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Medsurg Exam 3 > Endocrine DIsorders > Flashcards

Endocrine DIsorders Flashcards

1
Q

risk factors for hypothyroidism

A

Hashimoto Disease
Thyroidectomy
Head and neck cancer
Women > Men
Elderly

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2
Q

early clinical manifestations for hypothyroidism

A

fatigue to somnolence,
loss of libido to amenorrhea,
apathy to mental and physical sluggishness,
nonpitting edema to pleural and pericardial effusions
hair loss, brittle nails, and dry skin are common
constipation
Paresthesia (numbness and tingling of the fingers) and nerve entrapment syndrome
hearing loss may occur

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3
Q

late signs of hypothyroidism

A

slow speech
subdued emotional responses
apathy
absence of sweating
cold intolerance
constipation
thickening of skin (due to accumulation of mucopolysaccharides in subcutaneous tissues)
dyspnea
weight gain
thinning of hair
alopecia
deafness
On assessment, patients usually present with swelling of eyelids, pitting edema, bradycardia, hypotension, and hypothermia

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4
Q

the most extreme, severe stage of hypothyroidism resulting in pt being hypothermic and unconscious

A

myxedema coma

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5
Q

why is myxedema coma life threatening

A

leads to swelling of the tongue and respiratory drive is depressed

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6
Q

management of hypothyroidism

A

hormone replacement
restoration of euthyroid state as safely and rapidly as possible

levothyroxine (synthroid)

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7
Q

teaching necessary for use of levothyroxine

A

It may take 8 weeks to see the full effect
∙ Report signs of hyperthyroidism
∙ Tachycardia, heart palpitations,
weight loss, insomnia, anxiety ∙ Monitor T4 & T3 levels
∙ Take once a day (in the morning before breakfast) ∙ Take at the same time everyday
∙ Take on an empty stomach

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8
Q

causes of hyperthyroidism

A

Enlarged thyroid gland
Thyroiditis
Graves’ disease
Over medication- hypothyroidism
Thyroid nodules

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9
Q

clinical manifestations of hyperthyroidism

A

Exophthalmos
Weight loss
Tachycardia / Atrial Fibrillation
Hyperthermia
Decreased fertility
Increased peristalsis
Loss of bone minerals

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10
Q

complications of hyperthyroidism

A

Thyrotoxicosis
Thyrotoxic crisis or thyroid storm

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11
Q

what is the difference between thyrotoxicosis and thyroid storm

A

Thyrotoxicosis is a common endocrine condition that may be secondary to a number of underlying processes.

Thyroid storm (also known as thyroid or thyrotoxic crisis) represents the severe end of the spectrum of thyrotoxicosis and is characterized by compromised organ function

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12
Q

management of hyperthyroidims

A

Nutritional therapy
Radioactive iodine
-Beta-adrenergic blocking agents
Surgery
Antithyroid agents

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13
Q

goals for management of hyperthyroidism

A

Block adverse effects of thyroid hormones
Suppress hormoneover secretion
Prevent complications

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14
Q

diet for pt with hyperthyroidism

A

high in carbs and proteins

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15
Q

radio active iodine: What does it do? How long does it take to become effective or for symptoms to resolve?

A

destroy overactive thyroid cells
2-3 months

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16
Q

Thyroidectomy: What is your role for this patient following surgery? What should you assess? How should you position your patient? What complications should you monitor for?

A

administer preop medications
possibly iodine
position in fowler’s position
monitor for bleeding, hematoma

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17
Q

assessment of pt with thyroid disorders

A

History
Assessment
-Cardiovascular assessment
-Respiratory Assessment
-HEENT
-Skin, hair, and nails
Monitor vital signs

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18
Q

planning for pt with thyroid disorders

A

Experience relief of symptoms
Maintain a euthyroid state
Maintain a positive self-image
Comply with lifelong thyroid replacement therapy
Improve nutritional status
Improve coping ability
Maintenance of normal body temperature
Absence of complications

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19
Q

nursing diagnoses for hypothyroidism

A

Activity intolerance
Constipation
Impaired memory
Altered body temperature

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20
Q

nursing diagnoses for hyperthyroidism

A

Altered nutrition
Ineffective coping
Altered body temperature
Discomfort

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21
Q

thyroid disorders implementation for acute care

A

Skin care
Vital signs, weight, IandO, edema
Cardiovascular response to hormone
Energy level
Mental alertness

22
Q

education for thyroid disorders

A

Encourage patient to be an active participant
Comfort
Education to patient and families
Low-calorie diet
Written instructions important
Need for lifelong therapy
Thyroid medicine in morning on empty stomach
Side effects of medication
Do not switch brands

23
Q

expected outcomes for thyroid disorders

A

Have relief from symptoms
Maintain euthyroid state
Avoid complications
Adhere to lifelong therapy

24
Q

function of the thyroid gland

A

produce T3, T4, and calcitonin (iodine needed)
gives you energy

25
Q

function of parathyroid gland

A

produces and secretes PTH - controls calcium in blood

26
Q

risk factors for hyperparathyroidism

A

Tumor or hyperplasia
CKD

27
Q

clinical manifestations of hyperparathyroidism

A

Symptoms of hypercalcemia
-bone pain
-Arrhythmias
-cardiac arrest (bounding pulses)
-kidney stones
-muscle weakness ↓ (DTR)
-Excessive urination
Complications
-Ventricular dysrhythmias
-Hypercalcemic crisis
Musculoskeletal symptoms

28
Q

diagnostics for hyperparathyroidism

A

Labs- Serum calcium
Radioimmunoassay
Bone scans
Ultrasound
MRI

29
Q

management of hyperparathyroidism

A

Parathyroidectomy
Hydration
Patient mobility
Nutrition
Medication
Emotional support

30
Q

possible medications for treatment of hyperparathyroidism

A

Phosphates, calcitonin, & IV or oral bisphosphonates

31
Q

risk factors for hypoparathyroidism

A

Thyroidectomy
Parathyroidectomy
Radical neck dissection

32
Q

clinical manifestations of hypoparathyroidism

A

Symptoms of hypocalcemia
Anxiety
Delirium
ECG changes
Hypotension
Complications
-Seizures
-Tetany

33
Q

management of hypoparathyroidism

A

Parenteral PTH
Calcium Gluconate
Supplements
Dietary changes

34
Q

function of adrenal medulla

A

releases catecholamine hormones epinephrine and norepinephrine

35
Q

function of adrenal cortex

A

secretes glucocorticoids, mineralocorticoids, and androgens

36
Q

primary addison’s disease

A

Insufficiency of the adrenal cortex
Corticosteroids-glucocorticoids, mineralocorticoids, and androgens

37
Q

secondary addison’s disease

A

Lack of pituitary ACTH
Glucocorticoids and Androgens

38
Q

life threatening addisonian crisis

A

∙ Profound fatigue ∙ Dehydration
∙ Renal failure
∙ Rapid respiration ∙ Hyponatremia
∙ Hypokalemia
∙ Cyanosis
∙ Fever
∙ Nausea/vomiting
Think SHOCK!
* Hypotension
* Weak rapid pulse
Treatment:
Fluid resuscitation & high-dose hydrocortisone

39
Q

diagnostics of addison’s disease

A

Serum cortisol <165 nmol/L
Plasma ACTH > 22.0 pml/L
↑ Potassium
↓ Chloride, sodium, glucose
CT scan, MRI

40
Q

management of addisonian crisis

A

Shock management
High-dose IV hydrocortisone replacement
0.9% saline solution and 5% dextrose
Vasopressorsq

41
Q

acute care for addison’s disease

A

Antibiotics
Correct fluid and electrolyte imbalance
-Assess vital signs and neurologic status
-Daily weight
-Accurate I and O

42
Q

teaching for admin of corticosteroids

A

report ss of corticosteroid deficiency
carry ID and wear bracelet
emergency kit
how to admin IM hydrocortisone

43
Q

High levels of serum cortisol
Too much ACTH

A

cushing syndrome

44
Q

common causes of cushin syndrome

A

Iatrogenic administration of exogenous corticosteroids
ACTH-secreting pituitary adenoma
Adrenal tumors
Ectopic ACTH production by tumors

45
Q

symptoms of excess glucocorticoids

A

hypertension, obesity, osteoporosis, fractures, impaired immune function, impaired wound healing, glucose intolerance, and psychosis

46
Q

symptoms of excess mineralocorticoids

A

hypertension, hypokalemia, low birth weight, failure to thrive, hypertension, polyuria and polydipsia, and poor growth

47
Q

symptoms of excess androgens

A

Acne.
Changes in female body shape.
Decrease in breast size.
Increase in body hair in a male pattern, such as on the face, chin, and abdomen (called hirsutism)
Lack of menstrual periods (amenorrhea)
Oily skin

48
Q

diagnostic studies for cushing syndrome

A

Urine free cortisol
Salivary cortisol
Dexamethasone suppression test(takes 1 mg med - returns next morning for labs)
Radioimmunoassay measurement of ACTH
Serum Cortisol
CT
Ultrasound
MRI

49
Q

management for cushing syndrome

A

adrenalectomy
hydrocortisone
education
Risk for falls
Risk for infection
Promote periods of rest
Skin care
Dietary changes
Family education

50
Q

other clinical manifestations of cushings

A

moon face
buffalo hump
ecchymosis
purple striae
slow wound healing
thin skin

Medsurg Exam 3 (4 decks)

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