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NCLEX > Endocrine Part 1 > Flashcards

Endocrine Part 1 Flashcards

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1
Q

What does thyroid produce??

A

T3, T4, Calcitonin

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2
Q

How does calcitonin work?

A

Decreases serum calcium by taking it from the blood and putting it back in the bone

Tx osteoporosis

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3
Q

What do you need to make hormones?

A

Dietary Iodine

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4
Q

What hormone gives us energy?

A

Thyroid hormone

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5
Q

S/S Hyperthyroidthyroidism (Graves)

Energy?
Wt: 
Temp: 
Attention: 
Constipation or diarrhea?
BP:
A 
TOO MUCH energy
Wt: Loss
Temp: Hot/sweaty
Attention span decreases (can't focus)
Nervousness / irritable
GI: fast - Diarrhea
BP ^
Thyroid enlarges/hypertrophy
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6
Q

How do we diagnose hyperthyroidism?

A 
T4 count (Increased)
Thyroid scan
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7
Q

What must a patient do before obtaining a thyroid scan?

A

DC any iodine containing medication 1 week prior to the scan

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8
Q

What drug contains high levels of iodine?

A

Amiodarone - may affect thyroid function

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9
Q

5 ways to treat hyperthyroidism

A
  1. Anti-thyroids
  2. Iodine compounds
  3. Beta blockers
  4. Radioactive Iodine
  5. Surgery
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10
Q

What are 2 examples of anti-thyroid medications?
How do they work?
When is it used?

A

propylthiouracil, methimazole

Stops the thyroid from making hormones

Used preoperatively to stun the thyroid (decrease bleeding risk)

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11
Q

2 examples of iodine compounds
Are these the same as dietary iodine?
How does it work?
How do we give it?

A

Potassium iodine, strong iodine solution (Lugol’s)
NO
These decreases the size and vascularity go the gland - all endocrine glands are VERY VASCULAR

Give in milk or juice and use a star because it stains teeth

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12
Q

How to BB work in regards to hyperthyroidism?

Who do we not give these to?

A

Decrease HR, BP, contractility, CO generally, but especially decrease anxiety in these patients

Asthma, DM (masks glucose changes)

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13
Q

How does radioactive iodine work? What does this lead to? Is this adverse?

A

Destroys the thyroid cells
Hypothyroidism
This is expected, not adverse

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14
Q

How many doses of radioactive iodine are given?

How are they given?

A

1

PO (liquid or tablet) after pregnancy is ruled out

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15
Q

Precautions to taking radioactive iodine

A

Stay away from babies and no kissing for 24 hours

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16
Q

What is a thyroid storm?

A

Also called thyrotoxicosis and thyrotoxic crisis, it is like hyperthyroidism x 100

Could be a rebound effect after radioactive iodine (But can occur without it)

EMERGENCY - ICU: could lead to MI

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17
Q

Post-op teaching of thyroidectomy (total or partial)

A

Support the neck to avoid any tension on the suture line

Put personal items close by

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18
Q

How do we position a patient after a thyroidectomy?

Where do we check for bleeding?

A

Elevate HOB to prevent edema in the neck

Check for bleeding behind the neck

19
Q

Nutrition after thyroid removal

A

Increased calories because they are burning do many

20
Q

What would hoarseness indicate after thyroid removal?

What could this lead to?

A

Damage of the laryngeal nerve

Vocal cord paralysis or airway obstruction & immediate trach if both cords have paralysis

21
Q

Do we want thyroidectomy patients to speak much?

A

No, but we need to listen for hoarseness and teach them to report ANY feelings of pressure

ASSUME THE WORST

22
Q

Why do we keep a trach at the bedside?

A

Swelling
Laryngeal nerve damage
Hypocalcemia

23
Q

What could have been removed when removing the thyroid?

How would we know?

A

Some of the parathyroid glands (there are 4 total)

Assess for LOW CALCIUM - *not enough sedation (think about laryngospasm especially here)

24
Q

What is not fixed when removing the thyroid?

What do we do about it?

A

Eye or vision problems

Hypoallergenic tape if they can’t close their lids
Dark glasses for photosensitivity
Artificial tears

25
Q

Another name for hypothyroidism

What is this called when it is present at birth?

A

Myxedema

Cretinism - can lead to slowed mental status and physical development if undetected

26
Q

S/S hypothyroidism

Energy?
GI
Weight
Temp  - precautions?
Women
Speech
Face
A 
No energy - Could be so bad they are BEDRIDDEN 
Slow GI
Increased weight
Amenorrhea
Slowed/slurred speech
No expression

Cold - can’t tell if something is too hot.. don’t give them things like heating pads

27
Q

Hypothyroid and Hyperthyroid could be mistaken for what?

A

Depressed or Manic

Psych - Need a thyroid profile

28
Q

Medication for hypothyroidism
How often taken?
What effect will they have on the patient?

A

Levothyroxine, thyroglobulin, liothyronine
Once a day for life
Increased energy, BP, HR

29
Q

Common comorbidity with hypothyroidism

A

CAD - worry about heart trouble and chest pain!

30
Q

Too much PTH will cause _____ while too little PTH will cause _____

A

Too much PTH = ^ serum Ca

Too little PTH = low serum Ca

31
Q

Hyperparathyroidism = what 2 things

A

Increased calcium - sedated

Low Phosphorus

32
Q

HypOparathyroidism = what 2 things

A

Low Ca - rigid

Increased Phosphorus

33
Q

How to treat Hypoparathyroidism

A

IV calcium to increase Ca

Phosphate binders to lower phosphorus

34
Q

What do adrenal glands help us do?

A

Deal with stress

35
Q

What does adrenal medulla have vs adrenal cortex?

Problems associated with each?

A

Medulla: Epi and NE; pheochromocytoma

Cortex: Glucocorticoids, Mineralocorticoids, Sex hormones; Addisons, Cushings

36
Q

What is Pheochromocytoma

A

Benign tumors that secrete epi and NE in boluses

37
Q

S/S pheochromocytoma

A

^BP, ^HR

Flushing/sweaty

38
Q

How do you diagnose pheochromocytoma?
How is it done?
What are we looking for?
What will alter results?

A

VMA (vanillylmandelic acid test)
24 urine - throw away the first void and keep the last - can’t miss a single mL or else start over
Look for epi and NE

No stress the day before to prevent any boluses
VANILLA WILL ALTER THIS

39
Q

How to treat pheochromocytoma?

A

Surgery to remove tumors

40
Q

PO/IV vs biologic GC, MC and sex hormones?

A

Even though our body secretes these normally, adverse effects are more pronounced when the patient receives PO/IV steroids

41
Q

What are the 4 functions of glucocorticoids?

A
  1. Change mood
  2. Alter defense mechanisms (Suppress immune system)
  3. Breakdown fats and proteins (alter growth)
  4. Inhibit insulin (hyperglycemic)
42
Q

What does aldosterone do to the body?

A

Makes you retain Na and water and LOSE K

43
Q

Too much aldosterone = ___ K

Too little aldosterone = ___ K

A

Too much: low K, fluid excess

Too little: high K, fluid deficit

44
Q

Other “fancy words” NCLEX lady will use for increased steroids

A

Adrenocorticotropin (ACTH)
Cortisol
Hypercortisolism

NCLEX (23 decks)

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