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NCA spring > EXAM 3 - endocrine > Flashcards

EXAM 3 - endocrine Flashcards

1
Q

The nurse provides care for a conscious client with severe ketoacidosis. The nurse anticipates which treatment modality?

A

insulin

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2
Q

The nurse provides care for a client with Addison disease. The nurse assesses for which of the following conditions most importantly?

A

dysrhythmias

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3
Q

A client is evaluated in the outpatient clinic for hypothyroidism. The nurse expects the client to exhibit which symptom?

A

fatigue

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4
Q

A client is recovering from a subtotal thyroidectomy. The nurse identifies which symptom indicating damage to the parathyroid gland?

A

HYPOCALCEMIA:
numbness in fingers
face twitch (pos chovstek)
arm twitch (pos trosseaus)
stridor

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5
Q

The nurse counsels a client about preparation for a subtotal thyroidectomy. The client was prescribed an iodine solution to take prior to the surgery, and asks the nurse why this is necessary?

A

prevents post op hemorrhage

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6
Q

The nurse understands that glucocorticoids provide a source of energy during a stressful situation. Which statement best describes the action of glucocorticoids?

A

converts fat to glucose

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7
Q

A client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) reports nausea, vomiting, headache, and confusion. Which nursing intervention is an essential part of care

A

seizure precautions

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8
Q

A client has laboratory tests regarding thyroid function. Which test results indicate to the nurse the client an underactive thyroid gland?
3

A

high TSH
low BMR
high cholesterol

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9
Q

hormones produced by anterior pituitary

A

TSH and GH

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10
Q

thyroid produces what hormone

A

t3 / t4

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11
Q

posterior pituitary produces what hormone

A

ADH

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12
Q

is Na and K high or low in SIADH

A

low Na and high K

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13
Q

is Na and K high or low in DI

A

high NA and low K

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14
Q

is Na and K high or low in cushings

A

high Na, low K+

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15
Q

is Na and K high or low in addisons

A

low Na, high K

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16
Q

is Na and K high or low in DKA

A

low K , low Na

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17
Q

is Na and K high or low in HHS**

A

low K

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18
Q

tx for hyponatremia

A

push NaCl slowly

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19
Q

tx for hypernatremia

A

hypotonic saline

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20
Q

what is SIADH

A

increased ADH

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21
Q

9 ss of SIADH

A

hyponatremia
urinary retention
serum HYPOosmolality
fluid retention
tachycardia
anorexia
n/v
lethargy
polydypsia

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22
Q

positioning in bed for SIADH

A

flat HOB

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23
Q

4 interventions for chronic SIADH

A

fluid restriction
restrict K and increase Na
monitor F and E
ice chips for thirst

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24
Q

MOA of conivaptan

A

vasopressin - causes urination by increasing ADH

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25
Q

what to monitor for with vasopressin

A

liver function tests

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26
Q

what can diuretics cause

A

hypokalemia

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27
Q

what is DI

A

too little ADH

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28
Q

7 SS OF DI

A

high osmolality
high urine output (polyuria >2L)
low urine SG
HYPER natremia
fatigue
weakeness
polydypsia

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29
Q

nutrition for DI

A

lower Na in diet

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30
Q

desmopressin function

A

ADH supplement

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31
Q

indomethacin MOA

A

increases renal response to ADH

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32
Q

hyopituitary lab values 2

A

low TSH
low ACTH

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33
Q

tx meds for hypopituitary

A

LIFELONG hormone replacemnt

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34
Q

lab value for acromegaly

A

INC GH

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35
Q

octreotide use

A

lowers GH in acromegaly

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36
Q

hypophysectomy is

A

removal of pituitary

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37
Q

position in bed for hypophysectomy

A

30 deg

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38
Q

what are pts at risk for post hypophysectomy

A

SIADH and DI

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39
Q

what is most important action post hypophysectomy

A

assess for CSF

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40
Q

teaching post hypophysectomy

A

no straining, bending, lifting, coughing

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41
Q

lab values for hypothyroid and hyperthryoid

A

hypo: high TSH and low T3/4
hyper: low TSH and high T3/T4

42
Q

7 ss of hypothyroid

A

decrease sweat
cold intolerance
weight gain
constipation
LOW HR (bradycardia)
puffy face
high cholesterol

43
Q

4 ss of hyperthyroid

A

diaphoresis
weight loss
diarrhea
HIGH HR (tachycardia)

44
Q

3 shared ss of hypo and hyperthyroid

A

fatigue
hair loss
insomnia

45
Q

MOA of levothyroxine

A

inrease T4

46
Q

2 nursing actions for levothyroxine

A

monitor for DYRHYTHMIAS and chest pain

47
Q

4 teaching for levothyrox

A

lifelong taking
empty stomach
increase fiber
dont switch brands

48
Q

what are pts who have exothalamos at risk for

A

corneal lesions so tape over eyes

49
Q

popythyuracil MOA

A

decrease thryoid hormone synthesis

50
Q

methimazole MOA

A

decrease thryoid hormone synthesis

51
Q

main teaching for antithyroid meds

A

dont abruptly stop

52
Q

MOA of metoprolol in hyperthryoid

A

relieves symptoms of hyper, but not synthesis

53
Q

when are beta blockers used in hyperthryoid

A

during thyroid storm

54
Q

iodine MOA

A

dec T3/4 synthesis

55
Q

if pt has bucchal swelling, salivating, n/v what is happening and what to do

A

too much iodine, discontinue it

56
Q

teaching for someone doing RAI

A

use separate laundry, food, etc

57
Q

6 nutrition inc or dec for hyperthryoid

A

dec fiber
dec caffeine
dec iodine (like fish)

inc cal
inc carb
inc protein

58
Q

what does thyroiectomy accomplish

A

dec T3/T4

59
Q

most important complication of thyroidectomy

A

LOW CA because parathyroid may have been remvoed

60
Q

4 main nursing actions for thyroidectomy

A

trach tray
O2
suction
maintain airway

61
Q

4 teaching for thyroidectomy post op

A

lifelong meds
regular exercise
AVOID EXTREMES IN TEMP etc
WATCH FOR SS OF HYPOTHYROID

62
Q

9 ss of cushings

A

HIGH BP (HTN)
edema
purple striae
increased infection risk
buffalo hump
trunchal obesity
thin arms and legs
moon face
HYPERNATREMIA

63
Q

what VS for addisonian crisis

A

LOW BP and HIGH HR

64
Q

2 labs for addisons

A

low cortisol and low aldosterone

65
Q

5 ss of addisons

A

bronze skin
N/v
exhaustion
cramps
salt cravings

66
Q

how to dx cushings

A

dexamethasone test - if cortisol is increased then its pos for cushings

67
Q

how to dx addisons 2

A

ACTH stimulation - if cortisol doesnt rise, then pos for addisons

CRH stim - if no cortisol then pos for addisons

68
Q

most important teaching for cushings

A

body image

69
Q

most important teaching for cushings and addisons

A

avoid extreme temps

70
Q

IF SOMEONE IS HYPOKALEMIA WHAT IS PRIORITY OVER EVERYTHING ALWAYS

A

cardiac monitoring

71
Q

what is most important to monitor after adrenalectomy

A

F and E

72
Q

corticosteroid MOA

A

convert fat to glucose

73
Q

8 SE of corticosteroids

A

inc glucose
low BP
lowK
high Na
low CA
delayed healing
infection prone
dec protein

74
Q

important corticosteroid teaching when someone is stressed

A

inc dose when stressed

75
Q

8 SS of hyperglycemia and what are 2 disorders with hyperglycemia

A

glyocuria
diarrhea
cramps
polyuria
weakness
fatigue
blurry vision
mood swings
n/v

DKA and HHS

76
Q

what is number one cause of low K

A

DKA

77
Q

16 ss of DKA

A

kusmall resp
ketosis
acidosis
dehydration
dry membranes
tachycardia
increase urine
lethargy
weakness
sweet breath
low bicarb
high CO2
ketones in urine
hot dry skin
inc thirst
acidic PH of blood

78
Q

difference between HHS and DKA

A

HHS has no ketones in urine, no acidosis, no sweet breath, no KUSMALL

79
Q

tx for DKA

A

INSULIN

80
Q

9 ss of hypoglycemia

A

shakiness
pallor
hunger
confusion
change in mental
visual disturb
diaphoresis
palpitations
nervousness

81
Q

3 causes of hypoglycemia

A

alc without food
increased exercise
beta blockers

82
Q

if BG is below 70 what to do

A

give carb and juice and recheck in 15

83
Q

what to do if BG is low but above 70

A

investigate further

84
Q

if pt is unresponsive with low BG what to do

A

give dextrose and glucagon

85
Q

how to dx diabetes

A

H1ac (2-3 mo fasting)
or 8 hour fast and <99 is normal and 100-125 is prediabetes

86
Q

what is angiography

A

complication of diabetes - damage to blood vessels

87
Q

teaching for retinopathy

A

routine eye exams

88
Q

sensory vs autonomic neuropathy

A

sensory is loss of LE sensation and autonomic is systemic symptoms like gastroparesis

89
Q

capsacin use

A

sensory neuropathy

90
Q

amitriptyline use

A

inc pain signals to brain

91
Q

diabetic demopathy

A

red brown oval patches

92
Q

acanthsis nigricans

A

velvety skin

93
Q

necrobiosis diabeticorum

A

red yellow lesions

94
Q

what does glyburide do

A

stimulates insulin production

95
Q

if Q comes up with boxes and assessment datanew nclex what to choose

A

give fluids
+ sugar

96
Q

OPD of short acting insulin

A

30
2-5

97
Q

OPD of intermediate acting insulin

A

1-2
4-12

98
Q

4 nutriton teaching for diabetes

A

low fat
low carb
high fiber
limit alcohol

99
Q

exercise teaching for diabetics

A

dont exercise if BG > 300
exercise 1 hr after meal
monitor before during after exercise

100
Q

teaching for someone with insulin pump

A

need backup insulin

101
Q

teaching after pancreas transplant

A

need lifelong immunosupression

102
Q

if pt calls and has n/v diarrhea is suck what to do

A

monitor BG every 2-4 hours

NCA spring (9 decks)

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