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Med-Surge-1 > Endocrine alterations and nursing management > Flashcards

Endocrine alterations and nursing management Flashcards

1
Q

Acromegaly: what gland is affected, what hormone is out of balance?
what symptoms are likely?

A

anterior pituitary, growth hormone is high
symptoms: thickening of bones and soft tissue, deepening of voice, visual distrubances, HA, hyperglycemia, sleep apnea, cardiomegaly

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2
Q

what are some complications of Transphenoidal Hypophysectomy

A

leaking cerebral spinal fluid
(and other)

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3
Q

drug therapy for acromegaly

A

not treatment of choice, but Ocreotide (sandostatin) can decrease GH levels

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4
Q

what would be a priority assessment after a transphenoidal hypophysectomy?

what is a complication

A

*neuro checks, bleeding, cerebrospinal fluid, airway, pain control, reduction of ICP, seizure monitoring
*position of patient should be elevated
Dexamethasone - steroid good for brain stuff

complication: diabetes insipidus

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5
Q

what is the thyroid responsible for?

A

metabolism

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6
Q

what causes goiters

A

anything that makes the thyroid gland work harder
-or a lack of iodine in the diet
commonly found in patients with graves disease

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7
Q

_____ is released from the hypothalmus
That in turn stimulates ____ from the ant pituitary
This stimulates ____ from the THyroid gland

A

TRH is released from the hypothalmus
That in turn stimulates TSH from the ant pituitary
This stimulates T3/T4 from the THyroid gland

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8
Q

The pt with primary hyperthyroidism will have lab results:
T3 and T4 will be _____
TSH will be ______

A

T3 and T4 will be high
TSH will be low

(b/c of negative feedback)

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9
Q

what is a test that will differentiate graves from other forms of thyroiditis

A

Radioactive iodine uptake (RAIU)
the pt with graves will show a diffuse, homogenous uptake, whereas the pt with thyroiditis will show an uptake of less than 2%

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10
Q

the nurse is caring for a pt with an elevated T3 T4, what symptoms

A

tachycardi, goiter, exophalamus, excess perspiration, feeling warm
(Treadmill man)

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11
Q

nursing management for hyperthyroidism

A

heart monitor, oxygen, adequate nutrition

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12
Q

nursing management for someone with exopthalmus

A

artificial tears, salt restriction to reduce periorbital edema, taping the eyes shut to help them sleep

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13
Q

hyperthyroidism treatment

A

radioactive iodine is the treatment of choice for non-pregnant patients
antithyroid drugs: Propylthiouracil (PTU), Methimazole (tapazole), beta blocker agents as well

any of the treatments can lead to hypothyroidism

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14
Q

post operative treatment of thyroidectomy

A

-hypocalcemia is a potential risk
-tetany can lead to laryngeal spasm, keep tracheostomy tray at bedside
support head manually when turning in bed to relieve the stress on the surgical site

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15
Q

interprofessional care for someone coming in with a thyroid storm

A

start an iv
-beta blockers like propanolol
put them on a cardiac monitor
-give them oxygen
seizure precautions

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16
Q

the pt with primary hypothyroidism will have _____ T3/T4 and ____ TSH

A

low and high

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17
Q

the pt with secondary hypothyroidism will have _____ T3/T4 and ____ TSH

A

low and low

18
Q

to maintain normal thyroidhormone balance the hypothalamus releases

A

TRH

19
Q

a deficiency in TSH will cause

A

hypothyroidism

20
Q

TRH from the hypothalamus stimulates the release of

A

TSH

21
Q

pt has a tumor that is affecting the function of the anterior pituitary gland the TSH release is excessie because of the tummor

A

secondary hyperthyroidism

22
Q

the pt has dysfunction fo the thyorid gland and LOW T3 T4. and elevation TSH

A

primary hypothyroidism

23
Q

myxedema coma

A

low T3T4, dry skin, brady, hypoTNS, low body temp

24
Q

what time of day to give thyroid medications

A

in the morning on an empty stomach

25
Q

what is a normal urine specific gravity?
what is normal calcium

A

1.001=1.030
8.5-10.5

26
Q

what does parathyroid hormone do?

A

raise calcium

27
Q

what is the hormone that lowers calcium

A

calcitonin

28
Q

what is hyperparathyroidism

A

over secretion of PTH will lead to an increased serum calcium level, and low phosphorus levels
this will lead to deceased bone density and osteoporosis

29
Q

treatment of hyperthyroidism

A

increase fluid intake, to dilute the serum calcium
-furosemide IV increases the renal excretion of calcium
-decrease consumption of calcium (No TUMS )
-strain the urine to look for stones
-surgical parathyroidectomy

30
Q

post operative care of parathyroidectomy

A

major considerations:
hemorrhage, can compromise airway, monitor for tetany (tingling and laryngeal spasms), chvostek and trousseau’s signs,
hypocalcemia can develop quickly
encourage early ambulation

31
Q

____ is released from the Hypothalamus
this stimulates ____ from the anterior pituitary
this stimulates ___ from the adrenal glands

A

(CRH) is released from the Hypothalamus
this stimulates (ACHT) from the anterior pituitary
this stimulates (corticosteroids, epinephrine, norepi) from the adrenal glands

CRH, ACHT,
corticosteroids, epinephrine, norepi

32
Q

excess secretion of ACTH will result in

A

cushings syndrome

33
Q

the adrenal medulla secretes what?

A

epi, norepi, dopamine

34
Q

clinical manifestation of cushings syndrome

A

hypernatremia, metabolic alkalosis (bicarb loves sodium), hypokalemia

35
Q

what things will stimulate aldosterone release?

A

decreased blood pressure, hyponatremia, hyperkalemia

36
Q

why do people with addisons get hyperkalemia

A

** cardiac monitor **
they arent secreting aldosterone so they are holding on to the potassium

37
Q

what would an ACTH stimulation test show for someone with addisons disease?

A

normally cortisol steroid levels would rise after synthetic admin of ACTH, but with addisons, the cortisol levels will remain the same level as baseline

38
Q

Lab findings for addisons
sodium, potassium, bun, glucose
ECHT

A

sodium low, potassium high, bun high, glucose low
BUN would be high if we don’t have good hydration
ecg would be peaked

39
Q

nursing considerations for addisons disease

A

daily weights
protect from stressors
add salt in the diet esp if they live in hot and humid environment

40
Q

medications for addisons disease

A

hydrocortisone which includes both glucocorticoid and mineral corticoid
may need extra mineralcorticoid (fludrocortisone)

Med-Surge-1 (13 decks)

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