Final Endocrine Flashcards

Question

Adrenal cortex

Answer 1

Outer shell of adrenal gland Synthesizes: Glucocorticoids (cortisol) Mineralocorticoids (aldosterone) Small amounts of sex hormones (androgens, estrogens)

Answer 2

Inner core of adrenal gland Works as part of sympathetic nervous system Produces: Epinephrine Noepinephrine

Answer 3

Addison’s disease Cushing’s syndrome Aldosteronism (Conn’s syndrome)

Answer 4

Pheochromocytoma

Answer 5

Hyposecretion of adrenal cortex hormones (glucocorticoids and mineralocorticoids) Fatal if left untreated

Answer 6

Weakness GI disturbances Weight loss Emotional disturbances Bronze pigmentation to skin Electrolyte imbalances Hyponatremia Hypokalemia Hypotension Hypoglycemia Elevated BUN

Answer 7

Monitor vital signs Monitor weight and I&O Maintain fluid and electrolyte balance Monitor for infection Instruct client in a high-protein, high-carbohydrate diet Instruct client in the avoidance of stress Instruct client to avoid individuals with an infection Instruct client in the need for lifelong corticosteroids Instruct client to avoid over-the-counter medications Instruct client to avoid strenuous exercise Instruct client to wear a Medic-Alert bracelet Observe for Addisonian crisis secondary to stress, infection, trauma, surgery

Answer 8

A life threatening disorder caused by acute adrenal insufficiency It is precipitated by infection, trauma, stress or surgery Can cause Hyponatremia, hyerkalemia, hypoglycemia and shock

Answer 9

Severe headache Severe abdominal, leg and lower back pain Generalized weakness Irritability and confusion Severe hypotension Shock

Answer 10

Monitor vital signs Monitor neurological status, noting irritability and confusion Monitor I&O Administer IV fluids as prescribed to restore electrolyte balance Administer adrenocorticosteroids as prescribed on time schedule Protect client from infection Maintain bedrest and provide a quiet environment

Answer 11

Condition resulting from the hypersecretion of glucocorticoids from the adrenal Can result from the prolonged administration of corticosteroids

Answer 12

Obesity with thin extremities Moon face Buffalo hump Fragile skin that easily bruises Hirsutism (masculine characteristics in females) Mood swings Muscular weakness Signs of infection Signs of osteoporosis Hypertension Hypokalemia Hyperglycemia & glycosuria Elevated WBC Sodium and water retention

Answer 13

Monitor I&O Monitor weight Monitor glucose levels and urinary glucose Provide good skin care Allow client to discuss feelings related to body appearance Provide high-protein, low-calorie diet with potassium supplements Prepare client for adrenalectomy if prescribed Prepare client for radiation if prescribed Administer hormone replacement therapy as prescribed Administer steroids as prescribed if adrenalectomy was performed Administer chemotherapeutic agents as prescribed Instruct client in the administration of medications as prescribed Instruct client to avoid infection and, stress Instruct client in measures for adequate nutrition and rest

Answer 14

A hypersecretion of aldosterone from the adrenal cortex of the adrenal gland Due to an adrenal lesion that is usually benign

Answer 15

Generalized weakness Increased thirst, nocturia and polyuria Edema Weight gain Headache Hypertension Positive Chvostek’s sign Increased urinary aldosterone Hypokalemia Hypernatremia Metabolic alkalosis

Answer 16

Monitor vital signs Monitor weight Monitor I&O Assess muscular strength Monitor for positive Chvostek’s sign Monitor electrolytes Maintain sodium restriction as prescribed Administer potassium supplements as prescribed Administer antihypertensives, such as spironolactone (Aldactone) as prescribed Prepare client for surgical removal of tumor if prescribed

Answer 17

A catecholamine-producing tumor usually found in the adrenal gland but also may be found in the abdomen Causes hypersecretion of the hormones of adrenal medulla and secretion of excessive amounts of epinephrine and norepinephrine Typically benign but can be malignant Death can occur from shock, CVA, renal failure, dysrhythmias and dissecting aortic aneurism

Answer 18

Primary treatment is surgical excision of adrenal gland Symptomatic treatment initiated if surgical excision is not possible

Answer 19

Hypertensive retinopathy and nephropathy, myocarditis, CHF, increased platelet aggregation and CVA

Answer 20

Hypertension Headaches Hypermetabolism Diaphoresis Palpitation and tachycardia Apprehension Emotional instability Hyperglycemia and clycosuria Pain the chest/abdomen N&V Weight loss Fatigue and exhaustion

Answer 21

Monitor vital signs Monitor cardiovascular, neurological, and renal status Monitoring for hypertensive attacks such as hypertension can precipitate a CVA or sudden blindness Keep phentolamine (Regitine) at the bedside for hypertensive crisis Prepare to administer an alpha-adrenergic blocking agent, phenoxybenzamine (Dibenzyline), as prescribed to control blood pressure Be alert to stimuli that can precipitate a paroxysm, such as increased abdominal pressure, micturition, and vigorous abdominal palpation Avoid opiates preoperatively as they can precipitate a hypertensive crisis Monitor urine for glucose and acetone Promote rest and nonstressful environment Provide a diet high in calories, vitamins, and minerals Prohibit caffeine-containing beverages and food

Answer 22

Surgical removal of an adrenal gland Lifelong steroid replacement is necessary with a bilateral adrenalectomy Temporary steroid replacement, up to 2 years, is necessary for a unilateral adrenalectomy

Answer 23

Catecholamine levels drop as a result of surgery, which can result in cardiovascular collapse, hypotension and shock and the client needs to be monitored closely Hemorrhage can occur due to the high vascularity of the adrenal glands

Answer 24

Prepare client for surgical procedure Monitor electrolytes and correct electrolyte imbalances Assess for dysrhythmias Monitor for hyperglycemia Protect client from infections Administer steroids as prescribed

Answer 25

Monitor vital signs Monitor I&O, and if urinary output is less than 30 mL per hour, notify the physician, as this may be indicative of impending shock and renal failure Monitor daily weights Monitor electrolytes Monitor for signs of shock and hemorrhage, particularly during first 24 to 48 hours Assess dressing Monitor for paralytic ileus, as manifested by abdominal distention and pain, nausea, vomiting, diminished or absent bowel sounds, as paralytic ileus can develop from internal bleeding Administer IV fluids as prescribed to maintain blood volume Administer pain medication as prescribed, remembering that meperidine (Demerol) can cause hypotension Administer steroid replacement as prescribed Instruct client in the importance of steroid therapy following surgery

Answer 26

Located in the anterior part of the neck Controls the rate of body metabolism and growth Produces thyroxine (T4), triiodothyronine (T3), and thyrocalcitonin

Answer 27

Thyroxine = tetraiodothyronine = T4 - contains 4 atoms of iodine Triiodothyonine = T3 - contains 3 atoms of iodine

Answer 28

Calcitonin - helps regulate calcium homeostasis

Answer 29

- low levels of T3 and T4 or low metabolic rate stimulate the hypothalamus to secrete thyrotropin releasing hormone (TRH) - TRH enters the hypophyseal portal veins and is carried to the anterior pituitary gland, where it stimulates thyrotrophs to secrete thyroid stimulating hormone (TSH) - TSH stimulates almost all aspects of thyroid follicular cell activity, including iodide trapping, hormone synthesis and secretion, and growth of follicular cells - thyroid follicular cells release T3 and T4 into the blood until the metabolic rate returns to normal - an elevated T3 inhibits release of TRH and TSH

Answer 30

Goiter Nervousness/Irritability Palpitations (tachycardia) Unexplained weight loss Diarrhea Sleep Disturbances (insomnia) Vision changes (exopthalmos) Amenorrhea/Oligomenorrhia

Answer 31

Tremor Muscle weakness and fatigue Dyspnea Dependent edema Impaired mentation (confusion)

Answer 32

Heat intolerance Diaphoresis Increased appetite

Answer 33

Depression and loss of concentration Dry skin Cold intolerance Myalgias Somnolence and fatigue Menorrhagia

Answer 34

Goiter Unexplained weight gain Constipation Myxedema Memory loss/impairment

Answer 35

Bradycardia Habitual abortion / sterility Anorexia

Answer 36

Problem with the thyroid Thyroid is not making enough T3 and T4

Answer 37

Problem with the Pituitary Gland Pituitary gland is not making enough TSH Causes the thyroid to not make enough T3/T4

Answer 38

Problem with the hypothalamus Hypothalamus is not making enough TRH Causes the Pituitary gland to not make enough TSH Causes the thyroid to not make enough T3 and T4

Answer 39

Problem with the thyroid Thyroid is making too much T3 and T4

Answer 40

Problem with the Pituitary Gland Pituitary gland is making too much TSH Causes the thyroid to make too much T3 and T4

Answer 41

Problem with the Hypothalamus Hypothalamus makes too much TRH Causes Pituitary to make to much TSH Causes the Thyroid to make too much T3/T4

Answer 42

A thyroid function test that measures the absorption of the iodine isotope to determine how the thyroid gland is functioning THe amount of radioactivity is measured 2,6 and 24 hours after ingestion of the capsule

Answer 43

Normal value is 5% to 35% in 24 hours Elevated values are indicative of: Hyperthyroidism, thyrotoxicosis, decreased iodine intake or increased iodine secretion Decreased values indicate a low T4, the use of antithyroid meds, thyroiditis, myxedema, or hypothyroidism

Answer 44

Blood tests for the diagnosis of thyroid disorders

Answer 45

Regulate thyroid stimulating hormone

Answer 46

If T3 is elevated: Hyperthyroidism and T3 toxicosis T3 decreased: decreases with aging process or Hypothyroidism If T4 is elevated: hyperthyroidism Is T4 decreased: hypothyroidism

Answer 47

Blood test used to differentiate the diagnosis of primary hypothyroidism

Answer 48

T3: 25% to 35% T4: 3.8% to 11.4%

Answer 49

Normal: 0 to 6 µU/ml Elevated values indicate primary hypothyroidism Decreased values indicate hyperthyroidism or secondary hypothyroidism

Answer 50

Performed to identify nodules or growths in the thyroid gland A radioisotope of iodine or technetium is administered prior to the scanning

Answer 51

Make sure client had not received radiographic contrast agent within the past 3 months Check with physician about discontinuing meds containing iodine for 14 days prior Fast for 45 minutes after ingestion of oral isotope and scan done in 24 hours NPO after midnight on day before test

Answer 52

Aspiration of thyroid tissue for cytological examination No special client prep Light pressure is applied to the aspiration site after the procedure

Answer 53

Cretinism Myxedema

Answer 54

Grave’s disease Thyrotoxicosis

Answer 55

Hereditary Congenital Trauma Environmental Secondary to other disorders

Answer 56

Most common type Hashimoto’s thyroiditis - autoimmune

Answer 57

2nd most common kind Radioactive iodine Tx or surgery for hyperthyroidism

Answer 58

Iodine deficiency: Endemic goiter Endemic cretinism: most common cause of congenital hypothyroidism in deficient areas Rare inherited enzyme deficiencies

Answer 59

Failure of H-P axis d/t deficient TRH or TSH secretion

Answer 60

A severe thyroid hypofunction that results in hyposecretion of thyroid hormones in the fetus or soon after birth Pot belly with umbilical hernial Sensitivity to cold

Answer 61

Severe physical and mental retardation Dry skin Coarse, dry, brittle hair Slow teething Large tongue Poop appetite Constipation Yellowish coloration to skin

Answer 62

Provide emotional support Provide warmth and skin care Prevent injury Prevent constipation Encourage parents to discuss feelings Administer hormone replacement of desiccated thyroid, thyroxine (synthroid), triiodothyronine (cytomel) as prescribed Instruct parents regarding meds

Answer 63

A hypothyroid state resulting from a hyposecretion of thyroid hormones Occurs in adulthood

Answer 64

Slowed rate of body metabolism Lethargy and fatigue Intolerance to cold Weight gain Dry skin and hair, loss of body hair Bradycardia Constipation Generalized puffiness and nonpitting edema Forgetfulness and loss of memory Menstrual disturbances Cardiac disorders

Answer 65

Monitor vitals Monitor for cardiac complications Admin and monitor thyroid replacements Instruct client in low-calorie, low-cholesterol, low saturated fat diet Assess for anorexia and fecal impaction Provide roughage and fluids (prevents constipation) Provide warm envi Avoid sedatives and narcotics Monitor for overdose of thyroid meds

Answer 66

Rare but serious disorder that results from a persistent, low thyroid production

Answer 67

acute illness, rapid withdrawal of thyroid meds, anesthesia and surgery, hypothermia and the use of sedatives and narcotics

Answer 68

Hypotension Hypothermia Bradycardia Mental depression Mood swings Hyponatremia Hypoglycemia Coma

Answer 69

Maintain airway Monitor vital signs and LOC Assess temp frequently Assess BP Admin IV fluids Monitor electrolytes and glucose level Admin IV glucose Keep client warm Monitor for changes in mental status Admin sodium IV Admin corticosteroids Avoid sedatives and hypnotics

Answer 70

Hyperthyroid state resulting from a hypersecretion of thyroid hormones Also known as thyrotoxicosis

Answer 71

Increased rate of body metabolism Enlarged thyroid gland Cardiac dysrhythmias (tachycardia & palpitations) Protruding eyeballs (exophthalmos) Hypertension Heat intolerance Diaphoresis Weight loss Smooth soft skin and hair Nervousness and fine tremors of hands Personality changes Irritability and agitation Mood swings

Answer 72

Provide adequate rest Administer sedatives as prescribed Provide cool and quiet environment Obtain daily weights Provide psychosocial support Admin meds to block thyroid synthesis Admin iodine prep which inhibits release of thyroid hormones Admin meds for tachycardia Prepare client for radioiondine and thyroidectomy

Answer 73

An acute and fatal thyroid condition that occurs from manipulation of the thyroid gland during surgery and the release of thyroid hormones Admin into the bloodstream Can also be caused by severe infection and stress

Answer 74

Fever Diaphoresis Dehydration Tachycardia Congestive heart failure and pulmonary edema N&V and diarrhea Systolic hypertension Tremors Irritability, agitation and restlessness Delirium and coma

Answer 75

Monitor vitals Decrease temp frequently Assess Avoid palpating thyroid Monitor I&O Monitor fluid and electrolyte balance Monitor for dehydration and overhydration Monitor pulmonary and cardiac status Admin iodine prep Admin tachycardia meds Admin glucocorticoids Admin cardiac meds

Answer 76

Removal of the thyroid gland Performed if conditions where persistent hyperthyroidism exists

Answer 77

Obtain vitals and weight Assessment electrolyte levels Assess for hyperglycemia and glycosuria Assess LOC Assess for signs of thyroid storm Admin antithyroid meds (deplete iodine and hormones) Admin iodine to decrease vascularity of the thyroid gland

Answer 78

Monitor resp distress Have tracheotomy set O2 and suction at bedside Maintain semi-Fowler’s position Monitor for signs for bleeding Check dressing Limit talking and assess level of hoarseness Mon for laryngeal nerve damage Monitor for signs of tetany Prepare to admin calcium gluconate

Answer 79

Involuntary muscle contractions

Answer 80

+ chvostek’s sign + trousseau’s sign Numbness of extremities and spasm of glottis Irritability Wheezing and dyspnea Visual disturbances Muscle and abdominal cramps

Answer 81

Located near the thyroid Controls calcium and phosphorus Produces parathyroid hormones Admin into (PTH)

Answer 82

Condition caused by hyposecretion of parathyroid hormone by the parathyroid gland Occurs following thyroidectomy from removal of parathyroid tissue

Answer 83

Hypocalcemia and elevated phosphorus levels Numbness and tingling of extremities Cramping Signs of tetany Signs of hypocalcemia Increased neuromuscular irritability Confusion Visual problems Depression

Answer 84

Weakness and tingling of the extremities Cramping Signs Painful muscle spasms Dysrhythmias irritability Anxiety

Answer 85

Monitor vital signs and cardiac status Admin iodine Monitor tetany Initiate seizure precautions Place tracheotomy set, O2 and suctioning at bedside High calcium low phosphorus diet Quiet envi Admin aluminum hydroxide (decrease phosphate levels) Admin parathyroid hormones Prepare to administer IV calcium gluconate Teach client how to administer calcium carbonate and vitamin D

Answer 86

Monitor cardiac function and renal status Monitor I&O Provide hydration Monitor fluid and electrolyte balance Monitor calcium and phosphorus levels Admin furosemide (lower calcium levels) Admin IV saline (lower calcium) Notify Dr immediately if drop in calcium Assess for tingling and numbness Admin phosphates (interfere w/ calcium absorption) Admin meds to decrease skeletal calcium release Admin cytotoxic antibiotics Prepare for parathyroidectomy

Answer 87

Removal of one or more of the parathyroid glands

Answer 88

Monitor electrolytes, calcium, phosphate and magnesium levels Ensure calcium levels are decreased to near normal levels Inform client that talking may be painful

Answer 89

Monitor for resp distress Tracheotomy set, oxygen, and suctioning at the bedside Monitor vital signs Position in semi fowler’s Assess neck dressing for bleeding Monitor for hypocalcemic crisis (tingling and twitching) Assess for + trousseau and Chvostek signs (tetany) Monitor for changes in voice pattern and hoarseness Instruct client in admin of calcium and vitamin D