Endocrine Flashcards
What three glands are produced with thyroid hormones?
T3,t4, calcitonin
What does calcitonin do?
Decrease cal levels putting from blood to bone
What makes hormones
Iodine
What do thyroid hormones do?
Provide energy
Hyperthyroidism
S/s GRAVES / too much energy Nervous Irritable Short attention span Weight down Appetite up Exopthalmus GI fast BP/BPM up Arrythmia Increase in thyroid
Diagnosis T4 is Tsh Thyroid scan - must discontinue 1 week and restart in 6 weeks Ultrasound/MRI/CT
Txt Anti thyroid methimazole Stops making thyroid Used for preop Euthyroid
Iodine
Decrease size of gland
Use straw why? With milk/juice
Beta blockers LOL propanol Decrease myocardial contractility Decrease HR/BP Anxiety *contra for diabetics and asthmatics
Radioactive therapy 1 dose Po -r/o pregnancy Destroys thyroid cells Stay away from babies 1 week no contact 1wk
*thyroid storms
Surgery thyroidectomy
Priority* hemorrhage
Reporting pressure
Check bleeding on incision
How to care for thyroidectomy pt2?
Assess for bleeding at incision Laryngel damage? How? Potential paralysis requires trach Trach set at bedside Swelling Hypocalcemia -assess parathyroid removal theyre not sedated they are rigid
Teach:
Support neck
Personal items close
Increase calories post op
Hypothyroidism
S/s No energy Tired Slow speech Weight increase Gi slow Cold Ammenorrhea
Diagnosis
t4 decreased
Tsh increased
Txt
Levothyroxine empty stomach
Tend to have CAD because of increased LDL
Forever on meds
What is a parathyroid problem
Affects Ca
Hyperparathyroidism=hypercal=hypophos
Too much pth, sedated
Txt
Partial parathyroidectomy to decrease PTH
Monitor for hypocal (tight ridgid muscle)
Hypopara=hypocal=hyperphos
Too little pth, ca low, not sedated
Txt:
Iv ca
Pho binding drugs
What does your adrenal gland do?
Respond to stress with two parts,
adrenal cortext and adrenal meddulla
What does the adrenal medulla release
Epi and Norephi
What is a complication of adrenal medulla
Phenochromocytoma, which is a benign tumor that releases in boluses.
Familial
S/s of Phenochromocytoma?
Bp UP HR UP Palpitations Yes Flushing and diaphoretic headache Yes
How to diagnose Phenochromocytoma?
Catecoline levels VMA/MN
24 hr specimen - throw away first void, keep last void
Avoid activities that increase nor and ephi
Surgery to remove tumors
*Avoid palpating abdomen as this can activate release and increase bp
Purpose of Adrenal Cortex?
Secretes hormones - gluccorticoids, mineralocorticoids, and sex hormones
What does the gluccorticoids do in a/cortex?
Chnage your mood alter defense mechanisms immunosupressed = risk for infection breaks down protein and fats - energy inhibit insulin - hyperglycemic
What does mineralocorticoids / ald do?
Retain Na and H2o, and lose potassium
What does sex hormones do?
Hirsutism
Acne
Irreg Menstral cycle
What are the problems with Adrenal Cortex?
Not enough steroids shock hyperkalemia hypoglycemia Addison's disease
What is addisons disease?
Not enough steroids.
S/S Extreme fatigue nause/vo/diah weightloss hypotension confusion decreased sodium potassium, hypoglycemia hyperkal hyperpig vitiligo
What is the treatment for addison?
Fight against shock increase sodium processed fruit/broth increase i/o Bp will likely be low, and losing weight/FVD
Meds
Corticosteriods - 2x a day split morning and evening
Fludocortisone acetate synthetic aldosterone
daily weight and bp monitored *monitor for Bp changes
What is addision crisis?
Sever hypotension and vascular collapse due to infection, emotional stress, and stopping steroids abruptly. b/sugar down.
What is cushing’s ?
Too much steriods
