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medsurg Flashcards

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1
Q

___ ___ secretes hormones directly into the blood stream. Plays a vital role in regulating homeostatic processes of
-metabolism, growth, fluid, electrolyte balance, reproductive processes, sleep and wake cycles

A

endocrine glands

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2
Q

___ ___ is connected by stalk to the hypothalamus. it has three lobes and is called the “master gland” bc it regulates function of other endocrine glands.

A

pituitary gland

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3
Q

___ is located between the cerebrum and brain stem
it influences the pituitary gland, creates a pathway for neurohormones
-stimulate, inhibit pituitary gland secretions
-hormone regulation- feedback loop controls hormone levels. Most hormones secreted in response to neg feedback.
-Most endocrine disorders: overproduction or underproduction of specific hormones

A

Hypothalamus

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4
Q

Pituitary hormones

Anterior lobe secretes:

A

TSH, ACTH, LH, GH

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5
Q

Pituitary hormones:

Posterior lobe secretes

A

oxytocin, ADH

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6
Q

___ ___ is small bean shaped bodies embedded in lateral lobes of thyroid (usually four)

A

parathyroid glands

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7
Q

The parathyroid gland secretes what?

A

parathormone. Parathormone maintains consistence of CA levels in blood and body fluids. It also helps maintain normal excitability of nerves and muscles.

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8
Q

__ __ is in the upper part of the chest above or near the heart. It is large during childhood then usually shrinks by adult hood bc the production of T lymphocytes decrease with age. Functional disorders are rare

A

thymus gland

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9
Q

The thymus gland secretes what two hormones

A

thymosin and thymopoietin.

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10
Q

___ ___ is attached to the thalamus. Function of melatonin is to help regulate mood and sleep-wake cycles

A

pineal gland

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11
Q

__ ___ Is located above the kidneys. each is divided into two parts: adrenal cortex and adrenal medulla.

A

adrenal glands.

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12
Q

the adrenal cortex secretes _____

A

corticosteroids. SWEET- glucocorticoids (cortisol) helps suppress inflammation, support metabolism, and help body withstand stress.
SALTY- mineralcorticoids (aldosterone)-regulates level of electrolyte and h2o in body.
-SEXY- gonadocorticoids (androgens) convert to estrogen and testosterone

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13
Q

the adrenal medulla secretes

A

epinephrine (adrenaline) and norepinephrine-functions for fight or flight.

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14
Q

The ___ is below the stomach with head of gland close to the duodenum. Both and endocrine and exocrine gland. Exocrine portion secretes digestive enzymes and endocrine is islets of Langerhans: Beta cells (insulin) and alpha cells (glucagon)

A

Pancreas

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15
Q

the gonads are the ____ and ___-

A

ovaries and testes.: importance of sex glands.

-secretion of testosterone, estrogen, and progesterone.

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16
Q

Atria of the heart releases the hormone

A

atrial natriuretic peptide.

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17
Q

kidneys release

A

renin; erythropoietin.

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18
Q

A metabolic disorder of the pancreas: CHO, fat, protein, metabolism, chronic disorder. Most common endocrine disorder in US. Seventh cause of death in US, 23.6 million in US have this. Incidence increased among African americans, latinos, native americans, Asian americans.

A

Diabetes mellitus

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19
Q

___ ____ is abdominal obesity. HTN, elevated LDL, tryglycerides, blood glucose levels and low HDL

A

Metabolic syndrome

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20
Q

Risk factors for metabolic syndrome

A

Heredity, obesity, life style, stress, pregnancy and oral contraceptives, viruses, autoimmune, medications.

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21
Q

__ is produced by beta cells in islet of Langerhans

A

Insulin.

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22
Q

Pre diabetes can lead to

  • type 2 diabetes
  • heart disease
  • stroke
A

know

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23
Q

Impaired fasting glucose (IFG) is __ to ___

A

100-125 mg/dL

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24
Q

Impaired glucose tolerance (IGT) __ to ___

A

140-199 mg/dL

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25
____ can be associated with other disorder. Pancreatitis, adrenocortical hormones, diuretics. -management with insulin
hyperglycemia.
26
what is the issue with someone with juvenile Dm? - lipolysis, ketones, ketoacidosis. - autoimmune disorder
no insulin production
27
with type 2 dm what is the three issues
insulin resistant, insufficient insulin, inherited.
28
Type 2 dm - obesity-trigger - glycosuria - impaired renal threshold - ketonemia - kussmals respirations
know
29
S/S of type 2 DM
- polyuria - polydipsia - polyphagia - weight loss - dehydration - blurred vision - thirst - infs- - skin, urinary tract, vaginal.
30
diagnostic finding of type 2 dm
urinary tests, blood tests, glucometer, hgb a1c test
31
Medical management of DM
- diet and weight loss: major component of tx -exercise: improves need for insulin, improves circulation -insulin: types of insulin: human; beef and pork. dosage U100; type. Onset peak, duration. IV Subq, lipoatrophy, lipohypertrophy. -insulin pen. Jet injector, insulin pump
32
Medical management of DM
Oral antidiabetic agents- type 2 - pancreas transplantation - islet cell transplantation
33
___ ____ is brittle diabetes, noncompliance with treatment; injection. -acidotic state; coma.
diabetic ketoacidosis
34
S/S of diabetic ketoacidosis.
- weakness - thirst - anorexia - vomiting - drowsiness - abdominal pain - kussmauls respirations - low bP
35
Diagnostic finding of diabetic ketoacidosis
blood glucose, urine test, lab test, blood ph
36
Medical management of diabetic ketoacidosis
main goals - reduce elevated blood glucose - correct fluid and electrolyte imbalances - clear the urine and blood of ketones - IV insulin - Isotonic fluid - potassium replacements
37
___ ___ ___ ___ results from serious illness, blood glucose is over 500 and the ph is in the normal range.
hyperosmolar hyperglycemic nonketotic syndrome
38
During Hyperosmolar Hyperglycemic Nonketotic syndrome S/S
-Hypotension, mental changes -extreme thirst, dehydration, tachycardia -fever, neurologic signs, physical examination. Diagnostic findings: blood glucose, serum potassium, sodium.
39
Medical management of hyperosmolar hyperglycemic nonketotic syndrome
- insulin administration | - correction of fluid and electrolyte imbalances.
40
___ is a blood glucose less than 70 mg/dL Contributing factors is diet, exercise, alcohol. S/S drowsiness, nausea, hunger, malaise, excessive perspiration; confusion, coordination difficulty, personality or behavior changes.
Hypoglycemia
41
Diagnostic findings of hypoglycemia
blood glucose levels, glucometer test
42
Medical management of hypoglycemia.
Administration of 15g of simple carb as soon as possible. Recheck bp sugar in 15 min. - Glucagon, - IV admin of 50% glucose - complex carbs
43
____ ___ is poor glucose control, decreased blood circulation to nerve tissue.
``` Peripheral neuropathy -motor neuropathy -sensory neuropathy -autonomic neuropathy Assessment finding: pain, swollen feet ```
44
S/S of Peripheral neuropathy
-disturbing sensations -digestive, urinary, and sexual dysfunction -dizziness -smaller skeletal muscles Diagnostic findings: neurologic exam, screening test, electromyography.
45
Medical Management of peripheral neuropathy
Diet, exercise, pain relief measures. | -drug therapy, antibiotic therapy, drugs to reverse diabetic neuropathies.
46
Diabetic Neuropathy: -glomerular deterioration; five stages. -swollen feet, hands, gradually increasing bp, tiredness, weakness, urinalysis. Dx findings: serum creatinine test, renal creatinine clearance test.
Medical Management: drug therapy, dietary protein reduction, smoking cessation
47
__ ___ vascular changes in the retina can lead to blindness
diabetic Retinopathy
48
Assessments and findings of Diabetic Retinopathy:
Diminished visual acuity | ophthalmic examination; fluorescein angiography.
49
Medical Management of Diabetic Retinopathy
Laser photocoagulation, vitretomy, ACE inhibitor
50
Nursing management of Diabetic Retinopathy
Encourage therapeutic regimen for tight glucose control. - client education - complications of diabetes - regular ophthalmic exams - medication
51
Vascular disturbances: thickening of the arterial walls, coronary artery disease, hyperlipidemia. -cool extremities, leg cramps, gangrene, skin ulcers, MI. Dx testing: Lab test, angiography, doppler ultrasonic flow studies. Medical and surgical management: lipid lowering measures, vasodilators, platelet aggression reduction drugs, amputation, insulin, antidiabetic drugs
know
52
Diabetes sick day rules;
``` take meds a/o check bs q 3-4 hr follow med plan if hyperglycemia/hypoglycemia n/v diarrhea then notify MD fluids q 1/2 hr to 1 hr ```
53
_____ is the oversecretion of GH due to hyperplasia
acromegaly.
54
some products of Acromegaly is - giantism- oversecretion of GH before puberty. - dwarfism- insufficient GH during childhood - acromegaly-oversecretion of GH during adulthood
S/S -coarse features, huge lower jaw, thick lips, thickened tongue, bulging forehead, bulbous nose, large hands and feet, enlarged organs, muscle weakness.
55
___ is the over secretion of GH before puberty
giantism
56
___ is the insufficient GH during childhood
dwarfism
57
__ is the over secretion of GH during adult hood
acromegaly
58
DX of acromegaly (hyperpituitarism)
GH level, glucose tolerance test.
59
TX of acromegaly (hyperpituitarism)
surgery-hypophysectomy, hormone therapy, drug therapy. Nursing care: -psychological support, pacing activities, pain relief, self care, post op care.
60
Post op care for acromegaly
monitor for inc ICP - avoid coughing, sneezing, bending over, drinking from straw- to prevent dislodging of graft/seal between cranium and nose. - monitor nasal drainage if packing.
61
___ ___ is rare, the anterior pituitary hormone activity stops. S/S is hypothyroidism, hypoglycemia, adrenal insufficiency, gonads and genitalia atrophy, premature aging, cachexia.
Simmonds disease (panhypopituitarism)
62
tx of Simmonds disease
substitute hormones Nursing care: -client teaching -adherence, medication schedule, monitor blood hormone level
63
___ ___ is a disorder of the posterior lobe of the pituitary.
Diabetes insipidus Types: -neurogenic -nephrogenic
64
Causes of diabetes insipidus
Head trauma, congenital, lithium, pituitary removal.
65
___ is a hormone that increase h20 absorption in kidney tubules which increases fluid volume. -releases in response of thirst and fluid loss, raising bp by signaling peripheral arteries to constrict
ADH - also called Vasopressin - If we do not have enough ADH our tubules do not respond to it and we secrete large amts of h20
66
S/S of ADH
polyuria, polydipsia- can have urine output 20 L/24 hrs - weight loss, weakness, dehydration - decreased specific gravity. - DX: fluid deprivation test- urine specific gravity. - TX: Neurogenic- Vasopressin- Lypressin/DDAVP nasally. - Nephrogenic -fluids, thiazide diuretics, dec protein and NA in diet.
67
Nursing care for ADH imbalances:
free fluids, monitor iv infusions, monitor I&O | weights, monitor electrolyte levels, teach compliance with meds and diet.
68
____ Is renal absorption of h2O instead of secretion. (opposite of diabetes insipidus) Causes: brain/cns tumors, CVA, head trauma, tricyclic antidepressants, oral hypoglycemic. S/S: increased fluid volume. (h2O retention) hyponatremia, h/a, muscle cramps, n/v, muscle twitching change in LOC Dx: based on s/s- serum NA is decreased and urine NA is increased
SIADH
69
TX for SIADH is
tx underlying cause.-fluid restriction and NA replacement. -furosemide -Osmitrol/mannitol -3% hypertonic saline. Nursing care: monitor VS, I&O, S/s fluid overload, med education
70
``` Thyroid disorders: TSH regulates the thyroid hormone T4 & T3 Calcitonin often difficult to tx and dx ```
know
71
____ is hypersecretion of thyroid hormones. | Causes: Idiopathic, neoplasm, inflammation, thyroid sup, emotional distress.
``` Hyperthyroidism S/S: -restlessness -agitated -hand tremors -heat intolerance -diarrhea -increased appetite -weight loss -visual changes -exophthalmos, neck swelling (goiter) ```
72
Dx for hyperthyroidism: T3 and T4 is elevated - TSH decreased - thyroid scan - US
TX: antithyroid drugs- PTU/Tapazole - potassium iodine- SSKI - thyroidectomy - radiation - I:131
73
Nursing care for hyperthyroidism:
Monitor VS, weight, sleep, promote rest, and avoid over stimulation - may need 4,500-5,000 cal/day to maintain weight - post op thyroidectomy-keep rescue equipment readily available.
74
Thyrotoxic crisis: -triggering factors: T3 and T4 oversecretion, epinephrine release. S/S high temp, rapid pulse, dyspnea, cardiac dysrhythmias, vomiting, delirium, extreme restlessness. DX: hyperthyroidism, history, lab tests TX: immediate tx, antithyroid drugs, IV TX
know
75
Nursing care for thyrotoxic crisis
``` O2 monitor VS antipyretics/cooling blanket beta blockers IV fluids corticosteroids ```
76
____ inadequate thyroid hormone secretion: myxedema.
Hypothyroidism: S/S: -slow metabolic rate (cold), lethargy, weight gain, dry skin, menstrual disorders. -enlarged heart, atherosclerosis, anemia, mask like unemotional face, swelling of lips, tongue, eyelids, constipation, speech slow and low pitched.
77
Dx for hypothyroidism.
TSH levels are increased. - TX: thyroid replacement-levothyroxine. - effects may start to be noticed in 48 hr - Nursing care: high fiber diet, low calorie diet, stool softeners, thyroid supplement

med surg 49-51 (1 decks)

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