endocrine Flashcards
hormones produced by the thyroid gland x3
T3
T4
calcitonin
calcitonin action
decreases serum Ca by taking Ca out of blood and returning it to bone
iodine purpose
hormone creation
thyroid hormone purpose
energy
hyperthyroidism
aka Graves Disease
too much energy!
hyperthyroidism: s/s
nervous, irritable
sweaty, hot
exophthalmos
thyroid hypertrophy
decreased
- attention span
- weight
increased
- appetite, gi motility
- bp (workload of heart)
hyperthyroidism: dx
increased serum T4
thyroid scan
antiarrhythmic drug containing high levels of iodine
amiodarone (Cordarone) - may affect thyroid function
prior to thyroid scan…?
discontinue iodine-containing medications 1 week prior
hyperthyroidism: tx
anti-thyroid medications iodine compounds beta blockers radioactive iodine surgery
anti-thyroid medications: action
- stops thyroid from making thyroid hormone
- for hyperthyroidism
used prepoperatively to stun thyroid
anti-thyroid med
iodine compounds: action
- decreases the size and vascularity of thyroid gland
- for hyperthyroidism
beta blockers for hyperthyroidism: action
decreases myocardial contractility
- decreases HR, BP, anxiety
- could decrease cardiac output
radioactive iodine: administration
- for hyperthyroidism
- 1 dose PO (liquid or tablet form)
- RULE OUT PREGNANCY FIRST
important nursing consideration for radioactive iodine
rule out pregnancy before admin!
radioactive iodine: action
destroys thyroid cells resulting in hypothyroidism (not ae - expected)
possible rebound effect post-radioactive iodine
thyroid storm
thyroid storm
thyrotoxicosis, thyrotoxic crisis
- uncontrollable hyperthyroidism
- can be caused by thyroid manipulation, severe infection, stress
MEDICAL EMERGENCY
do not give beta blockers to… x2
asthmatics or diabetics
- block catecholamine sites (epi, NE)
thyroid gland regulates
body metabolism and growth
use straw with iodine compounds because…?
stains teeth
radioactive precautions
no babies or kisses for 24 hours
thyroidectomy: positioning
HOB up to decrease risk of edema
sign of recurrent laryngeal nerve damage post-thyroidectomy
hoarseness
why keep a trach set at the bedside post-thyroidectomy?
- swelling
- recurrent laryngeal nerve damage (vocal cord paralysis)
- hypocalcemia
why is hypocalcemia a consideration post-thyroidectomy?
possible parathyroid removal
s/s hypocalcemia: tight, rigid muscles, seizure possiblity
hyperthyroidism and eyes
dry eyes, photosensitivity
hypothyroidism aka
myxedema
hypothyroidism: s/s
no energy!!, fatigue increased weight cold decreased gi motility, speech no expression
cretinism
hypothyroidism present at birth, can lead to slowed mental and physical development if undetected
hypothyroidism: tx
meds (levothyroxine, thyroglobulin, liothyronine): take FOREVER
common hypothyroidism co-morbidity
CAD - every aspect of metabolism slows down; basement membranes not proliferating = narrower artery walls = CAD
possible to throw clots!
hyperthyroidism + hypoglycemia
do not give beta blockers to diabetics because they block signs of hypoglycemia
beta blockers: decrease HR, BP, clammy (sweaty), nervous/anxious
hypothyroidism + depression
tired, weight gain, immobility (in bed)
parathyroid problem think
calcium!
parathyroid hormone: action
pull Ca from bone and into serum - serum Ca goes up
hyperparathyroidism =
hypercalcemia = hypophosphatemia
hypoparathyroidism =
hypocalcemia = hyperphosphatemia
hyperparathyroidism: s/s
too much PTH
serum Ca up
serum P down
SEDATED!
hyperparathyroidism: tx
partial parathyroidectomy
partial parathyroidectomy
take out 2 parathyroid glands
PTH secretion goes down, serum Ca goes down
monitor for what post-parathyroidectomy?
hypocalcemia: tight, rigid muscles, seizures
hypoparathyroidism: s/s
not enough PTH
serum Ca down
serum P up
hypocalcemia s/s
hypoparathyroidism: tx
IV calcium - give SLOWLY
phosphorous binding drugs
ESRD patients tend to retain…
phosphorous therefore serum Ca is down
adrenal glands for
stress
adrenal medulla hormones
epinephrine
norepinephrine
pheochromocytoma
benign tumors on adrenal medulla that secrete epi and NE in boluses
pheochromocytoma: s/s
increased BP, HR
flushing, diaphoretic
vanillylmandelic acid test
24 hour urine specimen checking for increased levels of catecholamines (epi, NE) - used for dx of pheochromocytoma
pheochromocytoma: tx
surgery to remove tumors
adrenal cortex hormones
glucocorticoids
mineralocorticoids
sex hormones
glucocorticoids: actions x4
- mood
- immunosuppression (decrease inflammation)
- inhibit insulin = hyperglycemic…
- fat, protein metabolism
accuchecks + steroids
steroids (glucocorticoids) inhibit insulin