Endocrine Flashcards
Thyroid gland produces three hormones: ____, _____ and ______; you need ___ to make hormones
Thyroid hormone gives us ______
T3, T4
calcitonin, iodine
ENERGY
Hyperthyroid = too much ________ (____ disease)
S/S include nervous, _______, attention span _____, appetite ______ weight _______, ______ intolerance = ______/hot, exopthalamos is _______, GI _______ = diarrhea, BP and pulse _____ d/t increased _____ on heart, so you can have _______ or palpitations, thyroid size ________
Dx: T3/T4 _______, TSH _______; thyroid scan client must D/C any ________ containing meds (multivites) ____ week prior and wait ____ weeks to restart; ________ contains high levels of iodine and may affect ____ function
energy, graves' irritable, decreases increases, decreases, heat sweaty, irreversible, increases increase, workload arrhythmias increases
increased, decreased iodone 1, 6 amiodarone thyroid
Medication treatment of hyperthyroidism includes an anti-thyroid like _______ (#1 choice) and PTU _____ the thyroid from making hormones, used _______ to stun the thyroid, we want the client ______ before surgery; Iodine compounds _______ the size and ______ of thyroid, give it in _____ or juice d/t __________, examples are potassium iodine (______ and _____ solution); Beta blockers are for treatment of _______, _______ is BB of choice, decreases ____, ____ and ____ may also ______ anxiety; RAI is ____ dose given ____ –MUST R/O _______ FIRST, it destroys _____ cells so expect __________, follow radioactive ________ and stay away from ______ for 1 week and no _____ for 1 week
DO NOT GIVE BETA BLOCKERS TO _______ OR ______
methimazole stop, pre-operatively euthyroid decrease vascularity, milk teeth staining, SSKI Lugol's symptoms, propranolol, HR BP, CO, decrease, ONE PO, PREGNANCY thyroid, hypothyroidism precautions, babies, kissing
DIABETICS, ASTHMATICS
Surgical Treatment of hyperthyroidism is a ________, can be _______ or complete, teach client to report feelings of ________ because that means ______ compression; check for bleeding at the ______ and ______ neck, assess for laryngeal nerve damage via _____ as it could lead to vocal cord _______, paralysis of _______ vocal cords = _______ obstruction and will require ______
Keep _________ set at bedside for risks of _____, vocal cord ______, ___________; teach client how to support _____, keep items _____ so they don’t ______, position with HOB _______ to ______ edema, client needs more _______ pre and post-op
thyroidectomy partial pressure, airway incision, behind hoarseness paralysis, both airway, trach trach, swelling paralysis, hypocalemia neck, close, reach elevated, decrease calories
Hypothyroidism = not enough _____, S/S include _______, __ expression, speech is ______, weight _______, GI ______ = constipation, intolerance to ______–don’t use a _______, amenorrhea, myxedema can lead to _______ tongue and ______ edema
Dx: T3/T4 _______, TSH _______
Treat with meds: __________ will be taken in the ______ on ______ stomach, they will take this med _______, energy will _____ when med started, start on a _____ dose and ______ over time
People with hypothyroidism tend to have ______ d/t _______ LDL–worry about ______ when these meds are started
enough fatigue, no, slow/slurred increases, decreases cold, heating pad protruding, facial
decreased, increased
synthroid, morning
empty, forever
increase, low
increase
CAD
elevated, MI
Parathyroid = _____; parathyroid glands secrete ______ which makes you pull _______ from bone and place it in _______, so serum calcium ______; _______ PTH = ______ Ca, _______ PTH = ______ Ca
Hyperparathyroidism = _________ = __________
Calcium acts as a ______, so S/S related to sedation
Treated with partial ___________, PTH secretion ______ monitor for ___________ post-op
Hypoparathyroidism = _________ = __________
S/S related to Calcium as _______, not enough = ______ sedated; treatment is _____ calcium and ________ binders
Calcium, PTH
calcium
blood, increases, increased
increased, decreased, decreased
Hypercalcemia, Hypophosphatemia
sedative
parathyroidectomy
decreases, hypocalcemia
Hypocalcemia, Hyperphosphatemia
sedative, not
IV, phosphate
Need _______ glands to handle ______
Adrenal Medulla = epi and norepi = _____ or _____
Problems include pheochromocytoma, which are _____
S/S include ______ BP, ____ HR, palpitations, flushing/_______ diaphoretic, headache
Dx with catecholamine levels: _____ or MN, ______ hour urine specimen looking for _______ levels of epi and norepi, client needs to ______ stress
VMA = vanillylmandelic acid so foods that later the tests include anything with ______, caffeine, Vit ___, ____ juices and bananas
Treat with ____ to remove _____
DO NOT PALPATE _______ OF A CLIENT WITH SUSPECTED PHEO D/T SUDDEN RELEASE OF ________ CAUSING SEVERE _________
adrenal, stress fight, flight benign increased, increased extremely VMA, 24 increased decrease
vanilla, B, fruit
surgery, tumors
ABDOMEN
CATECHOLAMINES
HYPERTENSION
Adrenal Cortex = steroids and sex hormones
1. Glucocorticoids with 4 effects:
change your ______, alter _______ mechanisms, breakdown _____ and _____, inhibit ______
Results in a variety of moods, high risk for ______, increased byproducts of _______, _________–need to do _____ checks
- Mineralocorticoids = Aldosterone
makes you retain _____ and _____ and lose ______
too much aldosterone = fluid volume ______ and serum K ______; not enough aldosterone = fluid volume _____- and serum K ______ - Sex hormones = testosterone, estrogen and _________; too many can cause _______, ______ and irregular _______ cycles; not enough can cause _______ axillary/pubic hair, ______ libido
mood, defense fat, protein, insulin infection metabolism, hyperglycemia BG
sodium, water, potassium
excess
decreases, deficit
increases
progesterone, hirsutism, acne
menstrual
decreased, decreased
Adrenal Cortex Problems: not enough _______, SHOCK, _____kalemia, ______glycemia
steroids
hyper, hypo
Addison’s Disease = NOT ENOUGH ________
losing __ and ____ and retaining _____ so serum K will be _____
S/S: extreme ____, GI symptoms: __, __, __, weight _____ with ____, BP _____, confusion, sodium ______, potassium _____ and glucose ______, skin color changes, possible ____, FLUID VOLUME ______
Treatment: combat ______, ______ sodium in diet, I/O and daily ______, lifelong ______ including prednisolone and fludrocortisone = _________, monitor ____ and ____
Addisonian Crisis = severe _____ and vascular _______, can occur with _______, emotional _____, physical ______ or stopping meds ______
STEROIDS sodium, water, potassium high fatigue, N/V/D loss, anorexia, decreases, decreases increases, decreases vitiligo, DEFICIT
SHOCK, increase
weight, steroids
aldosterone
weight, BP
hypotension, collapse
infections, stress
exertion, abruptly
Cushing’s Syndrome = TOO MANY _________
retaining ___ and ___ and losing _____ so serum K will be ____
S/S: ____ face, ______ hump, increased risk of ______, ____ skin, ______ obesity, psychosis d/t ______, oily skin/_____, women with ____ traits, _____ BP, CHF, weight ______, FLUID VOLUME ________
If you do a 24-hour urine, cortisol (THINK _____) will be ______
Treatment: adrenalectomy, _____ environment to ______ stress, diet pre-treatment = ______ K, ______ Na, ______ Protein, _____ Ca: steroids ______ serum Ca by _____ through GI tract
Long-term _____ use can lead to _________
AVOID ________
Long-term steroid therapy, what values are expected to be altered in urine? ____ and _____
ketones in urine from breakdown of ____
STEROIDS
sodium, water, potassium
low
moon, buffalo, infection
thin, truncal, depression
acne, male, high
gain, EXCESS
STEROID
HIGH
quiet, decrease
increase, decrease
increase, increase, decrease
excreting
steroid, osteoporosis
INFECTION
glucose, ketones
fat
Diabetes type one = little or no _______, can be diagnosed up to age ____, S/S include the 3 P’s: _____, ______, ______; POLYURIA = THINK _____ FIRST, Hyperglycemia = 3 ______
First encounter is often ______ = metabolic _______
Treatment: need ________
Must have _____ insulin
insulin 30, polyphagia polyuria, polydipsia, SHOCK P's DKA, acidosis insulin basal
Diabetes type two = not able to make enough _______, or have become insulin ______, they are typically ______, treated with diet and exercise _______, then add oral _______, some will need _____
Clients with Type 2 should be evaluated for ______ syndrome–must have THREE OR MORE of these:
1. waist _______ > ___ M or > ___ F
2. triglycerides > _____
3. HDL < __ M or < ____ F
4. BP > ___/___
5. FBS > _____
insulin resistant overweight, first agents, insulin metabolic
circumference, 40, 35 150 40, 50 130/85 100
Gestational diabetes resembles type ____, mom needs ______ times more insulin than normal, risk factors include ____ and _____ history, screen all moms at __ to ___ weeks; complications to baby include ______ and _____ birth weight
2 2-3 obesity, family, 24 28, hypoglycemia increased
General Diabetes Treatment: Diet, Exercise, Meds
Majority of calories should come from ____ carbs, then _____ and finally _____; worried about carbs because sugar destroys _____ like ____ does = carb _____, carbs should come from ____ grains, ____ and low fat ___; high _____ slows down glucose absorption which will eliminate sharp rise/fall in ______; EXTREME BLOOD SUGAR = ______ DAMAGE
Exercise should begin after BS _______, prevent hypoglycemia prior to exercise by _______, exercise when blood sugar is at its _____, exercise at the ___ time and amount _____: establish ______
Oral anti-diabetics are for type ____, admin either ____ or _____; these improve how the body ______ insulin and how the body ____ insulin and glucose; used only when ____ and ____ have failed to control _____
ALL ORAL ANTI-DIABETICS WORK TO ______ AMOUNT OF _______ GLUCOSE
________ is most common, it doesn’t stimulate release of _____ so you won’t see _________; hold metformin before any procedure involving ________, resume ____ hours after if ____ function has returned and _____ is normal
complex fats, protein vessels, fat, count whole, fruits, milk fiber blood sugar VASCULAR
normalizes
eating
highest, same
daily, routine
2, PO
SubQ, produces
uses
diet, exercise, BS
DECREASE
CIRCULATING
metformin
insulin, hypoglycemia
contrast dye, 48
kidney, creatinine
