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NCLEX > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

thyroid gland produces what 3 hormones:

A

T3, T4, calcitonin

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2
Q

calcitonin decreased serum calcium levels how?

A

by taking calcium out of the blood and pushing it back into the bone

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3
Q

you need _____ to make thyroid hormones

A

dietary iodine

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4
Q

thyroid hormone gives us _____

A

energy

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5
Q

hyperthyroidism AKA

A

graves disease

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6
Q

sx of hyperthyroidism

A 
nervous
irritable
decreased attention span
increased appetite
decreased weight
sweaty/hot
exopthalamos
increased GI motility
increased BP and Pulse
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7
Q

T4 and TSH level with hyperthyroidism

A

T4 increased

TSH decreased

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8
Q

the client must discontinue any iodine containing medications ____ week prior to the thyroid scan and must wait _____ weeks to restart medications

A

1 week

6 weeks

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9
Q

treatment for hyperthyroidism

A 
anti-thyroid meds
iodine
BBs
radioactive iodine therapy
surgery
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10
Q

example of anti-thyroid meds

A

PTU and methimazole

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11
Q

anit-thyroid meds are used to ?

A

stun the thyroid pre-op

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12
Q

decrease the size and the vascularity of the gland

A

iodine compounds

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13
Q

why do you give iodine compounds through a straw?

A

stains teeth

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14
Q

decreases myocardial contractility
could decrease CO
decreases HR and BP
decreased anxiety

A

Beta Blocker

propranolol

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15
Q

do not give beta blockers to _____ or ____

A

diabetics or asthmatics

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16
Q

radioactive iodine therapy is given _____ to destroy the thyroid cells

A

PO

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17
Q

what is the expected outcome after radioactive iodine therapy

A

they will become hypothyroid

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18
Q

post-op priority for thyroidectomy

A

hemorrhage

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19
Q

post-op thyroidectomy we should tell our patients to report feelings of ______

A

pressure

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20
Q

where to check for bleeding post-op thyroidectomy

A

back of the neck

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21
Q

assess for recurrent laryngeal nerve damage by listening for ______ post-op thyroidectomy

A

hoarseness

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22
Q

if their parathyroid was removed would you monitor for hypo or hypercalcemia?

A

hypo

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23
Q

hypothyroid symptoms?

A 
no energy
fatigue
no expression slowed speech
weight gain
slowed GI motility
cold 
amenorrhhea
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24
Q

T4 and TSH levels with hypothyroid

A

decreased T4

increased TSH

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25
Q

treatment for hypothyroid

A

levothyroxine

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26
Q

people with hypothyroidism tend to have ____

A

CAD

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27
Q

the parathyroids secrete ____, which makes you pull calcium from the ___ and place it into the blood

A

PTH

bones

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28
Q

when PTH is secreted…serum calcium goes up or down?

A

up

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29
Q

if you have too much PTH in your body, the serum calcium level will be ___-

A

high

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30
Q

if you do not have any PTH in your body, the serum calcium level will be ___-

A

low

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31
Q

hyperparathyroidism is the same thing as which other 2 diseases?

A

hypercalcemia

hypophosphatemia

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32
Q

sx of hyperparathyroidism

A

too much PTH
serum Ca+ increased
serum phosphorus decreased
sedation!!!!!

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33
Q

treatment for hyperparathyroidism

A

partial parathyroidectomy

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34
Q

what do monitor for post op parathyroidectomy

A

sx of hypocalcemia (rigid muscles)

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35
Q

hypoparathyroidism is the same as which two other diseases?

A

hypocalcemia

hyperphosphatemia

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36
Q

sx of hypoparathyroidism

A

not enough PTH
serum Ca low
Serum Phosphorus high

NOT sedated!!!

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37
Q

tx of hypoparathyroidism

A

IV calcium

phosphorus binding drugs

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38
Q

you need your adrenal glands to handle _____

A

stress

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39
Q

the adrenal medulla secrete _____ and _____

A

epinephrine and norepinephrine

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40
Q

benign tumors that secrete epi and norepi in boluses

tend to be familial

A

pheochromocytoma

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41
Q

sx of adrenal medulla problems

A

increased BP and HR
heart palpitations
flushing
HA

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42
Q

how to diagnose an adrenal medulla problem?

A

vanillylmandelic acid test

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43
Q

foods that alter the vanillylmandelic acid test

A 
anything with vanilla in it 
caffeine
vitamin B
fruit juices
bananas
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44
Q

treatment for adrenal medulla problems

A

surgery to remove tumor

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45
Q

avoid palpating the abdomen of a client with a suspected pheochromocytoma as it may cause sudden release of ____ and severe _____

A

catecholamines and severe HTN

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46
Q

the adrenal cortex secretes which 3 steroids?

A

glucocorticoids
mineralocorticoids
sex hormones

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47
Q

4 functions of glucocorticoids

A

change your mood
alter defense mechanisms
breakdown fats and proteins
inhibit insulin

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48
Q

the most common minearlocorticoid secreted by the adrenal cortex

A

aldosterone

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49
Q

aldosterone makes you retain ___ and ____

A

Na and Water

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50
Q

aldosterone makes you lose ____

A

potassium (K+)

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51
Q

too much aldosterone = fluid volume ____

A

excess

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52
Q

too much aldosterone makes serum K+ go down or up?

A

down

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53
Q

not enough aldosterone is fluid volume ____

A

deficit

54
Q

not enough aldosterone makes serum K+ go down or up?

A

up!

55
Q

too many sex hormones

A

hirsutism
acne
irregular menstrual cycle

56
Q

not enough sex hormones

A

decreased axillary/pubic hair

decreased libido

57
Q

are made in the pituitary and they stimulate cortisol to be made

A

Adrenocorticotropin hormones (ACTH)

58
Q

increased ACTH =

A

increased cortisol level

59
Q

4 adrenal cortex problems

A

hyperkalemia
hypoglycemia
not enough steroids
shock

60
Q

addison’s disease has a ______ insufficiency

A

adrenocortical

61
Q

since you don’t have enough aldosterone with addison’s you will lose ___ and retain ____

A

lose Water and Na+

retain K+

62
Q

serum K+ with addison’s

A

increased

63
Q

sx of addison’s

A 
extreme fatigue
NVD
anorexia/weight loss
hypotension
confusion
bronze skin
vitiligo
64
Q

labs with addison’s

A

decreased Na
increased K+
hypoglycemia

65
Q

treatment for addison’s disease

A

combat shock
increase Na+ in diet
drink juice/broth
I/O daily weight

66
Q

addison’s is in a fluid volume ___-

A

deficit

67
Q

meds for addisons

A

prednisolone

fludrocortisone

68
Q

how is prednisolone administered?

A

take 2/3 in the morning

1/3 in the evening

69
Q

fludrocortisone is ______

A

aldosterone

70
Q

report a weight gain of >___ lbs per week

A

5

71
Q

addisonian crisis can occur with?

A

infections
emotional stress
physical exertion
stopping steroids abruptly

72
Q

addisonian crisis has severe _____ and ______ collapse

A

hypotension

vascular

73
Q

cushion’s disease has to many _____

A

steroids

74
Q

since the client with cushion’s has too much aldosterone, the serum K+ will be _____

A

low

75
Q

if you did a 24 hour urine on the client with cushings the cortisol levels would be ____

A

increased

76
Q

tx of cushing’s

A

adrenalectomy

quiet environment

77
Q

diet prior to treatment of cushing’s dx

A

increased K+, protein, and calcium

decreased NA+

78
Q

steroids decrease serum ____ by excreting it through the GI tract

A

calcium

79
Q

urine from a life long steroid use patient

A

glucose

ketones

80
Q

normal BG

A

70-110

81
Q

in type 1 DM they have little or no ____

A

insulin

82
Q

first sx of type 1 DM is usually _____

A

DKA

83
Q

3Ps with type 1 DM

A

polyuria
polydipsia
polyphagia

84
Q

why do type 1 DM have kussmaul respirations?

A

compensation for metabolic acidosis

85
Q

with polyuria think ____ 1st!!!

A

shock!

86
Q

treatment for type 1 DM

A

insulin only!!!

87
Q

type 2 DM don’t have enough ___, or the ___ they gave is no good

A

insulin

88
Q

type 2 DM is usually found by accident; or the client keeps coming back to the primary healthcare provider for things like?

A

wounds that won’t heal

repeated vaginal infections

89
Q

individuals with type 2 DM should be evaluated for _____ syndrome

A

metabolic

90
Q

features of metabolic syndrome

A 
Waist circumference >40
triglycerides >150
HDL <50
BP > 130/85
FBS >100
91
Q

treatment for type 2 DM

A

start with diet and exercise and then add oral agents

some need insulin

92
Q

in gestational diabetes the mom needs ___-___ x more insulin than normal

A

2-3

93
Q

if mom has r/f gestational diabetes, screen her at which visit?

A

1st

94
Q

screen all moms for gestational diabetes at __-____ weeks gestation

A

24-48

95
Q

complication for baby with gestational diabetes

A

increased birth weight

hypoglycemia

96
Q

oral anti-diabetic agents improve 2 things:

A

how the body produces insulin

how the body uses insulin and glucose

97
Q

all oral anti-diabetics work to decrease the amount of circulating _____

A

glucose

98
Q

most widely used oral anti-diabetic

A

metformin

99
Q

why is metformin a favorite anti-diabetic drug?

A

reduces glucose production and enhances how glucose enters the cell

100
Q

patients after procedures can resume their dose ___ hrs after contrast dye is used

A

48

101
Q

insulin dose is initially based on ____

A

body weight

102
Q

the average adult dose of insulin is ___-___ units/kg/day

A

0.4-1

103
Q

clear insulin

A

regular

104
Q

cloudy insulin

A

NPH

105
Q

only insulin that can be given IV

A

regular

106
Q

the goal is to keep the before meal glucose near normal at ____-____

A

70-130

107
Q

the most common method of daily dosing insulin is ___ ____ dosing

A

basal bolus

108
Q

clients should eat when insulin is at its _____

A

peak

109
Q

HbA1C gives an average blood sugar over the past ___-___ months

A

3-4

110
Q

what happens to your BG when you are sick or stressed?

A

increased

111
Q

HbA1C > ____% is diagnostic for diabetes

A

6.5%

112
Q

for people with diabetes, the ideal goal for their HbA1c is <

A

7%

113
Q

which type of insulin is used in infusion pumps

A

rapid acting

114
Q

sx of hypoglycemia

A 
cold 
clammy
confused
HA
hungry
increased HR
115
Q

if hypoglycemic, what should client do?

A

eat/drink simple carb

116
Q

snacks should be ____ g of carbohydrates

A

15

117
Q

glucose absorption is delayed in foods with lots of ___

A

fat

118
Q

once the blood sugar is up, what should they do?

A

eat complex carb/protein

119
Q

you enter a diabetic client’s room and they are unconscious…treat this as if they are ____

A

hypoglycemic

120
Q

if they are unconscious give ____ IVP through a large bore IV

A

D50W

121
Q

for prevention of hypogemia teach our clients what 4 things?

A

eat
take insulin regularly
sx of hypoglycemia
check BG regularly

122
Q

best choice for low BG

A

skim milk
apple juice
handful of raisins

123
Q

in DKA you have very little or no insulin and severe ____ which leads to fat breakdown and ____ acidosis

A

hyperglycemia

metabolic

124
Q

treatment of DKA

A

IV insulin
ECG
IVP

125
Q

insulin decreases ____ and ___ by driving them out of the vascular space into the cell

A

BG and K+

126
Q

fluid replacement with DKA starts with ___ until the BG reaches 250-300 then switch to ___ to prevent hypoglycemia

A

NS

D5W

127
Q

HHNK look like DKA without _____

A

acidosis

128
Q

with the HHNK patient have kussmaul respirations

A

NO

129
Q

DKA and HHS are both hyperosmolar states caused by _____ and _____

A

hyperglycemia and dehydration

130
Q

vascular damage in Diabetes causes

A

diabetic retinopathy

nephropathy

131
Q

a condition in diabetics in which the stomach emptying is delayed so there is an increased r/f aspiration

A

gastroparesis

NCLEX (10 decks)

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