endocrine hurst Flashcards
what does the thyroid produce
T3, T4, calcitonin
what does calcitonin do
decreases serum calcium levels by taking calcium out of the blood and pushing it back into the bone
what do you need to make hormones
iodine
what do thyroid hormones do
give energy
signs and symptoms of graves disease
nervous
irritable
attention span decrease
appetite increase
weight decrease
sweaty/hot
exophthalmos (bulging eyes)
GI fast
arrhythmia/palpitations
increase thyroid size
diagnosing graves disease
increased T4
decreased TSH
thyroid scan
ultrasound, mri, CT
what must you do before and after a thyroid scan
discontinue iodine containing meds 1 week prior and 6 weeks after
example of iodine containing drug
amiodarone
treatment of graves disease
antithyroids
iodine compounds
betablockers (supportive therapy)
radioactive iodine therapy
surgery
what do antithyroid do
stop thyroid from making hormones
used prop to stun thyroid
what do iodine compounds do
decrease the size and vascularity of the gland
how do you give iodine compounds
in milk or juice with a straw because it stains teeth
how do beta blockers help hyperthyroidism
decreases myocardial contractility
could decrease cardiac output
decreases HR, BP
decrease anxiety
how do you administer radioactive iodine therapy
1 PO dose
what must you do after radioactive iodine therapy
stay away from babies for 1 week
dont kiss anyone for 1 week
priorities after thyroidectomy
hemorrhage
laryngeal nerve damage
hypocalcemia (PTH is there)
signs of hemorrhage post thyroidectomy
feeling of pressure in the neck
bleeding at incision
pooling at back of neck
how do you assess for laryngeal nerve damage
listen for hoarseness and weakness
what can laryngeal nerve damage lead to
vocal cord paralysis
what happens if both vocal cords are paralysed
airway obstruction
signs of parathyroid removal
PTH decreased
rigid
tight
siezure
signs of hypothyroid
no energy
fatigue
no expression
speech is slow and slurred
weight up
cold
amenorrhea
what should you avoid giving a pt with hypothyroid
heating pads they may not feel it
diagnosis
T4 decreased
TSH increased
treatment of hypothyroid
levothyroxine
what does PTH do
makes you pull calcium from the bone and place it in the blood causing serum calcium to go up
hyperparathyroid signs and symptoms
too much PTH
serum calcium is high phosphorus is low
sedated
treatment of hyperparathyroid
partial parathyroidectomy
hyperparathyroidism signs and symptoms
not enough PTH
serum calcium is low and phosphorus is high
not sedated
treatment of hypoparathyroidism
IV calcium
phosphorus binders
what do you need adrenals for
handle stress
What do glucocorticoids do
affect mood
alter defense mechanism
breakdown fats and proteins
inhibit insulin
what do mineral corticoids do
make you retain water and sodium and lose potassium
signs of too many sex hormones
hirsutism
acne
irregular menstral cycle
signs of not enough sex hormones
decreased axillary and pubic hair
decreased libido
What is Addisons disease
not enough steroids
signs of Addisons disease
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
treatment of addisons
increase sodium in diet
I&O daily weight
if losing sodium and water bp will be low
fluid volume deficit
medications for Addisons disease
corticosteroids
how are corticosteroids given
twice a day 2/3 in the morning and 1/3rd at night.
its how body naturally secretes
what is cushings disease
too many steroids
signs of too many glucocorticoids
growth arrest
thin extremities and skin
hyperglycemia
psychosis to depression
moon faced
truncal obesity
buffalo hump
signs of too many sex hormones
oily skin/acne
women with male traits
signs of too many mineral corticoids
Signs of too many mineralcorticoids (aldosterone)
high BP
CHF
weight Gian
fluid volume excess
what will serum potassium be with too much aldosterone
low
what would cortisol levels with too many steroids be
high
diet pre adrenalectomy
increased potassium
decreased sodium
increased protein
increased calcium
characteristics of type 1 diabetes
little or no insulin
usually diagnosed in childhood
first sign may be DKA
appears abruptly
classic 3Ps
how is diabetes type two usually found
by accident or they keep coming back for things like a wound that one heal or repeated vaginal infections
what should individuals with type 2 diabetes be evaluated for
metabolic syndrome
what does metabolic syndrome increase the risk for
type 2 diabetes and cardiovascular disease
features of metabolic syndrome
waist circumference
>40 in males
>35 in females
triglycerides>150
HDL
<40 in males
<50 in females
blood pressure >130/85
FBS>100
how much insulin do pregnant women need
2-3 times more than normal
when does screening for gestational diabetes happen
when mom has risk factors screen at first visit
all moms at 24-28 weeks
complications to baby if mom has gestational diabetes
increased birth weight and hypoglycemia
diet for diabetes
complex carbs 45%
fats 30-40%
protein 15-20%
why are you concerned about carbs in a diabetic pt
sugar destroys vessels just like fat
how does fiber affect glucose
it slows down glucose absorption rate in intestines eliminating sharp rise and falls
when can you resume metformin after surgery
after 48 hours if kidney function has returned and creatinine level is normal
what is the goal for insulin
to keep before meal glucose to near normal at 80 to 130
What does an HBA!C measure
average blood sugar over past 3-4 months
what happens to blood sugar when sick
increases
HBA1c valcues
> 6.5 is diagnostic for diabetes
normal is <5.7
goal for diabetics < or equal to 7
what type of insulin can be used in infusion pumps
rapid only
signs of hypoglycemia
cold and clammy
confusion
shaky
headache
nervous
nausea
hunger
increased pulse
diabetic foot care
nails strait
not short
dry between toes
well fitting shoes
daily inspections
no harsh chemicals
signs of neuropathy
sexual problems
foot.leg problems pain, paresthesia, numbness
neurogenic bladder
gastroparesis
