Endocrine Problems

Question 1

Anterior Pituitary problems

Answer 1

• acromegaly: too much GH

- hypopituitarism: too little of 1 or more hormones

Question 2

Posterior Pituitary Gland Problems

Answer 2

• SIADH: too much ADH

- Diabetes insipidus: too little ADH

Question 3

Acromegaly

Answer 3

• enlarged gland, headache, visual probs, enlargement of hands and feet and tissues, tongue overgrowth
• high somatotropin, X-rays, MRI
• surgery: hypophysectomy

Question 4

Hypopituitarism

Answer 4

• personality changes, weight loss, weakness, sudden death
• treatment: surgery, radiation, meds
• treatment contraindicated for phlebitis, pulmonary embolism, some cancers

Question 5

SIADH signs

Answer 5

Low urine output, increased body weight, thirst, confusion, seizures

Question 6

Diabetes insipidus signs

Answer 6

Polyuria and polydipsia
hypotension
Tachycardia

Question 7

SIADH Care

Answer 7

• I&O, daily weights, fluid restriction
• fall and seizure precautions
• ice and sugarless gum to decrease thirst

Question 8

Diabetes insipidus care

Answer 8

Replace fluids and electrolytes

Low salt diet

Question 9

Goiter

Answer 9

Enlarged thyroid gland

Question 10

Thyroiditis

Answer 10

Inflammation of thyroid gland

Question 11

Thyroid hormones

Answer 11

Growth and development

Question 12

Graves Disease

Answer 12

Hyperthyroidism

• too much TH
• thyrotoxicosis
• intolerance to heat, exophthalmos, increased appetite, enlarged gland
• dependent edema, systolic HTN, increased HR

Question 13

Hypothyroidism

Answer 13

Too little TH, slow body processes

• tired, slow speech, weight gain, scaly tongue
• intolerance to cold

Question 14

Hyperthyroidism care

Answer 14

• low calorie diet, iodine
• surgery: monitor for laryngeal strider (hypocalcemia)
• F&E
• monitor for dysrhythmias
• cool environment

Question 15

Hypothyroidism care

Answer 15

• mxyedema coma: mechanical respiratory support and cardiac monitoring
• lifelong drug therapy

Question 16

Hyperparathyroidism

Answer 16

• excess PTH
• hypercalcemia and hypo phosphorus
• loss of appetite, constipation, fatigue, skeletal pain
• surgery (watch for tetany); calcium supplements (Chvosteks and Trousseaus)

Question 17

HypoPT

Answer 17

Little PTH

• hypotension, edema, abdominal cramps, difficulty walking, muscle spasms, hyperactive deep tendon reflex
• IV calcium for tetany (monitor EKG and give slowly)
• breathe in and out paper bag
• long term vitamin D

Question 18

Cushings

Answer 18

Too much ACTH

• truncal obesity, moon face, purple striae, hyperglycemia,
• labs: glucose
• VS, weight, watch for clot and inflammation
• watch BP and infections post surgery

Question 19

Addisons

Answer 19

too little ACTH

• brown pigmentation, hypoglycemia, hypotension, anorexia, nausea, weight loss
• life long steroids, how to take BP, increase salt intake, manage stress
• prevent infections, daily hygiene, avoid extreme temps, light, and noise

Question 20

Cushing preop

Answer 20

• control HTN and hyperglycemia
• correct hypo kale is
• high protein diet

Question 21

Cushings postoperative

Answer 21

Acute adrenal insufficiency: vomiting, dehydration, painful joints

• bed rest until stable BP
• wear alert bracelet at all times
• avoid exposure to extreme temps

Question 22

Adrenal therapy side effects

Answer 22

• low potassium and calcium
• high glucose and BP
• delayed healing
• infection

Question 23

Conns syndrome

Answer 23

Hyperaldosteronism

• sodium retention: hypernatremia, HTN, headache, no edema
• potassium excretion
• hypokalemia acidosis, muscle weakness, fatigue
• assess F&E and BP; surgery

Question 24

Pheochromocytoma

Answer 24

Tumor of adrenal medulla

• severe HTN
• profuse sweating, headache, tachycardia with chest pain
• surgery, monitor VS, cardiac, BP, and glucose

Question 25

Transsphenoidal Approach

Answer 25

• check CSF drainage: clear nasal drainage with glucose
• HOB at 30
• gentle mouth care
• avoid tooth brushing for 10 days
• avoid vigorous actions
• monitor I&O

Question 25

Physical assessment of thyroid technique

Answer 25

Patient swallow during inspection and palpitation