs.
DKA
Sx
Tx
From hyperglycemia, DMI only!
Sx:
3 Ps
Kussmal’s to counteract the acidosis
Tx:
Insulin
NS until BS is around 100, then D5W to avoid hypoglycemia because they are still getting insulin.
Likely to add K+ at some point due to insulin pushing it out K+.
HHNK
DMII only!
NO acidosis, due to the body having just enough insulin to avoid breaking down fats, so no keytones.
Diabetes and vascular damage
Sugar is large and damages the bloodvessels–>decrease the size of the lumen–>HTN, retinopathy, neuropathy.
Addison’s
Not enough adrenal hormones.
Lose Na+ and H2O, retain K+, fluid loss
Tx- add Na+ to diet! I/O/daily weight (fluid loss), fludrocortisone (nurse can increase or hold if weight is out of 2-3 lb of normal weight
Cushing’s
Too many adrenal hormones. Too much aldosterone=HYPOkalemia. Tx= adrenalectomy. to prep for this, prepare for loss of all those adrenal hormones- increase protien, K+, Ca+, decrease Na+.
Too much cortisol- hyperglycemia, liver,
Aldosterone
Produced by adrenal cortex.
Retains H2O and Na+
Lose K+
Diabetes Insipidus
Not enough ADH, or kidneys fail to respond to it.
Pituitary problems.
Parathyroid function
Releases parathyroid hormone, pulling Ca+ from the bones into the blood
Parathyroid hormone function
Pulls Ca+ out of bones into serum.
