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Hesi 2 > endocrine hurst > Flashcards

endocrine hurst Flashcards

1
Q

what does the thyroid produce

A

T3, T4, calcitonin

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2
Q

what does calcitonin do

A

decreases serum calcium levels by taking calcium out of the blood and pushing it back into the bone

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3
Q

what do you need to make hormones

A

iodine

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4
Q

what do thyroid hormones do

A

give energy

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5
Q

signs and symptoms of graves disease

A

nervous
irritable
attention span decrease
appetite increase
weight decrease
sweaty/hot
exophthalmos (bulging eyes)
GI fast
arrhythmia/palpitations
increase thyroid size

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6
Q

diagnosing graves disease

A

increased T4
decreased TSH
thyroid scan
ultrasound, mri, CT

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7
Q

what must you do before and after a thyroid scan

A

discontinue iodine containing meds 1 week prior and 6 weeks after

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8
Q

example of iodine containing drug

A

amiodarone

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9
Q

treatment of graves disease

A

antithyroids
iodine compounds
betablockers (supportive therapy)
radioactive iodine therapy
surgery

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10
Q

what do antithyroid do

A

stop thyroid from making hormones
used prop to stun thyroid

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11
Q

what do iodine compounds do

A

decrease the size and vascularity of the gland

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12
Q

how do you give iodine compounds

A

in milk or juice with a straw because it stains teeth

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13
Q

how do beta blockers help hyperthyroidism

A

decreases myocardial contractility
could decrease cardiac output
decreases HR, BP
decrease anxiety

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14
Q

how do you administer radioactive iodine therapy

A

1 PO dose

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15
Q

what must you do after radioactive iodine therapy

A

stay away from babies for 1 week
dont kiss anyone for 1 week

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16
Q

priorities after thyroidectomy

A

hemorrhage
laryngeal nerve damage
hypocalcemia (PTH is there)

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17
Q

signs of hemorrhage post thyroidectomy

A

feeling of pressure in the neck
bleeding at incision
pooling at back of neck

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18
Q

how do you assess for laryngeal nerve damage

A

listen for hoarseness and weakness

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19
Q

what can laryngeal nerve damage lead to

A

vocal cord paralysis

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20
Q

what happens if both vocal cords are paralysed

A

airway obstruction

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21
Q

signs of parathyroid removal

A

PTH decreased
rigid
tight
siezure

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22
Q

signs of hypothyroid

A

no energy
fatigue
no expression
speech is slow and slurred
weight up
cold
amenorrhea

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23
Q

what should you avoid giving a pt with hypothyroid

A

heating pads they may not feel it

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24
Q

diagnosis

A

T4 decreased
TSH increased

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25
Q

treatment of hypothyroid

A

levothyroxine

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26
Q

what does PTH do

A

makes you pull calcium from the bone and place it in the blood causing serum calcium to go up

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27
Q

hyperparathyroid signs and symptoms

A

too much PTH
serum calcium is high phosphorus is low
sedated

28
Q

treatment of hyperparathyroid

A

partial parathyroidectomy

29
Q

hyperparathyroidism signs and symptoms

A

not enough PTH
serum calcium is low and phosphorus is high
not sedated

30
Q

treatment of hypoparathyroidism

A

IV calcium
phosphorus binders

31
Q

what do you need adrenals for

A

handle stress

32
Q

What do glucocorticoids do

A

affect mood
alter defense mechanism
breakdown fats and proteins
inhibit insulin

33
Q

what do mineral corticoids do

A

make you retain water and sodium and lose potassium

34
Q

signs of too many sex hormones

A

hirsutism
acne
irregular menstral cycle

35
Q

signs of not enough sex hormones

A

decreased axillary and pubic hair
decreased libido

36
Q

What is Addisons disease

A

not enough steroids

37
Q

signs of Addisons disease

A

extreme fatigue
nausea, vomiting, diarrhea
anorexia, weight loss
hypotension
confusion
decreased sodium, increased potassium and hypoglycemia
hyperpigmentation-bronzing of skin and mucous membranes
white patchy area of depigmented skin

38
Q

treatment of addisons

A

increase sodium in diet
I&O daily weight
if losing sodium and water bp will be low
fluid volume deficit

39
Q

medications for Addisons disease

A

corticosteroids

40
Q

how are corticosteroids given

A

twice a day 2/3 in the morning and 1/3rd at night.
its how body naturally secretes

41
Q

what is cushings disease

A

too many steroids

42
Q

signs of too many glucocorticoids

A

growth arrest
thin extremities and skin
hyperglycemia
psychosis to depression
moon faced
truncal obesity
buffalo hump

43
Q

signs of too many sex hormones

A

oily skin/acne
women with male traits
signs of too many mineral corticoids

44
Q

Signs of too many mineralcorticoids (aldosterone)

A

high BP
CHF
weight Gian
fluid volume excess

45
Q

what will serum potassium be with too much aldosterone

A

low

46
Q

what would cortisol levels with too many steroids be

A

high

47
Q

diet pre adrenalectomy

A

increased potassium
decreased sodium
increased protein
increased calcium

48
Q

characteristics of type 1 diabetes

A

little or no insulin
usually diagnosed in childhood
first sign may be DKA
appears abruptly
classic 3Ps

49
Q

how is diabetes type two usually found

A

by accident or they keep coming back for things like a wound that one heal or repeated vaginal infections

50
Q

what should individuals with type 2 diabetes be evaluated for

A

metabolic syndrome

51
Q

what does metabolic syndrome increase the risk for

A

type 2 diabetes and cardiovascular disease

52
Q

features of metabolic syndrome

A

waist circumference
>40 in males
>35 in females

triglycerides>150

HDL
<40 in males
<50 in females

blood pressure >130/85

FBS>100

53
Q

how much insulin do pregnant women need

A

2-3 times more than normal

54
Q

when does screening for gestational diabetes happen

A

when mom has risk factors screen at first visit
all moms at 24-28 weeks

55
Q

complications to baby if mom has gestational diabetes

A

increased birth weight and hypoglycemia

56
Q

diet for diabetes

A

complex carbs 45%
fats 30-40%
protein 15-20%

57
Q

why are you concerned about carbs in a diabetic pt

A

sugar destroys vessels just like fat

58
Q

how does fiber affect glucose

A

it slows down glucose absorption rate in intestines eliminating sharp rise and falls

59
Q

when can you resume metformin after surgery

A

after 48 hours if kidney function has returned and creatinine level is normal

60
Q

what is the goal for insulin

A

to keep before meal glucose to near normal at 80 to 130

61
Q

What does an HBA!C measure

A

average blood sugar over past 3-4 months

62
Q

what happens to blood sugar when sick

A

increases

63
Q

HBA1c valcues

A

> 6.5 is diagnostic for diabetes
normal is <5.7
goal for diabetics < or equal to 7

64
Q

what type of insulin can be used in infusion pumps

A

rapid only

65
Q

signs of hypoglycemia

A

cold and clammy
confusion
shaky
headache
nervous
nausea
hunger
increased pulse

66
Q

diabetic foot care

A

nails strait
not short
dry between toes
well fitting shoes
daily inspections
no harsh chemicals

67
Q

signs of neuropathy

A

sexual problems
foot.leg problems pain, paresthesia, numbness
neurogenic bladder
gastroparesis

Hesi 2 (10 decks)

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