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NCLEX > Endocrine/toys/laminectomy > Flashcards

Endocrine/toys/laminectomy Flashcards

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1
Q

hyperthyroidism is also known as

A

graves disease
- memory trick: your going to run yourself into the grave

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2
Q

hyperthyroidism

A
  • turn the word thyroid into metabolism= hyper metabolism
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3
Q

hyperthyroidism s/s

A
  • everything high and hot
  • weight loss
  • high HR
  • goiter
  • increased bp
  • irritable/hyper
  • heat intolerance ( always sweating so cant handle the heat)
  • cold tolerance (always sweating so like the cold)
  • exopthalamus
  • confusion
  • diarrhea
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4
Q

treatment for hyperthyroidism

A
  1. radioactive iodine
  2. PTU
  3. thyroidectomy
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5
Q

radioactive iodine for tx of hyperthyroidism

A
  • pt should be isolated for 24 hours after
  • they have to be careful with their urine (flush 3 times)
  • if they spill urine: call hospitalist hazmat team
  • dangerous if pregnant
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6
Q

PTU for hyperthyroidism

A
  • puts thyroid under: decrease thyroid
  • monitor: WBC since this is a cancer drug
  • could be immunosupressed
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7
Q

thyroidectomy for the tx of hyperthyroidism

A
  • will need life long hormone replacement
  • risk for hypocalcemia (watch for trousseus and chevestoks)
  • if its a total: need life long tx
  • if its su: risk for thyroid storm since you still have some thyroid- may need temporary thyroid reeplacment
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8
Q

thyroid storm

A
  • EMERGENCY and can be caused by anything that can stimulate body (stress, na+ in diet, soda, coffee, etc)
  • very high temps ( even in 105 +)
  • very high bp-stroke category (about 210/180)
  • sever tachycardia
  • delirious
  • can cause brain damage
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9
Q

tx for thyroid storm

A
  • ice pack (first)
  • cooling blanket (best)
  • 02 per mask @ 10 L
  • lower bp: beta blockers, ccb, dilators (nitro)
  • 2 staff pt
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10
Q

post op risks of thyroidectomy

A
  1. in the first 12 hours: top priority is airway for total and sub since thyroid is in neck
  2. 2nd is hemorrhage since the endocrine gland has alot of blood vessels
  3. 12-48 hours for total is tetany due to hypocalcemia, 12-48 Hours for sub is storm

*NEVER PICK INFECTION IN FIRST 72 HOURS

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11
Q

hypothyroidism is also known as

A
  • myexedema or hashimotos
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12
Q

hypothyroidism

A
  • low metabolism
  • low and slow
  • hashimotos
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13
Q

s/s of hypothyroidism

A
  • everything low, slow, and cool
  • obese
  • decreased temp
  • hair loss
  • decreased mood and libido
  • decreased RR
  • confusion
  • constipation
  • low infertility
  • boring
  • dull
  • heat tolerance (ALWAYS COLD SO LIKE HEAT)
  • cold intolerance (always cold so dont like the cold)
  • pulse and BP low
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14
Q

tx of hypothyroidism

A
  • thyroid hormone synthroid (levothyroxine)
  • do not sedate these people because they will go into myexedema coma since already kinda sedated
  • never hold thyroid meds the day of a surgery
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15
Q

myexedema coma

A
  • life threatning
  • resp. failure
  • help breathe, trach kit at bedside, et set up at bedside
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16
Q

Addison disease

A
  • under secretion of adrenal cortex
  • low steroid (need to add them= addisons)
17
Q

s/s of addison

A
  • hyperpigmentation
  • cannot adapt to stress: any added stress can kill client
  • stress = shock (glucose and bp will go down)
  • skinny steve: skinny, weak, frail, no hair, hyperkalemia, decreased everything except k+ (energy, bp, sugar), salt craving and sodium loss (hyponatremia)
18
Q

tx of addisons `

A
  • steroids (“sones”)
  • increase steroids when something adds stress
  • monitor bp closely when in stress
19
Q

Cushing syndrome

A
  • over secretions of adrenal cortex
  • cushy = more tushy
  • high steroids
20
Q

s/s of cushing

A
  • big hairy weightlifter
  • increased everything
  • moonface
  • bruises
  • muscle atrophy (skinny arms and legs)
  • high glucose (needs increased insulin especially if diabetic)
  • striae
  • buffalo hump
  • loses k+ and retains na+ and h20
  • central or truncal obesity
  • gynecomastia
  • hirsutism (excess hair)
  • irritable
  • immunosuppressed
21
Q

tx of cushing

A
  • bilateral adrenalectomy (which can lead to addisons which means they have to take steroids which makes them seem like they have cushings all over again
22
Q

safety when it comes to kids and toys

A
  1. no small toys for kids under 4
  2. no metal/die-cast toys if 02 in use (sparks)
  3. beware of fomites (teddy bear) because these no living objects can harbor microorganisms
23
Q

0-6 months toy

A
  • musical mobile
  • soft and large things
  • sensorimotor stage `
24
Q

6-9 months toys

A
  • teach object permanence (looks for the toy when you hide it)
  • best option is “cover/uncover toys”
  • second best is large plastic/wood/metal
  • worst toy is musical mobile
  • never pick answers with the words: build, sort, stack, make, construct, for a child under 9 months
25
Q

9-12 months toys

A
  • learning to speak
  • speaking toys
  • talking books
  • purposeful activities (build, sort, stack, make, construct)
26
Q

toddlers (1-3) toys

A
  • push/pull toys (stroller, doggie, wagon)
  • working on gross motor skills (running, jumping, do not choose answers with finger dexterity like cutting or using pencils or coloring) not including finger painting
  • parallel play- play alongside other kids but not with them
27
Q

preschoolers (3-5 years) toys

A
  • finger dexterity/working on balance
  • tricycles, tumbling, class/dance class, coloring
  • cooperative play= play together (they like to pretend play) : everyone wins and gets some prize
  • imaginative thinkers
28
Q

school aged kids

A
  • create, collect, competitive
  • they like games where there is a winner
  • legos
29
Q

adolescence

A
  • hang out with friends (unless pt is fresh out of post op (<12 hours), contagious disease, or immunosuppressed
30
Q

laminectomy

A
  • removal of vertebral spinal processes (winged ends of vertebrae)
  • relieves nerve root compression
  • the most important thing to pay attention to is location
31
Q

s/s of nerve root compression

A
  • 3 p’s
  • pain
  • paresthesia
  • paresis (muscular weakness)
32
Q

cervical

A
  • neck
  • innervates the diaphragm and arms
  • pre op: airway and arms (and hands)
  • complications: pneumonia
33
Q

thoracic

A
  • upper back
  • innervates abd. and gut muscles
  • pre op: cough/bowels (coughing using abdominal muscles)- can still breathe but cant cough
  • complications: pneumonia and paralytic ilieus
34
Q

lumbar

A
  • lower back
  • innervates bladder and legs
  • pre op: bladder (distended? voided?) and legs
  • complication : urinary retention and leg problems
35
Q

anterior thoracic

A
  • from the front thru the chest to the spine- will have chest tube
36
Q

laminectomy with fusion

A
  • bone graft from iliac crest
  • 2 incisions (hip-most bleeding, most pain, and most drainage and spine- increased chance of rejection)
  • both have 50/50 chance of infection
37
Q

post op spinal #1 answer

A
  • log roll
  • dont dangle pt legs
  • dont sit for longer than 30 minutes
  • they may walk, stand, lay down w/o restriction
38
Q

dc teaching for spinal

A
  • 4 temporary restrictions: 6 weeks
    1. dont sit for longer than 30 minutes
    2. lie flat and log roll
    3. no driving
    4. do not lift more than 5 lbs (gallon of milk)

-3 permanent restrictions:
1. never lift objects by bending at the waist
2. cervical lams not allowed to lift anything over head
3. no jerking, horse back riding, 6 flags

NCLEX (15 decks)

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