MDC2 Final exam study Flashcards

1
Q

What is graves disease?

A

An autoimmune disorder that is caused by hyperthyroidism and is characterized by a goiter and exopthalmos

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2
Q

Treatment for graves disease

A

methimazole, atenolol, iodine 131

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3
Q

nursing interventions for hyperthyroidism

A

provide a calm/cool environment, assess for pain, maintain airway, cardiac monitoring, v/s, prepare patient for surgery

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4
Q

Hyperthyroidism hallmark assessment

A

heat intolerance

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5
Q

lab tests for hyperthyroidism

A

increased t3 and t4, decreased TSH

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6
Q

which 2 deficiencies are the most life threatening

A

ACTH, TSH

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7
Q

Anterior hypopituitarism labs and diagnostics

A

decreased t3, t4, prolactin, testosterone, estradiol
blood work done first

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8
Q

anterior hyperpituitarism labs

A

increased lab values, besides gonadtropin

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9
Q

Cushings disease priority interventions

A

prevent infection, handwashing

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10
Q

cardiovascular signs and symptoms of Cushing disease

A

hypertension, edema, bruising, petechiae

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11
Q

lab tests in Cushing disease

A

increased BG, NA, cortisol
decreased lymphocyte count and Ca level

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12
Q

What gland causes diabetes insipidus

A

posterior pituitary gland

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13
Q

Key symptoms of diabetes insipidus

A

Losing water, polyuria, polydipsia, dehydration, dilute urine (less than 1.005), tachycardia, hypotension

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14
Q

drug therapy for diabetes insipidus

A

desmopressin acetate

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15
Q

What is Addison’s disease?

A

adrenal gland hypofunction

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16
Q

Education regarding glucocorticoids

A

must be withdrawn slowly to prevent Addisonian crisis

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17
Q

Addison’s disease signs and symptoms

A

muscle weakness, joint pain, fatigue

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18
Q

lab tests for Addison’s disease

A

increased K, Ca, BUN
decreased cortisol, fasting BG, Na

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19
Q

Hyperaldosteronism lab tests

A

increase Na
decrease K

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20
Q

pheochromocytoma

A

a benign tumor of the adrenal medulla that causes the gland to produce excess epinephrine, constant state of fight or flight

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21
Q

pheochromocytoma patient education

A

Do not smoke, drink caffeine, or change position suddenly
eat a diet rich in calories, vitamins, and minerals. avoid tyramine foods, never palpate

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22
Q

hypothyroidism hallmark assessment

A

cold intolerance

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23
Q

hypothyroidism s/s

A

dehydration symptoms, poor memory, fatigue, lack of energy, brittle hair, blank facial expression

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24
Q

hypothyroidism labs

A

increased TSH, serum thyroglobulin level (thyroid cancer)
decrease t3 and t4

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25
Q

nursing interventions for hypothyroidism

A

Maintain fluid restriction, warm blankets, monitor for s/s of a myxedema coma,

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26
Q

When will thyroid therapy work?

A

improvement occurs within 2 weeks

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27
Q

What can a thyroidectomy cause?

A

iatrogenic hypoparathyroidism

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28
Q

What is the biggest thing to watch for post-op thyroidectomy

A

thyroid surgery can cause parathyroid gland injury which results in tetany and hypocalcemia

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29
Q

hypoparathyroidism s/s

A

think about s/s hypocalcemia, muscle cramps, mild tingling, seizures, positive chvostek and trousseaus, thyroid storm

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30
Q

Foods to avoid with hypoparathyroidism

A

milk (high in phosphorus)

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31
Q

Hyperparathyroidism treatment

A

diuretic to help reduce serum calcium, monitor for numbness and tingling, cardiac function, patient is at high risk for fractures

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32
Q

type 1 diabetes - DKA

A

3 p’s, kussmaul respirations, fruity breath, abdominal pain, weight loss, dehydration

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33
Q

diabetes mellitus labs

A

increased A1C, random blood glucose, fasting blood glucose

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34
Q

Normal range for A1C

A

<6.5%

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35
Q

the normal range for fasting blood glucose

A

<110

36
Q

If a patient is getting Novolin R, when are they at the most significant risk for hypoglycemia

A

This is short-acting, regular insulin. At the peak point of 2.5-5 hours

37
Q

NPH intermediate-acting insulin

A

onset 1-5 hours, peak 4-12 hours

38
Q

DKA immediate treatment

A

IV normal saline, regular short-acting, hydration

39
Q

Why is it important to keep glucose maintained?

A

Glucose is the main fuel for the CNS because the brain cannot make or store glucose

40
Q

Hypoglycemia education

A

carbohydrate count, wear a medical alert bracelet, carry a snack

41
Q

Patient education stoma

A

A stoma should be beefy red. Measure stoma, nutrition changes to control gas and odor,

42
Q

chronic pancreatitis surgical procedure

A

pancreatectomy

43
Q

What labs will be elevated in chronic pancreatitis

A

amylase, lipase

44
Q

Ulcerative colitis treatment

A

nutritional therapy, antidiarrheal, steroids,

45
Q

how many stools a day does a patient with ulcerative colitis have?

A

10-20 liquid bloody stools

46
Q

signs and symptoms of crohns disease

A

weight loss, fever, abdominal pain, bloody stool, malabsorption syndrome (treated with TPN)

47
Q

SIADH s/s

A

weight gain, fluid retention, fluid overload, n/v, tachycardia, hypertension, bounding pulse, muscle weakness, fatigue, seizures

48
Q

Medications for SIADH

A

diuretics, 3% hypertonic saline, remove fluid and add sodium

49
Q

s/s of cholecystitis

A

upper abdominal pain radiating to the right shoulder, tachycardia, pain triggered by eating, jaundice

50
Q

diverticulitis treatment

A

stool softeners, fiber, fluids
avoid laxatives and enemas

51
Q

microvascular complications of diabetes

A

retinopathy, neuropathy, nephropathy

52
Q

the first sign of hypoglycemia

A

altered mental status

53
Q

what lab value confirms the diagnosis of colorectal cancer

A

increased CEA

54
Q

islet of langherans (beta cells)

A

the region of the pancreas that is responsible for producing insulin

55
Q

s/s of peritonitis

A

abdominal pain, decreased urine output, tachycardia, hypotension, diminished bowel sounds

56
Q

Addisonian crisis treatment

A

emergency treatment - dexamethason 4-12 mg
early detection: cortisol replacement, prednisone

57
Q

dumping syndrome management

A

eliminate liquids with meals, high protein, high fat, moderate carb diet. eat small meals throughout the day, acarbose

58
Q

Upper GI bleed signs and symptoms

A

hematemesis, melena, decreased hemoglobin and hematocrit, increased hr, decreased bp

59
Q

causes of respiratory alkalosis

A

hyperventilation, fear, anxiety, salicylate toxicity, early-stage pulmonary problems

60
Q

s/s of respiratory alkalosis

A

CNS increase, anxiety, seizures, positive chvostek and trousseaus, hyperreflexia, increased HR, hyperventilation, Charley horses
most caused by low calcium

61
Q

treatment of respiratory alkalosis

A

antiemetics, fall prevention, replacement of Ca and K

62
Q

s/s of respiratory acidosis

A

low o2, respiratory depression, barrel chested, cyanosis, cough, CNS depression, bradycardia, hypotension, dry skin, muscle weakness

63
Q

causes of respiratory acidosis

A

respiratory depression - anesthetics, opiods, electrolyte imbalance
inadequate chest expansion - muscle weakness, airway obstruction, alveolar capillary block
hypoventilation, sleep apnea, pneumonia, copd, asthma

64
Q

treatment of respiratory acidosis

A

drug therapy (anti-inflammatories, nebulizer, bronchodilator, mucolytics), pulmonary hygiene, mechanical ventilation, oxygen therapy

65
Q

treatment of metabolic acidosis

A

hydration (IV fluids), antidiarrheals, insulin if DKA, treat the cause

66
Q

s/s of metabolic acidosis

A

diarrhea, abdominal pain, bradycardia, hypotension, CNS depression, muscle weakness, kussmaul respirations, warm, flushed, dry skin

67
Q

causes of metabolic acidosis

A

DKA, starvation, heavy exercise, seizure activity, fever, hypoxia, ethanol and methanol intoxication, salicylate intoxication, kidney failure

68
Q

causes of metabolic alkalosis

A

antacids, blood transfusion, parenteral nutrition, vomiting, NG suction, high dose loop/thiazide diuretics

69
Q

s/s of metabolic alkalosis

A

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

70
Q

treatment of metabolic alkalosis

A

antiemetics, fall prevention, replacement of k and Ca

71
Q

symptoms of a rolling hiatal hernia

A

fullness, breathlessness, feeling of suffocation, feeling of angina, worse in recumbent

72
Q

symptoms of a sliding hiatal hernia

A

heartburn, regurgitation, chest pain, dysphagia, belching

73
Q

secondary stomatitis

A

results from infection, viruses, fungi, bacteria, chemo, radiation, steroid drug therapy

74
Q

primary stomatitis

A

noninfectious stomatitis, herpes simplex, traumatic

75
Q

Cancer development stages

A

Initiation - the cell becomes irreversibly damaged
promotion - repeat exposure to damage enhances growth
progression - increase production of malignant cells
metastasis - movement of cancer cells

76
Q

primary cancer prevention

A

use of sunscreen, stop tobacco use, reduce alcohol consumption, vaccinations

77
Q

secondary cancer prevention

A

routine screenings, genetic testing

78
Q

benign cells

A

small nuclear to cytoplasmic ratio, they contribute to the body in some way, grow at a normal rate

79
Q

cancer risk factors

A

age, chemicals, radiation, red meat, genetic risk

80
Q

neutropenic precautions

A

no fresh flowers, no fresh food, no kids, caretaker must wear mask, patient must wear mask, wash hands

81
Q

Superior vena cava syndrom

A

assessment of respiratory and cardiac systems, maintain patent airway, monitor oxygenation, monitor labs

82
Q

hyponatremia s/s

A

cerebral changes, behavioral changes, muscle weakness, low deep tendon reflexes

83
Q

hypernatremia s/s

A

decrease mental status and cognitive function, muscle twitching, high pulse rate, distended neck veins, bp increase

84
Q

electrolyte changes with end-stage renal failure

A

loss of potassium, treatment is dialysis

85
Q

key concepts in dehydration

A

darker urine, dry mouth, dry eyes, muscle cramps, heart palpitation, decreased urine output, increasing heart rate