Exam 2 Flashcards
(91 cards)
A nurse is caring for a client following a transsphenoidal hypophysectomy. The nurse notices a large area of clear drainage seeping from the nasal packing, what should the nurse do?
check the drainage for glucose (this would indicate a CSF leakage)
A client reports experiencing a tingling sensation in the hands, soles of feet, and around the lips 1 day after a subtotal thyroidectomy. What should the nurse assess the patient for?
Chvostek’s sign (assess for hypocalcemia, a potential complication of subtotal thyroidectomy)
How can we assess for Chvostek’s sign?
tap face just below and in front of ear; positive sign would be twitching of facial muscles causes by neuromuscular excitability due to hypocalcemia
Which thyroid abnormality may cause frequent mood changes?
hyperthyroidism (they often can’t sit still)
How would a client appear during a myxedema coma (severe hypothyroidism)?
non-pitting edema everywhere, especially eyes, hands, and feet
+ bradycardia, constipation, and cold intolerance
What will TSH do in a client that has primary hypothyroidism?
it will be elevated
what s/s would be expected in a patient that developed thyrotoxicosis following taking too much levothyroxine?
heat intolerance, sweating, and hyperthermia
what are key manifestations of thyroid storm?
fever, tachycardia, and systolic hypertension
others: abdominal pain, n/v/d, anxiety, restlessness, tremors, confusion, dysrhythmias, and seizures
What are the lab findings in primary hyperparathyroidism?
increased magnesium, calcium, and PTH
- decreased phosphorus
What manifestations may be expected for a client with acromegaly?
loss of color discrimination( visual changes), coarse facial features, enlarged distal extremities, and hepatomegaly
why may a client with hypoparathyroidism experience numbness and tingling in hands and feet?
due to hypocalcemia caused by insufficient PTH
Why should a client’s voice be checked every 2 hrs following a thyroidectomy?
to monitor for hoarseness, a sign of laryngeal nerve damage
How often should a client deep breathe following a thyroidectomy to prevent atelectasis?
30 min - 1 hr
Which gland is responsible for the production of ADH (regulates fluid volume) and oxytocin (stimulates uterine contractions)?
hypothalamus
How may shock cause hypopituitarism?
- 4 steps
- hypotension causes decreased perfusion to pituitary gland
- lack of blood flow causes hypoxia
- infarction may occur
- result is reduction of hormone secretion
What assessment findings may be present in an individual experiencing decreased growth hormone secretion due to a pituitary tumor (hypopituitarism)?
- children - shorter stature
- adults - decrease bone density/muscle strength and increases risk for fractures
What symptoms may be seen with insufficient ACTH secretion (hypopituitarism)?
low cortisol, causing anorexia, decrease body hair, headache, hypoglycemia, hyponatremia, and postural hypotension
Following head trauma a patient has been experiencing cold intolerance, lethargy, weight gain, and slow cognition, what should the nurse suspect this patient is experiencing?
hypopituitarism resulting in insufficient thyroid (TSH) hormone
Which medication may be prescribed to a patient with decreased growth hormone r/t hypopituitarism?
somatropin
If a patient develops an adenoma (benign tumor) on the anterior pituitary gland that produces growth hormone, what condition are they at risk for developing?
acromegaly
Why my a patient with acromegaly experience visual/mental alterations?
(vision changes, headaches, neurologic dysfunction, increased ICP)
if it is caused by a pituitary adenoma, the growth can compress the surrounding brain tissue, including the centers for vision.
What type of surgical intervention is indicated for hyperpituitarism (ex. acromegaly)?
hypophysectomy (trans-nasally or transsphenoidal)
What type of DM is caused by no insulin production by the beta cells of the pancreatic islet cells of Langerhans?
Type 1
What type of DM is characterized by insulin resistance?
Type 2 DM
