Pituitary and Thyroid Dysfunction - EXAM 5 Flashcards
What are symptoms of hyperthyroid?
- Decreased weight
- Increased appetite
- Diarrhea
- Frequent defecation
- Cardiac dysrhythmias
- Warm, moist skin
- Palmar erythema
What are symptoms of hypothyroid?
- Increased weight
- Constipation
- Dry, thick, cool skin
- Decreased sweating
- Pallor
- Generalized edema
What are symptoms of thyrotoxicosis?
- Severe tachycardia
- Shock
- Hyperthermia
- Restlessness
- N/V/D
- Coma
- Death
What are symptoms of myxedema coma?
- Subnormal temperature
- Hypotension
- Hypoventilation
- Lethargy
- Change in level of consciousness
- Coma
What are symptoms of SIADH?
- Increased weight
- Decreased urine output
- Increased specific gravity
- Decreased BP
- Hyponatremia
- Lethargy
- Risk for seizures
- Coma
What are symptoms of DI?
- Polydipsia
- Polyuria
- Decreased specific gravity of urine
Levothyroine (Synthroid)
Classification: thyroid replacement
Mechanism of action: absorbed through the GI tract and used by the body to replace thyroid hormone
Use: hypothyroidism, post thyroid surgery
Side/Adverse Effects: symptoms of hyperthyroid CHA, palpitations, insomnia, diarrhea, tem)
Nursing Implications:
- Many drug interactions
- Take with full glass of H20
- Preferable to take on an empty stomach and in the morning
- Educate patient on need for consistent dose and process of taking drug
What is the pathophysiology of SIADH?
- Increased antidiuretic hormone
- Increased water reabsorption in renal tubules
- Increased intravascular fluid volume
- Dilution hyponatremia and decreased serum osmolality
What is the pathophysiology of DI?
- Decreased antidiuretic hormone
- Decreased water reabsorption in renal tubules
- Decreased intravascular fluid volume
- Increased serum osmolality
- Excessive urine output
What happens in SIADH?
Syndrome of inappropriate secretion of ADH
Overproduction of ADH
Fluid retention
serum decreases in osmolality
Hypochloremia
Concentrated urine despite normal or increased intravascular volume and normal RFT
What is the SIADH nursing assessment?
- VS
- I&O
- Urine SG
- Weight
- LOC
- Hyponatremia increases risk for
- decreased neuro
- Seizures
- N&V
- Muscle cramps and weakness
- Heart and lung sounds
What is the nursing management of SIADH?
- Remove potential cause (ex. meds)
- Fluid restriction (less than or equal to 1000mL daily)
- Safety
- Seizure precautions
- Oral care
How can the RN assist a patient who is thirsty while on fluid restrictions?
distraction
ice chips
sugarless gum
save fluids for social occasion
What is DI?
Diabetes Inspidous
Underproduction of ADH or decreased renal response
Fluid and electrolyte imbalances
Increased urinary output 5-20 L/day
Increased plasma osmolality (d/t hypernatremia)
What are the causes of DI?
Organic lesions (central DI, neurogenic DI)
Lithium (nephrogenic DI)
Cranial surgery/head injury