Endocrine disorders Flashcards
In acromegaly, what is the purpose of the glucose-tolerance test? what does it measure
growth hormone concentration
what is the pre-operative teaching for a patient scheduled for transphenoidal hypophysectomy?
a pituitary tumor will be removed - no sneezing after the procedure
An excess of what hormone causes the large flattened features of the patient with acromegaly?
growth hormone
what are the classic signs and symptoms of diabetes insipidus?
problem with posterior pituitary
massive diuresis, excessive thirst, very dilute urine. Massive dehydration.
why must a patient with Addison Disease take hydrocortisone?
regulate the excretion of potassium and sodium
what is nephrogenic DI and how does it differ from neurogenic DI?
nephrogenic does not respond to ADH and is inherited. Neurogenic is caused by a tumor, or cancer, or trauma
Why would a patient with Addison disease have a disturbed body image related to the color of their skin?
hyperpigmentation. bronze or smoky color skin
what is the cardinal indication of pheochromocytoma?
its a tumor in the adrenal glands, usually benign, excessive secretion of catecholamines. epinephrine and norepinephrine. Diastolic BP over 115
what are the signs and symptoms of an Adrenal crisis for a patient with Addison’s disease?
confusion, it is life threatening. electrolyte imbalances, hypoglycemia, tachycardia
What is the purpose of the lab test to measure the serum level of adrenocorticotropic hormone (ACTH)?
it is measured to detect elevations of deficiencies in pituitary hormones. Making sure the pituitary gland is sending the right message to the adrenaline gland to release the correct level of ACTH
what would be included in the discharge plan for a patient with Addison Disease related to risk for injury?
if they are dizzy, arise slowly, call for help before getting out of bed
why would a patient in adrenal crisis, after receiving the initial dose of IV Solu Cortef, need continued IV Solu Cortef?
to maintain blood levels
what would the nurse include in the teaching plan for a patient who has Addison Disease?
wear a medical alert bracelet.
What medication would cause a long term asthma patient to develop Cushing Syndrome?
corticosteroids
what are the expected findings when assessing a patient with Cushing Syndrome?
moon face, trunk obesity, extremity wastng, buffalo hump, swelling
What instructions would the nurse give a patient with Cushing Syndrome regarding self care?
avoid people with infections
what should a nurse anticipate when assessing a patient with Simmonds Cachexia, related to hypopituitarism?
muscle and organ wasting
in documenting a care plan for a 10 year old boy with hyperpituitarism, know what the nurse would tell the patient related to disturbed self image
they will continue to grow, increased growth
what is the nursing care for a patient who had a hypophysectomy, in which the whole pituitary was removed?
hormone replacement for life
What are the caused for an Addisonian Crisis?
adrenal surgery, pituitary destruction, stress and abrupt steroid removal
what is the discharge planning for the patient who underwent a hypophysectomy is focused on?
avoid straining, heavy lifting, self care
What nursing responses from the nurse would be best for the patient’s family and the patient if the patient has gigantism
hyper pituitary acceptance
for a patient with hypopituitarism, who must take medications for the rest of their life, what would the teaching plan include?
to be educated on signs and symptoms to know if meds are working affectively. Medical alert bracelet, signs of water toxicity
what is the drug Sandostatin for and how does it work?
acromegaly and it suppresses the growth hormone
If a patient complains of headache and nuchal rigidity after a hypophysectomy, based on these assessments, what should the nurse do?
meningeal irritation, report it to the physician
If a physician orders a T3 and T4, know what levels of these tests would indicate hypothyroidism?
decreased/low
if a patient starts taking potassium iodide SSKI, know what the nurse should instruct the patient to do?
use a straw - to prevent staining teeth
if a patient with hyperthyroid, cannot get to sleep, know what the nurse should suggest?
encourage bedtime rituals
know what significant instructions to give a patient who is scheduled for a thyroid scan?
wash hands with soap and water every time you go to the bathroom for 24 hours because of the radiation
if a patient had a lab test that showed a high level of thyroid-stimulating hormone (TSH) and a low level of T4, know what that would indicate?
hypothyroidism
know what “exophthalmos” is and when it goes away?
bulging eyes, goes away after treatment
know the pathophysiology of Graves Disease and how to explain that to a patient?
hyperthyroidism - subtotal thyroidectomy, remove most of it. Lifelong medications
if a patient was 1 day post-op after subtotal thyroidectomy and noted the patient’s color was poor, pulse and respirations were rapid and the patient felt war to touch, know what the nurses initial implementation should be
thyroid storm
if a patient had been given the drug “propylthiouracil” know what nursing implementations should include
used for hyperthyroidism, watch for hypothyroidism, weight gain and fatigue
know what an appropriate nursing diagnosis for a patient recently diagnosed with hyperthyroidism would be
decreased cardiac output, disturbed sleep pattern, hyperthermia, imbalanced nutrition: less than body requirement, risk for injury, disturbed sensory perception, diarrhea
a newly diagnosed patient with hypothyroidism begins a drug regimen, know what nurse instructions should be given relative to hormone replacement
watch for hyperthyroidism
what pre-surgical teaching is included for a patient scheduled for a sub-total thyroidectomy
demonstrate how to avoid straining the neck
support the head and neck during position changes
cough and deep breathe
after a patient undergoes thyroidectomy, know what explanation you would give the patient for the tracheostomy tray on the bedside table
in case of an emergency, the larynx can spasm and close the airway
How should a nurse asses for hemorrhage in a post thyroidectomy patient?
assess dressing,
check back of the neck for seeping blood
put in high fowlers to prevent swelling
how do foods such as soybeans, turnips and rutabagas have an effect on a person with a thyroid disorder?
suppresses the thyroid
why might an older persons daily dose of thyroid hormone, taken for many years, need to be decreased?
metabolism may decrease, so decrease hormone
a patient who is 2 days post-op total thyroidectomy, has a carpopedal spasm of the hand. know why this would occur and what the spasm is called
low calcium, hypocalcemia
how does the nurse initiate “chvostek sign” and what does it indicate?
facial nerve, spasm of facial muscle, hypocalcemia
what would a patient with hyperparathyroidism exhibit in their history
impaired urinary elimination due to renal calculi
if a patient who has hyperparathyroidism is to receive the drug Calcitonin (calcimar), know what the patient should be tested for, before receiving this drug
sensitivity
what is an appropriate nursing diagnosis for a patient with hyperparathyroidism?
impaired urinary elimination related to urinary calculi
