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Med Surg > Endocrine 4 > Flashcards

Endocrine 4 Flashcards

1
Q

describe diabetes insipidus

A 
ADH insufficiency (posterior pituitary)
water metabolism problem
lose fluid (4-10 L a day)
*pt randomly loses liters of pure water
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2
Q

what is DI usually the result of

A

result of trauma to head and tumor or craniotomy

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3
Q

ADH is inhibited
manifests r/t dehydration
urine is very diluted (low specific gravity <1.005)

A

DI

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4
Q

manifestations of DI

A 
excessive thirst
cardiac loss (K/Na)
urinary output
renal/urinary
skin (poor skin turgor, dry membrane)
dehydrated, confused
concentrated blood
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5
Q

interventions for DI

A 
replace hormone
vasopressin (ADH)
besmopressin acete (DDAVP)- ADH
teach pt to weigh self daily
never deprive fluids >24 hr
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6
Q

main nursing care for DI

A

replace/monitor fluid
neuro status
vital signs

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7
Q

describe what SIADH is

A

too much ADH

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8
Q

what occurs in SIADH

A 
retain a lot of water
dilutional hyponatremia
may be result of head injury
GI disturbance
wt gain
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9
Q

what does urine look like in SIADH

A

decreased volume
increased specific gravity
concentrated urine

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10
Q

what does plasma look like in SIADH

A

increased volume
dilatation
decreased sodium

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11
Q

interventions for SIADH

A

monitor for fluid overload
diuretics
safe environment
neurologic assessment changes

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12
Q

what is a safe environment for SIADH

A

risk for seizure due to Na levels

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13
Q

describe acromegaly

A

too much GH in pituitary
remove/manipulate pituitary
assess nasal drainage
watch for signs of DI

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14
Q

describe hypopituitarism

A

deficiency of 1 or more anterior pituitary hormones
panhypopituitarism
life threatening

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15
Q

panhypopituitarism

A

decrease production of all anterior pituitary hormone

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16
Q

why is hypopituitarism life threatening

A

deficiency of gonadotrpoins and GH

17
Q

describe hyperpituitarism

A 
hormone oversecretion (due to turmors)
overproduction of GH
18
Q

what does overproduction of GH lead to

A

gigantism and acromegaly

19
Q

what is treated with parlodel, dostinex, and permax

A

gigantism

20
Q

what is treated with sandostatin, somavert, bromocriptine

A

acromegaly

21
Q

what is the treatment of hyperpituitarism

A

hypophysectomy (removal of pituitary and tumor)

22
Q

post op of hypophysectomy

A 
*assess nasal drainage
check for glucose could be CSF
*avoid coughing directly after
avoid bending/strain during stool
*HOB elevated
avoid brushing
*major risk of diabetes insipidus is shock
23
Q

complications of hyperpituitarism

A

cardiac and respiratory problems and diabetes

24
Q

s/s of hyperpituitarism

A 
enlarged pituitary
headache and visual changes
slanting forehead
coarse facial features
menstrual changes
25
Q

thyroiditis
thyroid tissue is destroyed
autoimmune
triggered by infection

A

Hashimoto’s

26
Q

what does hyperparathyroid equal

A

hypercalcemia and hypophosphalemia (increase Ca and decreased phosphorous)

27
Q

Ca and phosphorus have an ______ relationship

A

inverse

28
Q

when you see para think _____

A

calcium

29
Q

what occurs in hyperparathyroid in relationship to Ca

A

hypercalcemia
PTH pulls calcium from bone and places in blood
INCREASES serum calcium

30
Q

what does hypercalcemia cause

A

reduces bone density

renal calculi

31
Q

education for hyperparathyroid pt

A

AVOID OTC meds with Ca
drink fluids
maintain active

32
Q

calcium acts like a _______

A

sedative

33
Q

s/s of hyperparathyroid

A

HTN
psychosis
muscle weakness
renal calculi

34
Q

hyperparathyroidism therapy

A

aledronate (Fosamax)- inhibits bone reabsorption

Cinacalcet- reduces PTH release

35
Q

s/s of hypoparathyroid

A

tetany
muscle spasms
hyperactive reflexes

36
Q

hypoparathyroid therapy

A

dietary supplements

need Ca and vitamin D

37
Q

post op thyroidectomy

A 
comfort measure
assess pain
semi fowlers
potential complications
keep emergency equipment
38
Q

post op adrenalectomy

A 
periodic turning
coughing, deep breathing
vital signs
intake/outake
*asepsis during procedure

Med Surg (23 decks)

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