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Nursing School > 🏥- Thyroid & Seizure Test > Flashcards

🏥- Thyroid & Seizure Test Flashcards

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0
Q

What hormones are secreted by the posterior pituitary (neurohypophysis)

A
  • ADH

- Oxytocin

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1
Q

What hormones does the anterior pituitary (adenohypophysis) secrete

A
  • growth hormone
  • adrenocorticotropic hormone
  • thyroid stimulating hormone
  • follicle stimulating hormone
  • luteinizing hormone
  • prolactin
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2
Q

What time of day should hormone supplements (such as GH) be taken

A

In the morning

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3
Q

Acromegaly

A

Thickening of bones; particularly hands, feet and facial bones

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4
Q

Clinical manifestations of acth in hyperpituitarism

A
  • increased glucocorticoids (hyperglycemia, increased cortisol levels)
  • increased mineralcorticods (hypernatremia, hypertension, hypokalemia)
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5
Q

Metabolism in hypo vs hyperpituitarism

A

Hypo- decreased (weight gain)

Hyper- increased (weight loss)

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6
Q

Clinical manifestations of acth in hypopituitarism

A
  • decreased glucocorticoid (hypoglycemia, decreased cortisol levels and decreased ability to handle stress)
  • decreased mineralcorticoids (hyponatremia, hypotension, hyperkalemia)
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7
Q

Bromocriptine mesylate

A

Parlodel

(Dopamine agonist)

Inhibits release of anterier pituitary hormones

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8
Q

Octreotide

A

Sandostatin

(Somatostatin analog)

Inhibit release of growth hormone

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9
Q

Transsphenoidal hypophysectomy

A

Removal of hypersecreting tumors of the pituitary gland

“Mustache dressing”

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10
Q

Complications of hyperpituitarism

A
  • hyperglycemia , hypertension
  • thyroid storm
  • CSF leaks (related to transsphenoidal surgery) = increases risk of meningitis
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11
Q

Desmopressin

A

DDAVP

has an antidiuretic effect which will increase blood volume and blood pressure

Synthetic analog of ADH

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12
Q

What are the primary clinical manifestations seen in a patient with diabetes insipidus

A

Polyuria, polydipsia, nocturia

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13
Q

A patient with DI may present with

A

Hypotension and tachycardia secondary to hypovolemia

Hemoconcentration observed with elevated Na and hematocrit

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14
Q

What 2 things are the key indicators of DI

A
  • urine osmolality of less than 200

- specific gravity of less than 1.005

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15
Q

Pitressin

A

Synthetic vasopressin

Used to treat DI

Require frequent monitoring of fluid status, electrolytes and urine output

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16
Q

Clinical manifestations of SIADH

A

Headache
Irritability
Confusion
Weakness

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17
Q

What is a complication of decreasingly low Na levels associated with SIADH

A

Seizures or comatose

**seizure precautions implemented with a Na less than 120

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18
Q

A patient with SIADH may present with

A
  • scant urine output
  • elevated specific gravity
  • decreased serum Na and osmolarity
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19
Q

Demeclocycline

A

Declomycin

A tetracycline derivative

Used in SIADH because it increases water excretion by the kidneys

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20
Q

Clinical manifestations of adrenal cortex insufficiency

A

Hyperpigmentation, mood changes, dehydration, hypotension

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21
Q

Normal range of cortisol

A

5-25 mcg/dL (morning)

3-16 mcg/dL (afternoon)

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22
Q

What is the definitive treatment for adrenal insufficiency

A

Replacement of cortisol

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23
Q

How can hyperkalemia be treated

A

With potassium binging or excreting agents (Kayexalate)

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24
Q

Complications of adrenal cortex insufficiency

A

Acute adrenal insufficiency or adrenal crisis - life threatening emergency that leads to sever hypovolemia and hypotension

**decrease in aldosterone and cortisol, loses Na and water. At risk for hyperkalemia and hypoglycemia

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25
Q

Conn’s syndrome

A

Hyperaldosteronism

Aldosterone- Na and water reabsorption; K excretion

In hyperaldosteronism - hypertension and hypokalemia develop

**MOST PREVALENT IN BLACK WOMEN

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26
Q

Clinical manifestations of cushing’s disease

A

Hyperglycemia , fluid retention , hypokalemia , abnormal fat distribution , decreased muscle mass

Females: virilization , breast atrophy , vocal changes (deepening) , amenorrhea

** moon face , buffalo hump , thin skin , truncal obesity , poor wound healing **

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27
Q

Virilization

A

Make sexual characteristics developing in females

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28
Q

Name 3 medications used to treat hypercortisolism

A

Aminogluthethimide

Cyproheptadine

Pasireotide (signifor)

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29
Q

What types of medications are used to treat hyperaldosteronism

A

Spironolactone

Potassium supplements

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30
Q

Complications of hypercortisolism

A

Osteoporosis , GI bleed

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31
Q

Complications of hyperaldosteronism

A

Hypertension , severe hypokalemia = cardiac dysrhythmias

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32
Q

Pheochromocytoma

A

Catecholamine (epinephrine and norepinephrine) producing tumors

-intermittent episodes of hypertension

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33
Q

Hashimoto’s thyroiditis

A

Most common type of hypothyroidism and is caused by an autoimmune response that leads to destruction of the thyroid gland by immunological processes

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34
Q

Hypothyroidism occurs most often in what demographic

A

Women between ages 30 and 60

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35
Q

Clinical manifestations of hypothyroidism

A

Goiter , decreased energy , weight gain , COLD INTOLERANCE , decreased appetite , constipation

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36
Q

What is the primary treatment for hypothyroidism

A

Replacement of thyroid hormone -dot commonly prescribed is levothyroxine (synthroid)

37
Q

At what time of day should levothyroxine be taken

A

Synthroid

Should be taken in the morning , and at the same time every day

38
Q

Complications of hypothyroidism

A

Myxedema coma

Characterized by hypoxia and carbon dioxide retention (secondary to hypoventilation), fluid and electrolyte imbalances and hypothermia

*bradycardic and hypotensive , hypoglycemia and hyponatremia develop

39
Q

What types of medications have to be closely monitored if given to a patient with hypothyroidism

A

Sedatives, hypnotics and narcotics because the metabolism of the medication is slower and respiratory compromise may occur with normal dosages

40
Q

Myxedema coma is characterized by/manifests as

A

Generalized nonpitting edema, particularly in the hands, feet, between the shoulder blades and around the eyes - edema of the tongue and around the larynx results in changes in speech and a husky tone

41
Q

Grave’s disease

A

Most common cause of hyperthyroidism and is an autoimmune disorder involving antibodies that bind to the thyroid gland

42
Q

Hyperthyroidism is most commonly diagnosed in which demographic

A

Women age 20-40

43
Q

Clinical manifestations of hyperthyroidism

A 
Elevated heart rate
Heat intolerance 
Increased appetite 
Weight loss
Nervousness 
Hair loss 
Increased GI activity 
Goiter
Exopthalmus
44
Q

Complications of hyperthyroidism

A

Thyroid storm

Clinical manifestations: tachycardia , fever , systolic hypertension , abdominal pain , tremors and changes in LOC

*airway management and fluid resuscitation are priorities

45
Q

List 4 drugs used to treat hyperthyroidism

A
  • propyithiouracil (ptu)
  • methimazole (tapazole)
  • lithium carbonate (lithonate)
  • iodine (potassium iodide, sski)
46
Q

Lab values in a patient with hyperthyroidism would reflect what

A

Elevated T3 and T4 - decreased TSH

47
Q

Clinical manifestations of hypoparathyroidism

A

Hypocalcemia

Numbness , tingling around mouth or hands and feet , severe muscle cramps , spasms of hands and feet and tetany

48
Q

Normal range of magnesium

A

1.6-2.6

49
Q

Normal range of phosphorus

A

2.5-4.5

50
Q

Two specific assessments observed in hypocalcemia are

A

Chvostek’s - abnormal reaction to stimulation of facial nerve

Trousseau’s - an indication of latent tetany in which carpal spasm occurs when the upper arm is compressed

51
Q

Diagnostic results consistent with hypoparathyroidism

A

Low calcium, high phosphate, low PTH

52
Q

Clinical manifestations of hyperparathyroidism

A

Polyuria , anorexia , constipation and generalized bone pain

53
Q

Diagnostic results consistent with hyperparathyroidism

A

High PTH and high ionized Ca

54
Q

Which type of diuretic should be avoided in patients with hyperparathyroidism

A

Thiazide diuretics because they increase absorption of Ca in the kidney

55
Q

Type 1 diabetes

A

Autoimmune process in which the insulin-producing beta cells of the pancreas are destroyed , resulting NO insulin

**requires insulin therapy

56
Q

Clinical manifestations of type 1 diabetes

A

Polyuria, polydipsia, polyphagia, fatigue and weight loss

57
Q

Fasting blood glucose

A

Prediabetes range: 100-125 mg/dL

DM: greater than 126

58
Q

2-hr post prandial (ogtt)

A

Prediabetes range: 140-199 mg/dL

DM: greater than 200

59
Q

Hemoglobin A1c

A

Prediabetes range: 5.7% - 6.4%

DM: greater than 6.5

60
Q

Random blood glucose

A

Greater than 200 - if accompanied by classic signs of hyperglycemia

61
Q

What are the 4 complications of type 1 DM

A

DKA , hypoglycemia , dawn phenomenon and somogyi effect

62
Q

DKA

A

Inadequate insulin for cells to obtain adequate glucose for normal metabolism

-the body attempts to obtain energy by the rapid breakdown of fat stores

63
Q

Kussmauls respirations

A

Rapid deep respirations that occur as a compensatory mechanism for the acidosis

*associated with DKA / fruity acetone smell to the breath

64
Q

List the 5 factors for a positive diagnosis of DKA

A
  • blood sugar greater than 250
  • ketonuria
  • pH less than 7.3
  • bicarb less than 15
  • positive anion gap
65
Q

Hypoglycemia

A

Blood sugar less than 65

66
Q

Dawn phenomenon

A

Results in increased blood sugar in the early morning

Naturally occurring release of hormones such as glucagon, cortisol and gh in the early morning

67
Q

Somogyi effect

A

Results in increased blood sugar in the early morning

Due to an excessive insulin dosage at night

68
Q

What drugs are used for prevention of cluster headaches

A
  • beta blockers: propranalol (inderal) and atenolol (tenormin)
  • anticonvulsants: valporic acid (depakote) and gabapentin (neurontin)
  • tricyclic antidepressants: amitriptyline (elavil) and imipramine (tofranil)
69
Q

Behaviors seen in cluster headaches

A

Often paces, walks, sits and rocks

70
Q

Behaviors seen in tension headaches

A

Neck and shoulder muscle tenderness and bilateral pain at the base of the skull and in the forehead “bandlike”

71
Q

Tonic-clonic seizure

A

Last 2-5 minutes begins with stiffening/rigidity of arms and legs usually and immediate loss of consciousness, clonic or rhythmic jerking then begins

72
Q

Tonic seizure

A

Abrupt increase in muscle tone, loss of consciousness and autonomic changes lasting 30 seconds to several minutes

73
Q

Clonic seizure

A

Muscle contraction and relaxation , lasts several minutes

74
Q

Absence seizure

A

Mostly in children, briefly periods of loss of consciousness and blank staring as though daydreaming; automatisms (involuntary behaviors lip smacking, picking at clothes)

75
Q

Myclonic seizure

A

Brief jerking or stiffening of extremities that may occur singly or in groups lasting a few seconds

76
Q

Atonic seizure

A

Sudden loss of muscle tone, falls, postical confusion

*most resistant to therapy

77
Q

2 types of partial seizures

A

Focal , one cerebral hemisphere

Complex and simple

78
Q

What is something important to note with topamax and zonergran

A

Carry increased risk of metabolic acidosis , use caution if taking metformin

79
Q

Serum levels and toxicity of phenytoin

A

Dilantin

Serum level: 10-20

Toxic: 30-50

80
Q

Signs of phenytoin toxicity

A 
Double vision 
Eye movements 
Dizziness 
Drowsiness 
Lack of coordination 
Slurred speech 
N/v
Decreased appetite
Bloating
81
Q

Seizure precautions

A
  • oxygen and suctioning equipment should be readily available
  • saline lock (INT) may be necessary
  • siderails should be up at all times
  • place bed in lowest position

NEVER insert padded tongue blades into the patients mouth during a seizure

82
Q

Status Epilepticus

A

Prolonged seizures lasting more than 5 mins

IV push lorazepam , diazepam - loading dose IV Dilantin

83
Q

Kernigs sign

A

Flex hip = pain

84
Q

Causes of encephalitis

A

Enterovirus, herpes, hiv, west nile, animal-borne illness

85
Q

Florinef

A

Replaces aldosterone

86
Q

Apraxia

A

Inability to use objects correctly

87
Q

Aphasia

A

Inability to speak or understand

88
Q

Anomia

A

Inability to find words

89
Q

Agnosia

A

Loss of sensory comprehension

Nursing School (36 decks)

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