Endocrine

Question 0

Hyperthyroidism medical Tx

3 types

Answer 0

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

Question 1

Calcitonin function

Answer 1

Released by thyroid gland
Puts Ca+ into bones.
Requires iodine

Question 2

Thyroidectomy

Answer 2

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.

Question 3

Hyperparathyroidism

Answer 3

Equals HYPERcalcemia, HYPOphosphatemia.

Sedation

Question 4

Pheochromocytoma-

Dx

Answer 4

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

Question 5

Adrenal cortex-

3 hormones

Answer 5

Glucocorticoids
Mineralcorticoids
Sex hormones

Question 6

Adrenal cortex-

Glucocorticoids

Answer 6

Acute mood changes
Immunosuppression
Breaks down fats and protiens

Question 7

Adrenal cortex-

Mineralcorticoids

Answer 7

Aldosterone- fluid management. Causes retention of Na+ and H2O loss of K+.

Question 8

Adrenal cortex-

Complications

Answer 8

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+.

Question 9

Patho of DMI

Answer 9

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.

Question 10

Gestational Diabetes-

Complications for baby

Answer 10

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.

Question 11

Oral hypoglycemics-

Action

Answer 11

Stimulate pancreas to make more insulin
Decreases glucogenesis in liver
Increase insulin receptivity in tissues

Question 12

Insulin types

Answer 12

Regular- clear
NPH- time released. Particles make it cloudy.
Clear, then cloudy

Question 13

Glucagon

Answer 13

Long acting. Lasts the day, but need to use short acting at meals for that food bolus.
Snacks are not required.

Question 14

A1C levels?

Answer 14

4-6%

>6.5% = diabetes

Question 15

Illness and diabetes-

Answer 15

Illness is an added stress, which can cause glucose levels to increase, with insulin deficient people, this will lead to DKA.

Question 16

A pt. With DM is unconscious, do you treat them for hypo or hyperglycemia?

Answer 16

Hypoglycemia

D50W or injectable glucagon

Question 17

Hypoglycemia
Sx
Tx

Answer 17

Cold/clammy, shaky, nervous, <70 bs

Eat, when BG is up, then eat complex carbs.

Question 18

DKA
Sx
Tx

Answer 18

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+.

Question 19

HHNK

Answer 19

DMII only!

NO acidosis, due to the body having just enough insulin to avoid breaking down fats, so no keytones.

Question 20

Diabetes and vascular damage

Answer 20

Sugar is large and damages the bloodvessels–>decrease the size of the lumen–>HTN, retinopathy, neuropathy.

Question 21

Addison’s

Answer 21

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

Question 22

Cushing’s

Answer 22

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,

Question 23

Aldosterone

Answer 23

Produced by adrenal cortex.
Retains H2O and Na+
Lose K+

Question 24

Diabetes Insipidus

Answer 24

Not enough ADH, or kidneys fail to respond to it.

Pituitary problems.

Question 25

Parathyroid function

Answer 25

Releases parathyroid hormone, pulling Ca+ from the bones into the blood

Question 26

Parathyroid hormone function

Answer 26

Pulls Ca+ out of bones into serum.