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NCLEX > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

What hormones does the thyroid glad produce?

A

T3
T4
Calcitonin

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2
Q

Calcitonin action

A

Decreases serum Ca levels by taking Ca out of the blood and putting it into the bone

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3
Q

What do you need in your diet to make hormones?

A

Iodine (completely different action than iodine drugs)

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4
Q

What does the thyroid hormone give you?

A

Energy

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5
Q

Another name for hyperthyroidism

A

Graves Dz

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6
Q

Graves Dz

A

Too much energy

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7
Q

S/S of graves dz

A 
Weight LOSS
Exophthalmos (bulging eyes, irreversible)
Increased appetite, fast GI
Increased BP, HR
Enlarged thyroid
Nervous/irritable
Decreased attention span
Sweaty, HOT
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8
Q

How to diagnose graves dz

A

Increased T4, thyroid scan

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9
Q

What must the client do 1 week prior to thyroid scan?

A

Discontinue iodine containing meds

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10
Q

Amiodarone

A

Anti arrhythmic

Contains high levels of iodine, affects thyroid function

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11
Q

Tx for Graves dz

A

Anti-Thyroid drugs, iodine compounds, beta blockers, radioactive iodine, sx

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12
Q

Anti thyroid meds

A

Propylthiouracil (PTU), methimazole

  • Stop thyroid from making hormones
  • Used prep to stun thyroid
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13
Q

Iodine compounds

A

Potassium iodine

  • Decrease size/vascularity of the gland
  • All endocrine glands are VERY vascular
  • Give in milk or juice, use straw (stains teeth)
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14
Q

Beta blockers

A

Propranolol

  • Decreases myocardial contractility
  • Can decrease CO
  • Decreases HR, BP
  • Decreases anxiety
  • Don’t let you release epi and norepi
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15
Q

Who do you not gibe beta blockers to?

A

Asthmatics (can precipitate an attack) or diabetics (will hide symptoms of hypoglycemia)

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16
Q

Radioactive iodine

A
  • One dose
  • Given PO liquid or tablet
  • Not used in pregnancy
  • Destroys thyroid cells leading to hypothyroid
  • Follow radioactive precautions (stay away from babies and don’t kiss anyone for 24 hours)
  • Watch for thyroid storm-rebound effect post radioactive iodine
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17
Q

Post op thyroidectomy

A
  • Partial or complete
  • Support neck, place personal items close to them
  • Elevate HOB
  • Check for bleeding behind neck, under skin (pooling)
  • Client needs calories before and after
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18
Q

What could hoarseness after thyroidectomy mean?

A

Recurrent laryngeal nerve damage

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19
Q

What could feelings of pressure mean after a thyroidectomy?

A

Vocal cord paralysis. Paralysis of both cords means airway obstruction and requires immediate trach

  • Have trach ready at bedside
  • Check for swelling, hypocalcemia (parathyroid removal)
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20
Q

Another name for myxedema

A

Hypothyroid

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21
Q

S/S of myxedema

A
  • Weight GAIN, slow GI
  • COLD
  • Fatigue, no energy
  • Amenorrhea
  • Slow and slurred speech
  • No expression
  • Possibly totally immobile client
  • Do not give them a heating pad, they can’t tell if it gets too hot
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22
Q

Cretinism

A

When hypothyroid is present at birth, very dangerous and can lead to slowed mental and physical development if not detected

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23
Q

Tx of myxedema

A

Levothyroxine, thyroglobulin, liothyronine

  • Take these meds forever
  • Makes their energy increase
  • Increased BP/HR and CAD
24
Q

PTH

A

Pulls Ca from the bone and places it in the blood

25
Q

Partial parathyroidectomy

A

2 parathyroids are removed, PTH secretion decreases

26
Q

What do you monitor for after partial parathyroidectomy?

A

Rigid/tight muscles

27
Q

Tx of hyperPTH

A

Partial parathyroidectomy

28
Q

Tx of hypoPTH

A

IV Ca, phos binding drugs

29
Q

What do you need your adrenal glands for?

A

To handle Stress

30
Q

Two parts of the adrenal gland

A

Adrenal medulla

Adrenal cortex

31
Q

What does the adrenal medulla secrete?

A

Epi and Norepi

32
Q

Pheochromocytoma

A

Benign tumors that secrete epic and norepi in boluses

33
Q

S/S of pheochromocytoma

A

Increased BP/HR

Flushing/diaphoretic

34
Q

Dx of pheochromocytoma

A

VMA (vanillylmandelic acid) test: 24 hour urine specimen to look for increased levels of epic and norepi
-Anything with vanilla will alter test, stay away for a week prior

35
Q

What are epi and norepi also called?

A

Catecholamines

36
Q

What to remember about 24 hour urine specimens

A
  • Throw away first void

- Keep last void

37
Q

Tx of pheochromocytoma

A

Sx to remove tumors

38
Q

What does the adrenal cortex secrete?

A

Glucocorticoids, mineralocorticoids, sex hormones

39
Q

What do glucocorticoids do?

A 
Change your mood (insomnia, depressed, psychotic, euphoric)
Alter defense mechanisms, immunosuppressed
Breakdown fats and proteins
Inhibit insulin (monitor BG)
40
Q

Mineralocorticoids are what?

A

Aldosterone

41
Q

Aldosterone action

A

Retain Na and water, excrete K

42
Q

Cortisol

A

ACTH from pituitary stimulates cortisol to be made. They are steroids

43
Q

Not enough steroids, think what?

A

Shock, high K

No aldosterone

44
Q

Addison’s Dz

A

Adrenocortical insufficiency, not enough steroids (glucocorticoids, mineralocorticoids, sex hormones)

45
Q

S/S of Addison’s

A

Initially, s/s of hyperkalemia
Then, anorexia/nausea, hyper pigmentation of skin and mucous membranes, white patchy areas of depigmented skin (vitiligo), decreased bowel sounds, GI upset, hypotension, decreased Na, increased K and hypoglycemia
Losing weight, low BP, fluid volume deficit

46
Q

Tx of Addison’s

A

Combat shock-Give Na in diet, processed juice/broth

I&O, daily weights, drugs

47
Q

Drugs for addison’s

A

Fludrocortisone (aldosterone)

DAILY WEIGHTS-keep within 2-3 lbs of normal weight

48
Q

Addisonian Crisis

A

Severe hypotension and vascular collapse

49
Q

Cushing’s Dz

A

Too many glucocorticoids, mineralocorticoids, sex hormones

50
Q

S/S of too many glucocorticoids

A 
Growth arrest
Thin extremities/skin (lipolysis)
Risk of infection
Hyperglycemia
Psychosis then depression
Moon faced (fat redistribution/fluid retention)
Truncal obesity (fat redistribution, lipogenesis)
Buffalo hump (fat redistribution)
51
Q

S/S of too many minerals

A

High BP
CHF
Weight gain
Fluid volume excess

52
Q

S/S of too many sex hormones

A

Oily skin/acne
Women with male traits
Poor sex drive/libido

53
Q

If the client has too much mineralocorticoid, what will the serum K do?

A

Decrease

54
Q

If you did a 24 hour urine on a client with too much minerals, would the cortisol levels be high or low?

A

High

55
Q

Tx of cushing’s

A

Adrenalectomy (unilateral or bilateral), if both are removed they’ll need a lifetime replacement
Quiet environment
Diet before treatment-high K, protein, and Ca, low Na
Avoid infection

56
Q

What might appear in the urine of cushing’s dz pt?

A

Glucose and ketones

57
Q

What do steroids do to the serum Ca?

A

Decrease it by excreting it through the GI tract

NCLEX (14 decks)

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