ENDOCRINE DISORDERS 2 Flashcards

1
Q

Decreased ADH

A

DI

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2
Q

DI: Causes:

A

Head trauma with increased ICP
Cerebral Injury
Brain tumors or infections

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3
Q

ICP signs and symptoms

A

Cushings triad
Anisocoria
Diplopia
Projective vomiting
Dolls eye sign

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4
Q

DI: If caused by cerebral injury, symptoms commonly appear _________ after initial injury and last ____________.

A

3-5 days; 7-10 days

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5
Q

DI: CLINICAL MANIFESTATIONS

A

Polyuria
Diluted Urine
Polydipsia
Decreased Skin turgor

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6
Q

DI: SPECIFIC GRAVITY:

A

Decreased (<1.010)

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7
Q

DI: CONFIRMATORY DIAGNOSTIC TEST:

A

WATER DEPRIVATION TEST

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8
Q

WDT: withhold fluid intake for __________ if no increase in urine concentration or specific gravity

A

4-18 hours

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9
Q

DI: SERUM ELECTROLYTES:

A

Hypernatremia

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10
Q

DI: NURSING INTERVENTIONS

A

Monitor I&O
Avoid Alcohol
Increase fluids
Daily weight
Manage Skin turgor

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11
Q

DI : IV fluids

A

Hypotonic

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12
Q

DI: DOC

A

Desmopressin acetate

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13
Q

Increased ADH

A

SYNDROME OF INAPPROPRIATE ADH SECRETION

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14
Q

SIADH: Causes

A

Malignant tumors (Pituitary gland)
Head Injury
Use of medications - TCA, Diuretics

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15
Q

SIADH: CLINICAL MANIFESTATIONS

A

Weight gain
Edema
Disorientation and Confusion
Headache
Hyponatremia

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16
Q

SIADH : IV fluids

A

normal saline or
hypertonic

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17
Q

HYPERTONIC

A

to shrink the cells

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18
Q

SIADH: DOC

A

Demeclocyline (Demlomycin)
Diuretics: Furosemide

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19
Q

In using Demeclocyline:

A

o No calcium containing foods
o No milk/antacids – affects absorption

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20
Q

In using diuretics:

A

o WOF: Decreased K+
o Administer slowly to prevent transient hearing loss

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21
Q

ADDISONS: Causes

A

o Autoimmune
o PGT- Pituitary Gland Tumor
o TB, AIDS

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22
Q

ADDISONS: S/Sx

A

Everything is LOW except K+, Ca+ and PR ; Dark skin

23
Q

ADDISON: INITIAL MANIFESTATION:

A

Fatigue

24
Q

ADDISONS: Recommended Diet:

A

Low K+, Low Ca+, High Salt, High Carbs

24
Q

ADDISONS: Encourage oral fluid intake of ___________ and increased
salt intake

A

3-4 L/day

24
Q

CARDIAC RYTHMS: Increased K+

A

Peak T wave, Prolonged PR interval, Wide QRS complex

24
Q

STEROID: VS _________ and weight

A

four times a day

25
Q

steroids is given________.

A

after meals

25
Q

STEROID DOSE:

A

2/3 in AM, 1/3 in PM

26
Q

STEROID: Monitor electrolyte levels

A

Hypokalemia, Hypocalcemia, Hypernatremia

26
Q

Monitor for___________ stressors

A

increased

26
Q

STEROIDS: S/E

A

Immunosuppressant
Poor wound healing
Easy bruising, thinning of skin
Increased protein metabolism

26
Q

STEROID: Monitor urine and blood glucose levels and urine
ketones.

A

R: Prone to HPN, Heart Disease

27
Q

SIDE EFFECTS OF STEROIDS: FBEQ

A

Mood swings
Easy bruising
Hirsutism
Acne
Altered fat metabolism (truncal obesity with thin arms and legs, buffalo hump)

27
Q

STEROID: Dose should be ____________

A

tapered and not stopped abruptly

28
Q

STEROIDS: Report the ff. to the physician:

A

Dizziness on sitting and standing, N/V, Malaise

28
Q

ADDISONIAN CRISIS: TRIGGERS/STRESSORS: sisa

A

o Stress
o Infection
o Surgery
o Abrupt withdrawal of steroid use

29
Q

ADDISONIAN CRISIS: BED REST?

A

STRICT BED REST

29
Q

ADDISONIAN CRISIS: MANIFESTATIONS

A

§ Severe HA
§ Generalized weakness
§ SV/D
§ Hypotension
§ Irritability and Confusion

29
Q

ADDISONIAN CRISIS: DOC

A

Glucocorticoids per IV then orally
(solu-cortef, hydrocortisone sodium
succinate)

30
Q

CUSHING’S SYNDROME : CAUSES

A

o pituitary adenoma or adrenal adenoma
o prolonged steroid therapy

31
Q

Cushing: DIET

A

Low sodium, High K+, High Ca+

32
Q

HYPERPITUITARISM: CAUSES:

A

Benign pituitary adenoma

32
Q
A
33
Q

Benign pituitary adenoma; may result from

A

Hyperplasia of pituitary tissues

33
Q

HYPOPITUITARISM: CAUSES:

A

q Tumors
q Trauma
q Autoimmunity
q Stroke, surgery/ radiation of pituitary gland

34
Q
A
34
Q
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35
Q
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36
Q
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36
Q
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36
Q
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36
Q
A