week 1 :endrocrine review Flashcards by mary doe

Cushing syndrome : alterations for diagnosis

risk of infections
alterations of nutrition
disturbed body image
risk of skin integrity

How well did you know this?

Not at all

Perfectly

cushing syndrome : what is it ?

excess glucocorticoids –> corticosteroids

How well did you know this?

Not at all

Perfectly

how do we prevent/inteventions for cushing syndrome

reduce corticosteroids:
find underlying issues : tumour = remove
too much - suppress - medication = ketoconodazole

How well did you know this?

Not at all

Perfectly

risk factors for cushing syndrome :

prednisone users
adrenal tumours
women 20-40 years olds

How well did you know this?

Not at all

Perfectly

expected findings for cushing syndrome :

centripenal fat - buffalo hump , purple striae, htn/moon face

How well did you know this?

Not at all

Perfectly

what are the diagnoses we use for cushing syndrome :
what do we teach out patient in terms of education :

ct/mri

patient education : avoid extreme temperatures, infection/being too stress

How well did you know this?

Not at all

Perfectly

cushing syndrome : nursing care

VS/glucose/daily wt
assess for any infection
monitor for thromboembolic events/pulmonary embolic
assess for any pain/loss of function

How well did you know this?

Not at all

Perfectly

what are the complications of cushing syndrome

hyperglycemia
loss of collagin
muscle wasting
loss of bone matrix- osteoporosis and back pain

How well did you know this?

Not at all

Perfectly

what are the signs of infection for cushing syndrome that we should look out for ?

drainage/extreme warmth

How well did you know this?

Not at all

Perfectly

what are the nutrition management for cushing syndrome

high protein, high potassium , high calcium
low carbs , low fat, low sodium
these help correct the effect of excess corticosteroids

How well did you know this?

Not at all

Perfectly

it is important to attain wt appropriate for the ht of the patient when it comes down to nutrition management of a Cushing syndrome patient.

yes this is true

How well did you know this?

Not at all

Perfectly

true or false. it is important to maintain a low calorie diet that meets nutritional needs

yes this is true

How well did you know this?

Not at all

Perfectly

what type of device do we use for a Cushing syndrome patient ?

use device of the bed ( sheep skin to protect the patient )

How well did you know this?

Not at all

Perfectly

what is hypothyrodism ?

inadequate amount of circulating t3/t4 hormones. decrease in metabollic rate.

How well did you know this?

Not at all

Perfectly

what are the alterations in diagnosis when it comes down to hypothyrodism

1: thyroid gland dysfunction
2 : anterior pituary, target cell dysfunction
3: hypothalamus not producting tr factor ( tertiary ( rare ) not enough tsh )

How well did you know this?

Not at all

Perfectly

health promotion/disease prevention

long drug therapy should not be stopped abrupt
diet should include iodine/selenium/zinc

How well did you know this?

Not at all

Perfectly

what are the risk factors for hypothyrodsim

female- older than 60 years , exposure to radiation in the neck prior to surgery
- inadequate iodine intake/autoimmune disease

How well did you know this?

Not at all

Perfectly

what is the expected findings for hypothyrodism
early findings vs. late findings

anemic- iron deficiency
early findings - irritability/fatigue.cold intolerance/constipation/wt gain/depression

late fings : low heart rate,rr,bp,dysrythmias,dry skin,peural effusion

How well did you know this?

Not at all

Perfectly

what is pleural effusion

too much fluid between the layers of your pleura

How well did you know this?

Not at all

Perfectly

what are the hormone levels for hypothyrodism

high tsh
low t4
high TPO
serum urine/acth/cotisol - normal

How well did you know this?

Not at all

Perfectly

true or false. monitor cardiac changes
- take meds on empty stomach when it comes to hypothyrodism

true

How well did you know this?

Not at all

Perfectly

what are the diagnostic tool for hypothyrodism

xray/ct scan/mri

How well did you know this?

Not at all

Perfectly

what are the safety consideration for hypothyroidism

fall risk
altered metabolism
mental changes
loss of conciousness
immobility due to depression

How well did you know this?

Not at all

Perfectly

what are the lab test for hypothyrodism

t3
t4
thyroid deficiencies
cholesterol
hgb
hct
rbc

How well did you know this?

Not at all

Perfectly

suddenly stopping levothyroxine can lead to what?

can lead to decrease hr, bp, rr , co, coma, hypoxia

what is the worst thing that could happen with hypothyrodism

myxedema coma - life threathening , impacted by stress

recall that constipation is one of the things that could occur with hypothyrodism , why is that

decrease in gastrointestinal motility

what is hyperthyroidism :

hyperactivity of the thyroid gland , with sustained increase in synthesis and release of thyroid hormones

what is the alterations in diagnosis of hyperthyrodism :

activity intolerance impaired nutrional status risk of impaired electrolyte balance

what is the health promotion/disease prevention

avoiding caffeine reducing stress smoking cessation

what is the risk factors for hyperthyrodism

women>men 20-40 years old family history of thyroid disease of autoimmune disease

what is the expected findings for hyperthyrodism

goitre bruits exopthlamus ( protusion of eyeballs from orbits, usually bilateral)

what could happen after thyroidectomy ?

airway obstruction, after thyroid surgery is an emergency, keep 02, suction/tracheostomy

what is exophathalmus

potential corneal injury related to dryness + irritation

nursing care for hyperthyrodism

monitor for dysrthimias ensure 02 give iv fluids - replace fluid and electrolyte losses from n and v calm and quiet assisting exercise involving muscle groups

what is the diet we should give hyperthyrodism

high protein, high calorie hypermetabolism tatchy , dyspnea, dysarthmias, diaphoresis, pallor, high bp

what are the laboratory test we should look upon when it comes down to hyperthyrodism

tsh levels t3 and t4 levels thyroid antibody levels

what is the diagnostic procedures

raiu test thyroid scan thyroid ultrasound

what are some interventions we could do with hyperthyroidism

surgical therpahy subtotal ( thyroidectomy ) nutritional diet ( high calorie ) radioactie iodine therpahy

complications for hyperthyrodism

acute thyrotoxicosis ( life emergency ) released into the circulation -afib -osteoporosis

what should the position for a hyperthyroidism patient be ? what should u do before surgery ( thyroidectomy )? what should u encourage the pt ?

have a pt sit upright as much as possible to promote fluid drainage from periorbital area before surgery - show pt how to support head manually while turning in bed to minimize stress on suture line encourage regular exercise

what is diabetes mellitus

partial or complete metabolic deficiency of insulin by destruction of pancreatic beta- type 1 arises when body fails to use insulin theraphy - type 2

alterations in heath when it comes down to diabetes mellitus

ineffective health management readiness to enhance nutrition --> hyperglycemia ( 3 Ps, weakness lethargy, malaise, blurring of vision, H/A ) risk of injury risk of peripheral injury ( neurovascular dysfunction )

what are the risk factors for dm

genetics can predispose type 1 toxins and viruses can predispose an individual to diabetes leading to type 1 obesity/ physical inactivity/ triglycerides>250/ htn - insulin resistance

when do we restrict exercise for dm

more than 14 mmol ( especially ketones present ) -- bodys requirement or 128 hz tuning fork for baseline findings -- comprehensive findings foot assesment

what is the health promotion and disease prevention

bg levels/exercise regimen/diet pattern

what is the laboratory test for diabetes mellitus

8 hr fasting blood glucose 126 mg/ml randome glucose of 200 mg/ml hb a1c > glycosated hgb oral glucose tolerance test

true or false. it is good self monitored blood glucose, before meals and bedtime

true it is good

nursing care for dm :

monitor vs/bg/in and out/skin integrity/healing wounds/sensory alterations/dietary patterns/exercise patterns

what is the complications when it comes down to dm

dka ( diabetic ketoacidosis ) this is life threatening ( ketones )

what is addison's disease?

decrease production of adrenal hormones, decrease in cortisol production initially followed by aldosterone

recall that addison's disease : decrease production of adrenal hormones, decrease in cortisol production initially followed by aldosterone both of which will what ?

increase acth and msh hormones due to the loss of negative feedback inhibition

true or false. addison disease can be prevented

false it cannot be prevented

risk factors for addison's disease

type 1 diabetes pernicious anemia testicular dysfunction graves disease mysastenia gravis

what is the expected findings for addisions

fatigue extreme weakness unexplained wt loss muscle aches dizziness fainting changes in bp or hr abdominal pain n and v

what are the laboratory test for Addison disease

cortisol acth aldosterone renin electrolytes renin bun creatine glucose crh

what is the diagnostic tests for addison's disease

abdominal ct xray

what is the safety consdierations for addison's disease

risk infection risk fluid imbalance risk for electrolyte imbalance

what is the nursing care for addison's disease

monitor i and o administer iv monitor electrolytes administer meds

what should we teach the patient for addison's

high sodium high caloric low potassium monitor fluids/med compliance

what are the complications for addison's disease

severe dehydration severe hypotension shock vomitting diarrhea extreme muscle weakness h/a extreme sleepiness coma death