Endocrine

Question 0

How should the HOB be elevated for the pt who just underwent a transsphenoidal hypophysectomy?

Answer 0

Elevated the HOB at 30° AT ALL TIMES

Question 1

Best hope for a cure for Acromegaly

Answer 1

Transsphenoidal hypophysectomy

Question 2

Assessment for neurological functions

Answer 2

Pupillary response, speech patterns, extremity movement

Question 3

Why should the nurse check for glucose in any clear nasal drainage?

Answer 3

This can indicate CSF drainage- surgeon should be notified immediately

Question 4

Other nursing responsibilities for pt post op trans. Hypo.sectomy

Answer 4

• mouthcare q4hrs
• avoid tooth brushing
• lifelong hormone replacement
• annual colonoscopies
• avoidance of vigorous coughing, sneezing, valsalva
• report persistent headache, supra orbital headache

Question 5

Main clinical manifestation of SIADH

Answer 5

LOW urine output!!!

• very concentrated urine
• dilute blood

Question 6

Management of pt with SIADH

Answer 6

• Restrict fluids to about 800-1000cc/day
• if feeling thirsty? Give ice chips/ hard candy

**use of HYPERtonic solutions**

Question 7

Clinical manifestations of Diabetes Incipidus

Answer 7

LARGE AMOUNTS of urine output

• VERY DILUTE urine (20L day)
• CONCENTRATED blood

Question 8

Components of a Water Deprivation Test

Answer 8

1. Pt is weighed, urine osmolality, volume and specific gravity are measured
2. Pt cannot drink 8-12 hours
3. DESMOPRESSIN is administered
4. Subsequent measurement of weight, urine osmolality, volume and specific gravity are monitored

Question 9

4 mgmt strategies for HYPERthyroidism?

Answer 9

1. Drug therapy
2. Radioactive iodine solution
3. Surgery- removal
4. Nutritional therapy

Question 10

Post-op interventions for pt who underwent removal of thyroid

Answer 10

• assess for s/s of HYPOthyroidism
• educate on need for hormone replacement
• ASSESS CALCIUM LEVELS- accidental removal of the PARATHYROID
  - trousseaus and choseks

Question 11

Indications for radioactive iodine

Answer 11

Non-pregnant adults

Question 12

Goals of care for pt with hypothyroidism

Answer 12

• return hormone levels to natural euthyroid stat
• drug therapy
• nutritional therapy with low cals

Question 13

Cushing disease mgmt is based on the cause, either ______ or _____

Answer 13

Tumor or prolonged corticosteroid administration

Question 14

Mgmt for Cushings related to prolonged corticosteroid administration

Answer 14

• NEVER ABRUPTLY D/C
• gradual d/c thru reduction in DOSE
• conversion to alternate day-dose

Question 15

Post op mgmt of hypophysectomy and adrenalectomy

Answer 15

Steroid administration!!!

• VS, fluid and lytes balance
• **critical importance- 24-48 hours to assess I&O

Question 16

Goals of mgmt for Addison’s disease

Answer 16

Aimed at cause

Question 17

Home mgmt teaching and education for addisons

Answer 17

• Tolerance to physical and emotional stress
• ADDITIONAL administration of corticosteroids: fever, flu, dentist, extreme physical activity
• emergency dose kit at all times

Question 18

Effects of corticosteroids (4)

Answer 18

1. Anti inflammatory
2. Immunosuppressive
3. Maintenance of BP
4. Decreased carb and protein metabolism

Question 19

Pt teaching for addisons: diet high in…..

Answer 19

Sodium, protein, calcium, potassium

Question 20

Pt teaching: ensure pt gets enough_____ and avoids _____

Answer 20

Gets adequate sleep/rest and avoids stress