MDC2 Final exam study Flashcards
What is graves disease?
An autoimmune disorder that is caused by hyperthyroidism and is characterized by a goiter and exopthalmos
Treatment for graves disease
methimazole, atenolol, iodine 131
nursing interventions for hyperthyroidism
provide a calm/cool environment, assess for pain, maintain airway, cardiac monitoring, v/s, prepare patient for surgery
Hyperthyroidism hallmark assessment
heat intolerance
lab tests for hyperthyroidism
increased t3 and t4, decreased TSH
which 2 deficiencies are the most life threatening
ACTH, TSH
Anterior hypopituitarism labs and diagnostics
decreased t3, t4, prolactin, testosterone, estradiol
blood work done first
anterior hyperpituitarism labs
increased lab values, besides gonadtropin
Cushings disease priority interventions
prevent infection, handwashing
cardiovascular signs and symptoms of Cushing disease
hypertension, edema, bruising, petechiae
lab tests in Cushing disease
increased BG, NA, cortisol
decreased lymphocyte count and Ca level
What gland causes diabetes insipidus
posterior pituitary gland
Key symptoms of diabetes insipidus
Losing water, polyuria, polydipsia, dehydration, dilute urine (less than 1.005), tachycardia, hypotension
drug therapy for diabetes insipidus
desmopressin acetate
What is Addison’s disease?
adrenal gland hypofunction
Education regarding glucocorticoids
must be withdrawn slowly to prevent Addisonian crisis
Addison’s disease signs and symptoms
muscle weakness, joint pain, fatigue
lab tests for Addison’s disease
increased K, Ca, BUN
decreased cortisol, fasting BG, Na
Hyperaldosteronism lab tests
increase Na
decrease K
pheochromocytoma
a benign tumor of the adrenal medulla that causes the gland to produce excess epinephrine, constant state of fight or flight
pheochromocytoma patient education
Do not smoke, drink caffeine, or change position suddenly
eat a diet rich in calories, vitamins, and minerals. avoid tyramine foods, never palpate
hypothyroidism hallmark assessment
cold intolerance
hypothyroidism s/s
dehydration symptoms, poor memory, fatigue, lack of energy, brittle hair, blank facial expression
hypothyroidism labs
increased TSH, serum thyroglobulin level (thyroid cancer)
decrease t3 and t4
nursing interventions for hypothyroidism
Maintain fluid restriction, warm blankets, monitor for s/s of a myxedema coma,
When will thyroid therapy work?
improvement occurs within 2 weeks
What can a thyroidectomy cause?
iatrogenic hypoparathyroidism
What is the biggest thing to watch for post-op thyroidectomy
thyroid surgery can cause parathyroid gland injury which results in tetany and hypocalcemia
hypoparathyroidism s/s
think about s/s hypocalcemia, muscle cramps, mild tingling, seizures, positive chvostek and trousseaus, thyroid storm
Foods to avoid with hypoparathyroidism
milk (high in phosphorus)
Hyperparathyroidism treatment
diuretic to help reduce serum calcium, monitor for numbness and tingling, cardiac function, patient is at high risk for fractures
type 1 diabetes - DKA
3 p’s, kussmaul respirations, fruity breath, abdominal pain, weight loss, dehydration
diabetes mellitus labs
increased A1C, random blood glucose, fasting blood glucose
Normal range for A1C
<6.5%
the normal range for fasting blood glucose
<110
If a patient is getting Novolin R, when are they at the most significant risk for hypoglycemia
This is short-acting, regular insulin. At the peak point of 2.5-5 hours
NPH intermediate-acting insulin
onset 1-5 hours, peak 4-12 hours
DKA immediate treatment
IV normal saline, regular short-acting, hydration
Why is it important to keep glucose maintained?
Glucose is the main fuel for the CNS because the brain cannot make or store glucose
Hypoglycemia education
carbohydrate count, wear a medical alert bracelet, carry a snack
Patient education stoma
A stoma should be beefy red. Measure stoma, nutrition changes to control gas and odor,
chronic pancreatitis surgical procedure
pancreatectomy
What labs will be elevated in chronic pancreatitis
amylase, lipase
Ulcerative colitis treatment
nutritional therapy, antidiarrheal, steroids,
how many stools a day does a patient with ulcerative colitis have?
10-20 liquid bloody stools
signs and symptoms of crohns disease
weight loss, fever, abdominal pain, bloody stool, malabsorption syndrome (treated with TPN)
SIADH s/s
weight gain, fluid retention, fluid overload, n/v, tachycardia, hypertension, bounding pulse, muscle weakness, fatigue, seizures
Medications for SIADH
diuretics, 3% hypertonic saline, remove fluid and add sodium
s/s of cholecystitis
upper abdominal pain radiating to the right shoulder, tachycardia, pain triggered by eating, jaundice
diverticulitis treatment
stool softeners, fiber, fluids
avoid laxatives and enemas
microvascular complications of diabetes
retinopathy, neuropathy, nephropathy
the first sign of hypoglycemia
altered mental status
what lab value confirms the diagnosis of colorectal cancer
increased CEA
islet of langherans (beta cells)
the region of the pancreas that is responsible for producing insulin
s/s of peritonitis
abdominal pain, decreased urine output, tachycardia, hypotension, diminished bowel sounds
Addisonian crisis treatment
emergency treatment - dexamethason 4-12 mg
early detection: cortisol replacement, prednisone
dumping syndrome management
eliminate liquids with meals, high protein, high fat, moderate carb diet. eat small meals throughout the day, acarbose
Upper GI bleed signs and symptoms
hematemesis, melena, decreased hemoglobin and hematocrit, increased hr, decreased bp
causes of respiratory alkalosis
hyperventilation, fear, anxiety, salicylate toxicity, early-stage pulmonary problems
s/s of respiratory alkalosis
CNS increase, anxiety, seizures, positive chvostek and trousseaus, hyperreflexia, increased HR, hyperventilation, Charley horses
most caused by low calcium
treatment of respiratory alkalosis
antiemetics, fall prevention, replacement of Ca and K
s/s of respiratory acidosis
low o2, respiratory depression, barrel chested, cyanosis, cough, CNS depression, bradycardia, hypotension, dry skin, muscle weakness
causes of respiratory acidosis
respiratory depression - anesthetics, opiods, electrolyte imbalance
inadequate chest expansion - muscle weakness, airway obstruction, alveolar capillary block
hypoventilation, sleep apnea, pneumonia, copd, asthma
treatment of respiratory acidosis
drug therapy (anti-inflammatories, nebulizer, bronchodilator, mucolytics), pulmonary hygiene, mechanical ventilation, oxygen therapy
treatment of metabolic acidosis
hydration (IV fluids), antidiarrheals, insulin if DKA, treat the cause
s/s of metabolic acidosis
diarrhea, abdominal pain, bradycardia, hypotension, CNS depression, muscle weakness, kussmaul respirations, warm, flushed, dry skin
causes of metabolic acidosis
DKA, starvation, heavy exercise, seizure activity, fever, hypoxia, ethanol and methanol intoxication, salicylate intoxication, kidney failure
causes of metabolic alkalosis
antacids, blood transfusion, parenteral nutrition, vomiting, NG suction, high dose loop/thiazide diuretics
s/s of metabolic alkalosis
increased CNS, anxiety, seizures, muscle cramping, positive chvostek and trousseaus, hyperreflexia, increased HR, decreased respiratory effort, muscle weakness
most due to low calcium and potassium
treatment of metabolic alkalosis
antiemetics, fall prevention, replacement of k and Ca
symptoms of a rolling hiatal hernia
fullness, breathlessness, feeling of suffocation, feeling of angina, worse in recumbent
symptoms of a sliding hiatal hernia
heartburn, regurgitation, chest pain, dysphagia, belching
secondary stomatitis
results from infection, viruses, fungi, bacteria, chemo, radiation, steroid drug therapy
primary stomatitis
noninfectious stomatitis, herpes simplex, traumatic
Cancer development stages
Initiation - the cell becomes irreversibly damaged
promotion - repeat exposure to damage enhances growth
progression - increase production of malignant cells
metastasis - movement of cancer cells
primary cancer prevention
use of sunscreen, stop tobacco use, reduce alcohol consumption, vaccinations
secondary cancer prevention
routine screenings, genetic testing
benign cells
small nuclear to cytoplasmic ratio, they contribute to the body in some way, grow at a normal rate
cancer risk factors
age, chemicals, radiation, red meat, genetic risk
neutropenic precautions
no fresh flowers, no fresh food, no kids, caretaker must wear mask, patient must wear mask, wash hands
Superior vena cava syndrom
assessment of respiratory and cardiac systems, maintain patent airway, monitor oxygenation, monitor labs
hyponatremia s/s
cerebral changes, behavioral changes, muscle weakness, low deep tendon reflexes
hypernatremia s/s
decrease mental status and cognitive function, muscle twitching, high pulse rate, distended neck veins, bp increase
electrolyte changes with end-stage renal failure
loss of potassium, treatment is dialysis
key concepts in dehydration
darker urine, dry mouth, dry eyes, muscle cramps, heart palpitation, decreased urine output, increasing heart rate
