Endocrine System Flashcards
What are they levels of t3, t4 and tsh in hyperthyroidism?
High t3 and t4
Low TSH
What is thyroid storm?
Thyroid storm is a life threatening emergency that occurs with uncontrolled hyperthyroidism due to graves disease. Symptoms include fever, tachycardia, agitation, anxiety, and HTN.
What drugs are used to treat thyroid storm?
Propylthiouracil and methimazole. These block the synthesis of T3 and T4
-Propranolol may be given to decrease excessive sympathetic stimulation
What is the diet for hyperthyroidism?
High calorie
High protein
Low caffeine
Low fiber
What should you have bedside postoperatively for a thyroidectomy?
Be prepared for laryngeal edema by having a tracheostomy set at the bedside, along with O2, and a suction machine.
Calcium gluconate should be easily accessible
What is the normal serum calcium level?
9.0 - 10.5 mEq/L
What is the best indicator of parathyroid problems?
A decreased in the clients calcium compared to the preoperative value
How do watch for tetany?
-Monitor serum calcium
-Check for tingling of toes and fingers and around the mouth
-Check Chvostek sign
-Check Trousseau sign
too low calcium
Hyperthyroidism is also called
Graves Disease and Goiter
Hypothyroidism is also referred to as
Hashimoto’s Disease and Myxedema
What precipitates a myxedema coma?
acute illness withdrawl of thyroid medication anesthesia use of sedatives hypoventilation
What is Addisions Disease?
Primary adrenocortical deficiency/ hypo function of the adrenal cortex
What is the diet requirements for a patient with Addison’s disease?
High Sodium
Low Potassium
High Carbohydrate
3L of fluid per day
What happens in an Addison’s Crisis?
Vascular collapse: hypotension and tachycardia (Nursing care is to administer IV fluids at a rapid rate)
Hypoglycemia: Administer IV glucose
Administer parenteral hydrocortisone
Aldosterone replacement with simultaneous administration of salt
What is Cushing’s Syndrome?
Excess adrenocorticoid activity
Physical assessment of cushing’s syndrome
Mood face truncal obesity buffalo hump abdominal striae hirsutism
What are the electrolyte balances in Cushing’s Syndrome?
Hyperglycemia
Hypernatremia
Hypokalemia
Teach clients to take steroids with meals
to prevent gastric irritation, they should never skip a dose.
What are the characterisitics of HHNKS (Hyperosmolar hyperglycemia nonketotic syndrome)
Hyperglycemia >600 Plasma hyperosmolality Dehydration Change in mental status Absent ketone bodies
What is glycosylated HGB (HbA1c)
Indicates glucose control over previous 90-120 days. It is a valuable measurement of diabetes control and informs the diagnosis of diabetes and prediabetes
The body’s response to illness and stress is to produce
glucose. Therefore, any illness result in hyperglycemia
What is basal insulin?
Long acting and intermediate acting insulin that suppresses glucose production between means and overnight
What is bolus insulin
limits hyperglycemia after meals. Rapid or short acting. Clear
Correction factor
The amount of insulin needed to correct hyperglycemia, usually give pre meal
What diagnostic test is used to determine thyroid activity
T3 and T4
What condition results from all treatments of hyperthyroidism
hypothyroidism, requiring thyroid replacement
State three symptoms of hyperthyroidism and three symptoms of hypothyroidism
Hyperthyroidism: weight loss, heat intolerance, diarrhea
Hypothyroidism: Fatigue, cold intolerance, weight gain
List five important teaching aspects for clients who are beginning corticosteroid therapy
- Continue medication until weaning plain is begun by physician
- Monitor serum potassium, glucose, and sodium frequently
- weigh daily
- and report weight gain of >5lbs/ week
- Monitor BP and pulse closely
- Teaching symptoms of Cushing’s Syndrome
Describe the physical appearance of clients who have Cushing syndrome
Moon face Obesity in trunk Buffalo hump in back Muscle atrophy Think skin
Which type of diabetes always requires insulin replacement
Type 1
Which type of diabetes sometimes requires no medication
Type 2
List five symptom’s of hyperglycemia
Polydipsia Polyuria Polyphagia Weakness Weight loss
List five symptoms of hypoglycemia
Hunger Lethargy Confusion Tremors or shakes SWeating
Name the necessary elements to include in teaching client newly diagnosed with diabetes
The underlying patho Management and treatment Meal planning exercise program insulin administration sick day management symptoms of both hypo and hyper foot care
In fewer than 10 steps, describe the method of drawing up a mixed dose of insulin
Clear to Cloudy
- Identify the prescribed dose and type of insulin
- Store unopened insulin in the refrigerator
- Opened insulin may be kept at room temperature
- Draw up regular insulin first
- Rotate injection sites
- May reuse syringe by recapping
Identify the peak action time of the following types of insulin:
Rapid acting
Intermediate acting
Long acting
Rapid acting: 2-4 hours
Intermediate: 6-12
Long; 14-20
When preparing a client with diabetes for discharge, the nurse teaches the client the relationship between stress, exercise, bedtime snacking, and glucose balance. State the relationship of each
- Stress and stress hormones usually increase glucose production and increase insulin need
- Exercise may increase the change of hypoglycemia therefore client should always carry a fast acting source of carbohydrates
When making night rounds, the nurse notes that a client prescribed insulin is complaining of a headache, slight nausea, and minimal trembling. This clients hand is cool and moist. What is the client most likely experiencing
hypoglycemia
Identify five foot care intervention that should be taught to a client with diabetes.
-Check feet daily
-report any break or sores
-wear well fitting shoes
-never go barefoot
-never personally remove corns or calluses
-wash feet daily with mild soap
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