Endocrine Disorders, Pediatric Play, & Laminectomy Flashcards
Treatments for hyperthyroidism
Radioactive iodine, PTU, thyroidectomy
Radioactive iodine nursing considerations
- patient should be alone for 24 hours
- be careful with urine d/t radioactivity: instruct patient to flush three times, hazmat team must clean up spilled urine
PTU nursing consideration
Monitor WBCC (d/t immunosuppression)
Total thyroidectomy nursing considerations
- Monitor for hypocalcemia
- educate patient about the need for lifelong hormone replacement
Subtotal thyroidectomy nursing considerations
Monitor for S/S of thyroid storm (medical emergency): extreme temperature elevation, extreme hypertension, severe tachycardia, psychotic delirium
Thyroid storm treatment
Decrease temp, increase O2: Ice packs, cooling blankets, oxygen mask 10L
Post-op risks for both total and subtotal thyroidectomy within the first 12 hours
Airway and hemorrhage
Post-op risk for total thyroidectomy between 12-48 hours
Tetany (d/t hypocalcemia)
Post-op risk for subtotal thyroidectomy between 12-48 hours
Thyroid storm
Hypothyroidism nursing consideration
- Do NOT sedate (risk for myxedema coma)
- NEVER hold levothyroxine prior to surgery (NPO) unless given express orders to do so
Undersecretion of the adrenal cortex
Addison’s Disease
S/S of Addison’s Disease
Bronze/tan hyperpigmentation, inability to adapt to stress resulting in hypoglycemia and hypotension
The purpose of the body’s stress response is to perfume the brain with blood and raise _________ and _________
Glucose; Blood Pressure
Addison’s Disease treatment
Glucocorticoids (Addison’s = ADD SONes; Ex: prednisone)
Oversecretion of the adrenal cortex
Cushing’s Syndrome
S/S of Cushing’s Disease
Moon face, hirsutism, buffalo hump, gynecomastia, truncal obesity w/ skinny arms and legs, striae, retention of sodium and water, potassium loss, elevated glucose (hyperglycemia), easily bruised, immunosuppression — these are also all S/S of steroids
