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NCLEX > Thyroid, Adrenal Cortex, Kids Toys, Laminectomy > Flashcards

Thyroid, Adrenal Cortex, Kids Toys, Laminectomy Flashcards

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1
Q

Is Graves Disease Hypothyroidism or Hyperthyroidism?

A

Hyperthyroidism
“you are going to RUN yourself INTO the GRAVE”

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2
Q

S/S of Hyperthyroidism
& Labs

A

-Graves Disease
Everything is sped up
-Appearance: Wt. Loss, Exophthalmos (Bulge eyes)
-Irritability, Hyper
-Vitals: Tachy, HTN
-Heat Intolerance (cold tolerant)
Labs: High T3 & T4

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3
Q

Medications for Hyperthyroidism

A
  1. Radioactive Iodine
    –24hr Isolation, Flush 3x careful w/ urine
  2. PTU (Put Thyroid Under)
    –Cancer drug, Must monitor WBC
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4
Q

What are 2 surgery’s for Hyperthyroidism?

A

Total thyroidectomy or subtotal thyroidectomy

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5
Q

What is pt. at risk of and needs with Total Thyroidectomy

A

Needs Lifelong hormone replacement
Risk of Hypocalcemia
–Ensure calcium gluconate is available

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6
Q

S/S of Hypocalcemia

A

Everything goes UP
Paresthesia 1st s/s
-Tetany, irritability, Seizures, tachy, HTN
Chvostek’s sign (Cheek)
Trousseaus sign (arm/hand spasm)

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7
Q

What is pt. at risk of and doesn’t need with Subtotal thyroidectomy

A

Pt does NOT need Lifelong hormone replacement
Risk for THYROID STORM or THYROTOCISIS a emergency

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8
Q

S/S of Thyroid Storm

A

Emergency
Pt. feels Anxious
Super HIGH TEMP (105+)
Extreme HTN (210/180)
SEVERE TACHY (180bpm)
Psychosis & Delirium

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9
Q

Tx. for Thyroid storm

A

**Decrease temp **
–ice packs (1st) & Cooling blanket
O2 via Face mask 10L/min
Must stay w/ pt.

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10
Q

What are POST OP risks for Thyroidectomy

A

0-12hr (for BOTH total & subtotal)
–Airway & Hemorrhage
-Monitor for stridor’s
-Keep suction+O2+Tracheostomy tray @ bedside
12-48hr
–Total thryroidectomy= Tetany
–Subtotal thryoidectomy= Thyroid Storm

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11
Q

NEVER pick Infection in first 72hr for anything

A

Only pick infection AFTER 72hr

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12
Q

S/S of Hypothyroidism

A

everything slowed
-Appearance: dry+thick skin, brittle nails, hair loss, facial edema, obese, pallor/anemia
-Vitals: Brady & HToN
-Fatigue, dull personality, depression
-Cold Intolerance (heat tolerance)
Labs: HIGH TSH & LOW T3 T4

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13
Q

Medications for Hypothyroidism

A

Levothyroxine–> Do Not Sedate Them can lead to MYEDEMA COMA
–Preop med question Ambien (sedative)
NEVER HOLD A THYROID MED

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14
Q

S/S of Myxedema Coma

A

Severe Hypothyroidism
Hypothermia (95F)
**Hypoventilation) (RR10/min)
Bradycardia
Decreased mental status, face & hand edema, hyponatremia, hypoglycemia

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15
Q

Tx. for Myxedema Coma

A
  1. Airway (bag-valve mask)
  2. IV levothyroxine (after Resp. status secured)
  3. Warming Blanket
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16
Q

What is causes Addison’s Disease

A

Under secretion of the adrenal cortex
tx. w/ steroid =sone

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17
Q

S/S of Addison’s Disease

A

-Hyperpigmented (Tan Skin)
-Wt. Loss, weakness, Hypoglycemia (everything low)
-Do NOT adapt to stress well (can go into Shock)
—Shock state raises Blood sugar and BP

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18
Q

S/S of Adrenal Crisis (Addison Crisis)

A

HToN
Tachy
Dehydration
Hyponatremia
Hyperkalemia
Hypoglycemia

19
Q

Tx for Addison’s

A

Steroids
-sone
ADD steriods for “ADD-i-sone disease”

20
Q

Tx for Addison’s

A

Steroids
-sone
ADD steroids for “ADD-i-sone disease”

21
Q

S/S of Cushing’s

A

Over secretion of adrenal cortex (and steroid SE)
Moon Face, Hirsutism (high body hair), buffalo hump. central obesity, Gynecomastia (man boobs), Retain Sodium & Water, Loses Potassium
Think CUSH MAN

22
Q

Tx of Cushing’s

A

Adrenalectomy–> replacement therapy–> need steroids

23
Q

0-6 month age appropriate toys

A
  1. Musical mobile
  2. Soft & Large toys
24
Q

6-9 months age appropriate toys

A

-working on object permanence
1. Cover/uncover toys (jack inthe box)
2. Hard & Large toys
Never pick musical mobile for this age

25
Q

9-12 months age appropriate toys

A

-working on vocalization
1. Speaking/vocalizing toys
*@9 months old child will do anything purposeful
Never pick an answer w/ infants less then 9 months: Build, Sort, Stack, Make, Construct these are all purpose words

26
Q

1-3 yr old age appropriate toys

A

-working on gross motor skills
1. push-pull toys
Never pick finger dexterity for toddlers (colored pencils, scissors)
-Finger painting is fine
Engaged in Parallel play

27
Q

3-5 yr old age appropriate toys

A

-work on fine motor skills/balance
Colored pencils, tricycles, tumbling, drawing
-Engaging in cooperative play & Imaginative play

28
Q

6-12 yr old age appropriate toys

A

Creative
Collective
Competitive

29
Q

Safety Considerations
1. No small toys for less then ____ yr old?
2. No ___ toys if O2 uses present
3. What toys are best to prevent Fomites?

A
  1. Less then 4 yr no small toys
  2. Metal toys if O2 used
  3. Best toys: Plastic toys
    Worst: Stuffed animals
    -Immunosuppressed pt. best toy is plastic
30
Q

Where is the Cervical part of spine located?

A

Neck

31
Q

Where is the Thoracic part of spine located?

A

Upper Back

32
Q

Where is the Lumbar part of spine located?

A

Lower Back

33
Q

What does the Cervical part of spine innervates?

A

Diaphragm
Arms
Hands

34
Q

What is the most important Preop Assessment for Cervical location for laminectomy?

A

Breathing
Hand/arm function

35
Q

What are post-op complication to cervical spine from a laminectomy?

A

Pneumonia–> Breathing is effected
-No lifting over head at all for rest of life

36
Q

What does the Thoracic part of spine innervates?

A

Coughing ability
Bowel (gut muscles)

37
Q

What does the Lumbar part of spine innervates?

A

Bladder
Legs

38
Q

What is the most important Preop Assessment for Thoracic location for laminectomy?

A

Coughing ability
Bowel Sounds

39
Q

What is the most important Preop Assessment for Lumbar location for laminectomy?

A

Last void/bladder distention
Leg & foot function

40
Q

What are post-op complication to Thoracic spine from a laminectomy?

A

Pneumonia ( coughing ability is affected)
Paralytic ileus

41
Q

What are post-op complication to Lumbar spine from a laminectomy?

A

Urinary Retention

42
Q

How do you move any laminectomy or spinal cord injury pt.

A

LOG ROLL

43
Q

Post OP Laminectomy nursing care pt. education

A

DO NOT DANGLE/SIT on edge of bed
–Pt. transition straight from supine to ambulation
Avoid Sitting
–may sit for 30 min MAX
Cannot lift things above the head

NCLEX (13 decks)

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