Module 4 Endocrine Flashcards
A new nurse on the neurological intensive care unit understands that the master gland of the human body is:
Pituitary gland
A nurse educator on the labor and delivery unit can determine that a group of new nurse graduates understand labor induction when they state:
Oxytocin is a hormone that is given by IV which causes contractions of the uterus. Oxytocin can be used to start labor or to speed up labor that began on its own.
A patient presents with symptoms of fatigue, puffiness around the eyes, irritability, thinning hair, dry skin, weight gain, and cold intolerance. The nurse expects the patient’s symptoms indicate which endocrine disorder?
Hypothyroidism which can be diagnosed by laboratory testing of T3, T4, and TSH levels. Testing of thyroid autoantibodies such as TPO (thyroid peroxidase antibodies) which are indicative of a autoimmune causes of hypothyroidism (Hashimoto’s disease). If thyroid cancer or goiters are suspected a thyroid scan, CT, MRI, ultrasound, or fine needle biopsy will be completed.
A patient presents with symptoms of anxiety, restlessness, difficulty sleeping, exophthalmos, tachycardia, weight loss, silky hair, and heat intolerance. The nurse suspects that the patient’s symptoms indicate a diagnosis of:
Hyperthyroidism which will be diagnosed by laboratory testing of T3, T4, and TSH. Laboratory testing of autoimmune causes of hyperthyroidism may include testing thyroid-stimulating immunoglobulins (TSI) and/or TSH receptor antibodies (TRAb). Graves disease is an autoimmune disorder resulting in hyperthyroidism.
A patient is suspected of having a diagnosis of Graves Disease. What symptoms would the nurse anticipate in this patient?
The nurse should anticipate exophthalmos, headaches, nervousness, emotional instability, weight loss, thyroid goiter, sweating, tachycardia, nausea, diarrhea, oligomenorrhea, muscle weakness, and tremors. Graves disease is an autoimmune disorder. Treatment can include beta-blockers, radioactive iodine therapy, anti-thyroid medications, and/or surgical removal of the thyroid gland.
A nurse is receiving shift change report on her assigned patients. The patient is reported as having a diagnosis of Addison’s Disease. What symptoms should the nurse anticipate this patient may have?
The nurse should anticipate symptoms of bronze skin, hypoglycemia, postural hypotension (low BP when moving from lying/sitting to standing), weight loss, weakness, GI disturbances, changes in body hair distribution, hyponatremia (low sodium), and hyperkalemia(high potassium).
A nurse is assigned the care of a patient with Cushing’s disease (Cushing’s Syndrome). What symptoms should the nurse anticipate this patient will have?
Symptoms of Cushing’s Disease include personality changes, hyperglycemia, red face, “moon” face, edema, purple striae, “buffalo hump,” gynecomastia (males), increased fat deposition in the abdomen, thin extremities, and increased susceptibility to infections.
What would be the expected findings of ACTH levels and cortisol levels of a patient with Addison’s Disease or Cushing’s Disease?
Addison’s Disease - ACTH level elevated, Cortisol level low
Cushing’s Disease - ACTH level elevated/normal, Cortisol level high
If ACTH levels are low a potential diagnosis would be adrenal gland tumor causing Cushing’s disease.
A group of nursing students is discussing the difference between type 1 diabetes and type 2 diabetes. The nursing instructor knows the students understand the difference between these two diabetes types when the students state:
Type 1 diabetes requires insulin because the patient’s pancreas produces little to no insulin. This diabetes type occurs more frequently in children and is the result of autoimmune destruction of the pancreas. Type 2 diabetes is more common in adults. This is an acquired disorder in which the body cannot use insulin correctly because not enough insulin is being produced or insulin resistance.
The nurse understands that a diagnosis of diabetes can be obtained from blood testing. What would be considered blood levels indicative of diabetes?
Normal fasting blood glucose: 70 - 99 mg/dL
Normal hemoglobin A1C test: below 5.7%
Diabetes fasting blood glucose: above 126 mg/dL
Diabetes hemoglobin A1C test: 6.5% or higher
List potential symptoms of diabetes:
Polyuria - increased urination Polydipsia - increased thirst Polyphagia - increased hunger Dry mouth Fatigue Vision changes Difficulty healing Yeast infections Numbness in extremities End organ damage
A patient with a history of diabetes presents with symptoms of fatigue, increased thirst, increased urination, rapid deep breathing, flushed skin, dry skin, fruity-smelling breath, high blood glucose, nausea, and vomiting. The nurse understands that the patient may progress to confusion or loss of consciousness as this complication of diabetes progresses:
The patient is presenting with symptoms of DKA (Diabetic Ketoacidosis). DKA develops when the body doesn’t have enough insulin to allow blood sugar into the cells for use as energy. So, the liver breaks down fat for fuel. This process produces acids called ketones. When too many ketones are produced too rapidly, they can build up to dangerous levels in the body.
Treatment of DKA includes:
Administration of fluids, replacement of electrolytes, and administration of insulin.
A patient diagnosed with diabetes should be taught the symptoms of hypoglycemia. An adverse effect of medications used to treat diabetes is hypoglycemia. What symptoms would the nurse teach a client indicate hypoglycemia?
Symptoms of hypoglycemia include a blood glucose less than 70 mg/dL, tachycardia, fatigue, pale skin, shakiness, anxiety, sweating, hunger, irritability, and tingling around lips, tongue, or cheek. As hypoglycemia worsens confusion, visual disturbances, seizures, and loss of consciousness will occur.
A nurse is teaching a patient and their family treatment for hypoglycemia. What teaching should be included on this topic?
If hypoglycemia occurs oral treatment is preferred unless IV treatment is absolutely necessary. Oral treatment includes eating/drinking 15 to 20 grams of fast-acting carbohydrates. These are sugary foods without protein or fat that are easily converted to sugar in the body such as glucose tablets/ gel, fruit juice, regular soft drinks, honey, and sugary candy. A blood glucose level should be rechecked in 15 minutes. If the blood glucose is within normal limits the patient should eat a snack or meal that has complex carbs to stabilize the body glycogen stores. If hypoglycemia is severe and the patient is unresponsive or unable to follow commands a glucagon injection or IV glucose may be administered for treatment.
