We are fucked Flashcards
what are the risk factors for DI?
trauma, kidney disease, medications, infection, cancer,
what the risk factors for SIADH?
vasopressin, NSAIDs, autoimmune, cancer, and pulmonary issues
what are the symptoms for DI?
polyuria…greater than 3L, polyphagia, polydipsia, signs of dehydrations…..hypotension, tachycardia, weak thready pulse, poor skin turgor
what labs will be run for DI
BMP- hypernatremia, hypokalemia, high bun and creatining
Urine specific gravity will be low
24 hour urine
what are the symptoms of hypernatremia?
decreased LOC, headache, thirst
What are the symptoms for SIADH
Oliguria, crackles in the lungs, signs of hypervolemia, hypertension, bounding, pulses, distended, neck, veins, hyponatremia…. nausea, vomiting, headache, fatigue, drowsiness, decreased LOC, and seizures
What labs will you run for SIADH?
BMP – hyponatremia, hyperkalemia, high bun, and creatinine
Urine specific gravity- high
24 hour urine
What are the treatment options for fixing diabetes insipidus
Vasopressin…don’t give to heart patients patients…can cause hypervolemia
What non-medical things should a nurse be watching for in DI and SIADH patients
Intake, output, and daily weights
What are the medical interventions for SIADH
Fluid restriction to 500 to 1500 ML’s
Diuretics
3% hypertonic saline
What precautions are SIADH patients on
Seizure
L what are the risk factors for Addison’s disease?
Auto immune disease, TB infection, trauma surgery
What are the symptoms of Addison’s disease?
Hyperpigmentation/vitiligo, week, weak, pulses, hypotension, hyponatremia, hypoglycemia, hypercalcemia, hyperkalemia, metabolic acidosis
What diagnostics are ran for Addison’s disease?
 BMP, cortisol levels, and ABG
What are the treatment options for Addison insufficiency?
Fluids with dextrose, prednisone, hydrocortisone
What caused an addisonian crisis?
Abrupt withdrawal of steroids, trauma, infection, stress
What is the treatment for addisonian crisis?
Hypertonic, fluids, steroids, electrolyte replacement, glucose, insulin, bicarb, if necessary
What are the risk factors for Cushing?
Steroid use, females age 25 to 45
What are the symptoms of Cushing’s disease?
Moon phase, Buffalo hump, trunk, obesity, hypertension, insomnia, hirusutism(hairy), increase risk of fractures, increase risk of infection and increase bleeding time
What happens to the electrolyte balance in Cushing’s
, hypokalemia, hypocalcemia, hypernatremia, and hyperglycemia
What precautions do you take in Cushing’s patients?
Sun, infection, exposure, sodium intake, bleeding, precautions, and skin precautions
What are risk factors for hypothyroidism?
Auto immune, cancer, surgery, hyper thyroid treatment, trauma, infections, women, iodine deficiency
What do you keep in mind for hypothyroid symptoms?
All symptoms are low and slow
What treatments are available for hypothyroidism
Levothyroxine
What should you keep in mind when giving levothyroxine
Take the medication early in the morning on an empty stomach, may cause tachycardia, and watch patients taking insulin
What can you do for patients with hypothyroidism?
Give oxygen, warm, IV, fluids, maintain airway, high fiber, diet,
What are risk factors for hyperthyroidism?
Graves’ disease women,too much iodine
What to keep in mind for symptoms for hyperthyroidism
High and fast
What are the treatment options for hyperthyroidism?
Proplythirouracil, methimazole, and radioactive iodine
What do you keep in mind when administering proplythiouracil
Avoid sick people and monitor for liver toxicity
What to keep in mind, when administering methimazole
Report signs of hypothyroidism and liver toxicity
What do you keep in mind when taking radioactive iodine
Use different toilets and flush with lid down at least three times
Put body fluids in radioactive bag
No sharing utensils
Wash clothes separately
Avoid contact with pregnant women
Isolation. For two more weeks.
Low iodine… Avoid shellfish and salt
What surgical procedure is used for hyperthyroidism thyroid?
Thyroidectomy
What to do with your thyroid ectomy patients?
Administer levothyroxine, monitor for hemorrhage, monitor for thyroid storm, monitor for hypocalcemia due to damage to parathyroid, put in semi-Fowlers
What causes a thyroid storm?
Uncontrolled hyperthyroidism, surgery, infection, trauma, DKA, palpation of goiter
What are symptoms of thyroid storm?
High, fever, severe, hypertension, tachycardia
What is the treatment for thyroid storm?
Give patent airway, give anti-thyroid medication’s give iodine, give, beta blockers, cardiac monitoring, cooling
What is the cause of myexedema edema coma?
Uncontrolled hypothyroidism, acute illness, surgery, discontinuing thyroid replacement
What are symptoms of myxedema coma
Respiratory failure, severe hypotension, hypothermia, hypoglycemia, hyponatremia
What is the treatment for myxedeam coma
IV. Levothyroxine, glucose, hypertonic, fluids, maintain airway.
What are the risk factors of hypoparathyroidism?
Removal of parathyroid glands, and autoimmune
What are the symptoms of hypoparathyroidism?
Hypocalcemia…. Tingling and numbness of mouth and hands, muscle cramps, tetany, seizures, LOC changes, positive Chvostek and troussea
What are the diagnostics for hypoparathyroidism?
Serum calcium levels will be low
phosphorus will be high
Ultrasound of the gland
What are the treatment options for hypo parathyroid?
Calcium, gluconate, oral, vitamin D, magnesium sulfate
What diet do hypoparathyroidism patients need?
Avoid milk, yogurt and processed cheese
Encouraged dark, leafy greens
Encourage dairy such as cottage cheese, blue cheese, feta, and Parmesan
What are the risk factors for hyperparathyroidism?
Parathyroid, tumor, neck, trauma
What assessment findings will you find in a hyperparathyroidism patient
Hypercalcemia… fractures, renal, calculi, osteoporosis, cardiac arrhythmias
What labs and diagnostics do you do for a hyperparathyroid patient
Calcium will be high phosphorus, will be low, ultrasound, the parathyroid gland
What operation do you do for a hyperparathyroid patient?
Parathyroidectomy
What medication will a hyperparathyroid patient take
Diuretics and calcitonin with large amounts of isotonic fluids
What diet will a hyperparathyroid patient be on?
Dair, whole grains, and nuts, and anything processed
What are the symptoms of hyponatremia?
Nausea, vomiting, headache, fatigue, drowsiness, decrease, seizures,
