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NCLEX > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

what 3 hormones does the thyroid gland produce

A

T3, T4 and calcitonin

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2
Q

what does calcitonin do

A

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

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3
Q

what is calcitonin typically used for treating

A

osteoporosis

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4
Q

what element do you need to make hormones? does our body make it?

A

iodine - no need it in diet

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5
Q

what do thyroid hormones give us

A

energy

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6
Q

when you see hyperthyroid what should you think? what are signs and symptoms

A

TOO MUCH ENERGY

  • S & S associated with too much energy
  • bulgy eyes like bucehmi
  • sweaty and hot
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7
Q

is your thyroid too big or too small in hyperthyroidism

A

too big

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8
Q

how is hyperthyroidism diagnosed

A

T4 and TSH level

thyroid scan - ultrasound/MRI/CT

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9
Q

in hyper throidism is T4 high or low? what about TSH?

A

T4 high

TSH low

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10
Q

what must a client do prior to a thyroid scan

A

discontinue any iodine containing meds 1 week prior and wait 6 weeks to restart

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11
Q

what is treatment for hyperthyroidism

A 
medications 
- anti thyroids
-iodine compounds
-beta blockers
radioactive iodine theraapy
sx - thyroidectomy (partial/complete)
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12
Q

what do anti thyroids do? are thye used for hyper or hypothyroidism

A

hyperthyroidism
stop thyroid from making homrones
used pre-op to stun the thyroid

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13
Q

what do iodine compounds do? are they used for hyper or hypo?

A

hyper
decrease the size and vascularity of the gland
give in milk or juice and use a straw - can stain teeth

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14
Q

why are beta blockers used in patients with thyroid problems? hper or hypo?

A

hyper

decrease contractility and co, decrease HR and BP decrease anxiety

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15
Q

what clients should not get a beta blocker

A

asthmatics or diabetics

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16
Q

what is radioactive iodine therapy? is it for hyper or hypothyroidism

A

hyperthyroidism

one dose given PO that destroys thyroid cells

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17
Q

if someone does radioactie iodine therapy what should be ruled out? what precautions need to be taken after

A

need to rule out pregnancy

follow radioactive precations - stay away from babies for 1 week and dont kiss anyone for one week

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18
Q

what is the biggest concern for people with hyperthyroidism especially with radioactive iodine therapy

A

thyroid storms

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19
Q

what is the biggest concern post thyroidectomy ? what are S & S of this concenr

A

hemorrhage - feelings of pressure in neck area, can see bleeding at incision site + behind neck

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20
Q

whyis it important to check for a hoarse voice following thyroidectomy sx

A

indicates laryngeal nerve damage - could lead to vocal cord paralysi

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21
Q

when ther is paralysis of vocal chords what does this mean

A

airway obstrcution - requries immediate trach

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22
Q

what needs to be at the bedside of a patient who has had neck surgery

A

trach set

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23
Q

what electrolyte imbalance are we worried about with thyroidectony

A

hypocalcemia - ptoential removal of parathyroids - look for non sedated and muscle rigidity and seizures

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24
Q

what care is important with hyperthyroid patients

A

eye care

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25
Q

what are the signs and symptoms of hypothyroidism

A

no energy symptoms
slow or slurred speech
cold
absence of menstration

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26
Q

hypothyroidism can be mistaken for what

A

depression

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27
Q

how is hypothyroid diagnosed

A

low T4

high TSH

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28
Q

what medication is taken with hypothyroidism

A

levothyroxine - must be taken on an empty stomach

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29
Q

what potential problem are we worried about with people starting levothyroxine

A

MI - they usually have CAD

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30
Q

does levothyroxine need to be taken forever

A

yes

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31
Q

what will happen to someones energy level when they start taking levo

A

increase

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32
Q

what do the parathyroids secrete

A

PTH

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33
Q

what is the role of PTH

A

pulls calcium from bone and puts it int he blood increases serum calcium

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34
Q

what will happen to the calcium elvel if you have too much parathromone in your body

A

increase

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35
Q

what are other names for hyperparathyroidism

A

hypercalcemia or hypophophatemia

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36
Q

what are the signs and symptoms of hyperparathyroidism

A

high serum calcium
low serum phosphorus
sedated

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37
Q

what is the treatement for hyperparathyroidism

A

partial parathyroidectomy - take out 2 of your parathyroids to decrease PTH secretion

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38
Q

what do you monitor for after parthyroidectomy

A

hypocalcemia - msucle rigidity tetany

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39
Q

what are other wods for hypopartathyroidisim

A

hypocalcemia - hyperphosphatemia

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40
Q

what are the signs and symptoms of hypopartahtyroidism

A

not enough PTH
serum calcium is low
serum phosphorus is high
muscle ridgiity

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41
Q

treatment for hypoparathyroidism

A

IV calcium

phosphorus binding drugs - drop phosphorus elevate calcium

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42
Q

what do we need our adrenal glands to handle

A

stress

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43
Q

what are the two parts of the adrenal gland

A

adrenal medulla

adrenal cortex

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44
Q

what does the adrenal medulla secrete

A

E and NE

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45
Q

what is a problem that can occur with the adrenal medualla

A

pheochromocytoma - benign tumor that secrete E and NE in boluses
tends to be familial - screen family

46
Q

what are signs and symptoms of pheochromocytoma?

A 
increased BP, HR
palpitations
flushing 
diaphorteitc 
HA
47
Q

how is pheochromocytoma diagnosed

A

catecholamine levels checked - VMA and MN test - cant have anything with vanilla
24 hour urine test - check for increased E and NE

48
Q

what is important to remember with 24 hour urine test

A

throw away first void, keep last

avoid activities that increase E and NE

49
Q

treatment for pheochromocytoma

A

surgery to remove tumors

50
Q

what does the adrenal cortex secrete

A

STEROIDS

glucocorticoids, mineralcorticoids, and sex hormones

51
Q

what is the role of clucocorticoids

A

change your mood - extremes
alter defense mechanisms - immunosurppresed
breakdown fat and proteins
inhibit insulin

52
Q

what is an example of minerocorticoids

A

aldosterone

53
Q

what does aldosterone do

A

retain sodium and water; lose potassium

54
Q

what is the problem with too much aldosterone

A

fluid overload

low potassium

55
Q

what is the problem with not enough aldosterone

A

dehydration

increased serum potassium

56
Q

name 3 examples of sex hormones

A

testosterone, estroge and progesterone

57
Q

what is the problem with too many sex hormones

A

hisutism (excessive hair), acne, irregular menstral cycle

58
Q

what is the problem with not enough sex hormones

A

decreased axiallary and pubic hair

decreased libido

59
Q

what should you think of with too much steroids

A

hypercortisolism –> too many steroids too much stress

60
Q

what are 3 adrenal cortex problems

A

not enough steroids
shock
hyperkalemia
hypogylycemia

61
Q

what disease is associated with too little steroids

A

addisons (aldosterone is a steroid!)

62
Q

what are the signs and symptoms of addisons

A

not enough aldosterone so losing water and sodiumand retaining potassium
extreme fatigue, nasuea, vomiting, anorexia, hypotension, confusion, hypogylcemia, hyperpigmentation, white patchy area of skin

63
Q

what is the treatment for Addisons

A 
combat shock
add sodium in diet
processed fruti juice and broth has a lot of sodium in it 
I & O
daily weight
64
Q

What is the pharmacological treatment for addisons

A

Steroids
prednisolone
Fludrocortisone - aldosterone

65
Q

How is Prednisolone given?

A

BID

2/3 in morning and 1/3 at night (this is how the body usually excretes steroids

66
Q

What needs to be monitored when giving steroids

A

BP and weight

67
Q

what is an addisonian crisis

A

severe hypotension and vascular collapse

can occur with infectons, emoional stress, physical exertion or stopping sterids abruptly

68
Q

What is Cushing’s disease

A

too many steroids

(glucocorticoids, mineralcorticoids, sex hormones

69
Q

These S & S indicate what steroid is in excess:
growth arrest
thin skin
increased risk of infetion
hyperglycemia
psychosis to depression
moon faced (fat redistribution or fluid retention)
truncal obesity (fat redistribution or fluid retention)
buffalo hump (fat redistribution)

A

glucorticoids

70
Q

What steroid is in excess when one has oily skin/acne or when women have male traits

A

sex hormones

71
Q

what steroid is in excess with high BP, CHF, weight gain, and fluid volume excess

A

mineral corticoids (aldosterone)

72
Q

In a client with cushing’s what will their potassium be

A

too much aldosterone so they will have low potassium

73
Q

if you did a 24 hour urine on a patient with cushing’s what would their cortisol level be

A

high

74
Q

what is the treatment for cushing’s disease

A

adrenalectomy (unilateral or bilateral) *if both are removed require lifetime replacement
quiet enviroment
avoid infection

75
Q

what diet is necessary for a cushing’s client prior to treatment

A

high potassium
low sodium
high protein
high calcium

76
Q

What do steroids do with calcium

A

decrease it by excreting it through the GI tract

77
Q

If a nurse is monitoring lab values of a client on long-term steroid therapy which values would the nurse expect to be altered in the urine

A

glucose and ketones - steroids made blood sugar go up body fat broken down so have ketones

78
Q

What are normal BG levels

A

3.9-6.1

79
Q

What nmight be the first sign of DM type 1

A

DKA

80
Q

What is the patho of DM type 1

A

insulin required to move glucose into cells –> no insulin stays in the blood –> blood beocmes hypertonic and pulls fluid –> glucose lost in urine –> cells are starving for glucose so break down fat and proteins –> ketones made (acidic) –> client goes into metabolic acidosis

81
Q

what type of breathing do diabetics do with high glucose

A

kussmal respirations to rid CO2

82
Q

What is th patho for NIDDM

A

don’t have enough insulin or are insulin resistant –> can’t make enough insulin to keep up with glucose they are taking in

83
Q

what should Type 2 diabetics be evaluated for

A

metabolic syndrome

84
Q

How much more insulin does a mom need in gestational diabetes

A

2-3X more insuilin than normal

85
Q

If a mom has risk factors for gestational diabetes when should they be screened

A

first prenatal vvisit

86
Q

when are all moms screened for gestational diabetes

A

24-28 weeks

87
Q

what complications to baby occur with gestational diabetes

A

hypoglycemia and increased birth weight

88
Q

What kind of diet should a diabetic hav

A

most calories should come from complex carbs and then fats, then proteins

89
Q

why are we worried about carbohydrates in a diabetics diet

A

sugar destroys vessels just like fat

90
Q

high fiber slows down what in diabetics

A

glucose absoprtion in the intestines

91
Q

what should diabetics remember with exercise

A

wait for blood sugar to normalize to begin exercies
eat prior to exercise
exercise when blood sugar is at its highest
exercise same time and amount daily

92
Q

how do oral antibiotics work

A

improves how the body produces insulin and how the body uses insulin and glucose
ALL work to decrease amount of circulating glucose

93
Q

Diabetics undergoing surgery or any radiological procedure that invovles contrast dye should temporarily discontinue what medication? why?

A

metformin

continue after 48 hours if kindey function returns to normal and creatinine is normal

94
Q

what is insulin dose based on

A

weight

95
Q

what is the standard insulin given IV

A

regular

96
Q

what is the most common daily dosing of insulin

A

basal/bolus

97
Q

what two insulins are used in basal/bolus dosing

A

long acting and rapid acting

98
Q

are snacks requrired with basal/bolus dosing

A

no

99
Q

what should you think about diabeitcs when they are ill

A

DKA

100
Q

with insulin injections what should you remember

A

rotate one area firt

101
Q

what type of insulin is used in an insulin pump

A

rapid

102
Q

what are the signs and symptoms of hypoglycemia

A 
cold and clammy
confused
nervous, nauseated
shaky, tachy
HA, hungry
103
Q

what should a client do if they are hypoglycemic

A

eat or drink a simple carb - snacks should be 15 g of carbohydrates

104
Q

what delays glucose absorption

A

fat

105
Q

whats the rule for hypoglycemics

A

15-15-15 wait 15 mins if below give 15g sugar wait 15

106
Q

once a diabetics blood sugar is back up what should they do eat

A

a complex carb and protein

107
Q

If you enter a diabetic client’s room and they are unconscious do you treat them as they are hypo or hyper

A

hypo - its more dangerous

108
Q

what is the treatment for DKA

A 
find the cause 
hourly blood sugar and K levels
IV insuin
ECG 
hourly outputs
ABG's --> metabolic acidosis 
IVFs --> polyruia causes shock; start with NS then switch to D5W to preven hypogylcemia
109
Q

Hyperosmolar hyperglycemic nonketois (HHNK) or Hyperglycemic Hyperosmolar State (HHS) differs from DKA how

A

no acidosis –> making just enough insulin so they are not breaking down body fat so no ketones

110
Q

what can happen with the GI tract regarding diabetics

A

stomach emptying delayed so risk for aspiration due to neuropathy

NCLEX (10 decks)

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