Final Exam: Unit 14 Flashcards
two main types of lupus
systemic and discoid
most common type of lupus
systemic lupus (SLE)
SLE can lead to
major organ failure
this kind of lupus attacks the skin
discoid lupus (DLE)
DLE can progress to
SLE
medication-induced lupus can be cured by
stopping the medication
condition where bone tissue dies due to a loss of blood supply
osteonecrosis
reason why SLE can be hard to dx
s/s are not visible or similar to other disorders
lupus causes a high risk for
pregnancy
why is there a fetal risk when treating lupus
medications used - methotrexate
goal of lupus treatment
control manifestations and decrease exacerbations
this class of medication can be used to treat lupus by reducing inflammation and arthritic pain
NSAIDs
this class of medication can be used to treat lupus by reducing inflammation and causing immunosuppression
corticosteroids
this class of medication can be used to treat lupus and has anti-inflammatory properties and suppression of synovitis, fever/fatigue, and decreases the risk of developing skin lesions
antimalarial drugs
condition where small blood vessels in the fingers become narrowed in response to cold or stress causing a change in color to the skin
Raynaud’s phenomenon
lupus can cause changes in
LOC
do not stop ____ abruptly
steroids
avoid these three things while treating lupus
live vaccines
prolonged sun exposure
crowds
leading cause of death in SLE
lupus nephritis
lupus nephritis may require this surgical intervention
kidney transplant
in lupus nephritis, monitor for swelling in these two areas
periorbital region and lower extremities
in lupus nephritis, monitor for this vital sign
hypertension
inflammation of the heart, its vessels, and the surrounding sac
pericarditis and myocarditis
the hypothalamus communicates with the
pituitary gland
main function of the thyroid gland
regulate metabolic activity
the thyroid gland produces these three hormones
calcitonin
T3
T4
the hypothalamus releases this hormone which then stimulates the pituitary gland
TRH
(thyroid releasing hormone)
once stimulated by the hypothalamus, the pituitary gland releases this hormone
TSH
(thyroid stimulating hormone)
why is hypothyroidism often undiagnosed in older adults?
it mimics the aging process
three stages of hypothyroidism
primary
secondary
tertiary
this stage of hypothyroidism is characterized by failure of the anterior pituitary gland to stimulate the thyroid gland due to pituitary tumors
secondary
this stage of hypothyroidism is characterized by failure of the hypothalamus to produce TRH
tertiary
this stage of hypothyroidism is characterized by dysfunction of the thyroid gland
primary
T3 and T4 in hypothyroidism will be
decreased
TSH in hypothyroidism will be
increased
blood cholesterol and lipids in hypothyroidism will be
increased
antithyroid antibodies in hypothyroidism will be
present
an ECG in hypothyroidism will show these two things
sinus bradycardia
dysrhythmias
this helps make T3 and T4
iodine
hypothyroidism can lead to this disease
Hashimoto’s Disease
a patient’s mood with hypothyroidism will be
depressed and fatigued
a patient will be (temperature) with hypothyroidism
cold
a patient with hypothyroidism will have this kind of skin
dry, brittle
a patient with hypothyroidism will have this kind of hair
hair loss
a patient with hypothyroidism will have this kind of appetite
lack of appetite
a patient with hypothyroidism will have weight _____
gain
a patient with hypothyroidism will have this GI effect
constipation
is a goiter typical in hypothyroidism?
yes - goiter will be present
main treatment option for hypothyroidism
levothyroxine
dosing of levothyroxine is
weight-based
take levothyroxine on a ____ stomach
EMPTY stomach (30-60 min before eating)
life-threatening complication of hypothyroidism
myxedema coma
side effects of myxedema coma will all be
low and slow - most adverse is a coma
main nursing care for myxedema coma
maintain the airway
most common cause of hyperthyroidism
Grave’s Disease
T3 and T4 in hyperthyroidism will be
elevated
TSH in hyperthyroidism will be
decreased
a patient with hyperthyroidism will have this kind of mood
elevated and excited
a patient with hyperthyroidism will be (temperature)
hot
a patient with hyperthyroidism will have this kind of skin
smooth, soft, and sweaty
a patient with hyperthyroidism will have this kind of appetite
increased appetite
a patient with hyperthyroidism will have this GI function
diarrhea
is a goiter typical in hyperthyroidism?
yes - more typical in hyperthyroidism than hypo
vital signs in hyperthyroidism will be
elevated
hyperthyroidism can often cause this due to pressure on the optic nerve
blurred vision
excess thyroid hormone (T3/T4) in the body
thyrotoxicosis
this iodine solution can be used to treat hypothyroidism
Lugol’s solution
this procedure can be done if the thyroid is putting pressure on the trachea
thyroidectomy
radioactive iodine ablation therapy is contraindicated in
pregnancy
this medication that’s used for hyperthyroidism works by preventing the thyroid gland from producing thyroid hormone
methimazole
methimazole can be toxic to this organ
liver
this medication that’s used for hyperthyroidism works by blocking thyroid peroxidase
propylthiouracil
main surgical consideration for hyperthyroidism
thyroidectomy
following a thyroidectomy, the patient should be monitored for
hypocalcemia
these two signs will be positive in hypocalcemia
Trousseau’s and Chvostek
medical emergency that can result from hyperthyroidism
thyroid storm
two classic findings of thyroid storm
high fever
rapid heart rate
s/s of thyroid storm are the same as in _____ , but are more severe
same as hyperthyroidism
thyroid storm can progress quickly to
multiple organ failure
a class of medication that can be used to treat hyperthyroidism and thyroid storm
beta blockers
a mineralocorticoid that the adrenal cortex produces
aldosterone
a glucocorticoid that the adrenal cortex produces
cortisol
a sex hormone that the adrenal cortex produces
androgens and estrogens
this disease is a result of decreased aldosterone and cortisol (adrenal insufficiency)
Addison’s Disease
“we need to ADD hormone in Addison’s”
most common cause of PRIMARY Addison’s Disease
autoimmunity
cause of SECONDARY Addison’s Disease
steroid withdrawal
Addison’s Disease can cause this in the skin
hyperpigmentation in the skin
Addison’s disease can cause the patient to crave
salt
chronic Addison’s Disease has a ____ progression
slow progression
Addisonian crisis has a ____ development
rapid development
main medication used to treat Addison’s Disease
prednisone (anti-inflammatory and immunosuppressive in nature)
do not do this with prednisone
do not stop abruptly
take prednisone ____ food
WITH food
prednisone increases risk of
infection
avoid these two drinks while treating Addison’s Disease
alcohol and caffeine
while treating Addison’s Disease, the patient should carry emergency
emergency hydrocortisone injection
when treating the patient for Addison’s Disease, position the patient like this
recumbent with legs elevated
side effects and lab values will generally be ____
decreased
“ADisson’s = Arrows Down”
the only electrolyte that will be elevated in Addison’s Disease
potassium
this disease is characterized by an excess of cortisol secretion
Cushing’s Disease
Too many steroids = They have a CUSHION
tumor of the adrenal medulla causing an excess secretion of certain hormones
pheochromocytoma
most common cause of Cushing’s Syndrome
long-term use of glucocorticoids
gender more at risk for Cushing’s Syndrome
female (2-40 year old)
vital signs and labs in Cushing’s disease will be
elevated
“Cushing is Pushing levels UP”
the only electrolyte that is decreased in Cushing’s syndrome
potassium
