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H & Illness 4: A & C illness > week 1 :endrocrine review > Flashcards

week 1 :endrocrine review Flashcards

1
Q

Cushing syndrome : alterations for diagnosis

A

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

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2
Q

cushing syndrome : what is it ?

A

excess glucocorticoids –> corticosteroids

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3
Q

how do we prevent/inteventions for cushing syndrome

A

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

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4
Q

risk factors for cushing syndrome :

A

prednisone users
adrenal tumours
women 20-40 years olds

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5
Q

expected findings for cushing syndrome :

A

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

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6
Q

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

A

ct/mri

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

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7
Q

cushing syndrome : nursing care

A

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

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8
Q

what are the complications of cushing syndrome

A

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

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9
Q

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

A

drainage/extreme warmth

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10
Q

what are the nutrition management for cushing syndrome

A

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

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11
Q

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.

A

yes this is true

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12
Q

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

A

yes this is true

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13
Q

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

A

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

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14
Q

what is hypothyrodism ?

A

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

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15
Q

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

A

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

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16
Q

health promotion/disease prevention

A

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

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17
Q

what are the risk factors for hypothyrodsim

A

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

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18
Q

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

A

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

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19
Q

what is pleural effusion

A

too much fluid between the layers of your pleura

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20
Q

what are the hormone levels for hypothyrodism

A

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

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21
Q

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

A

true

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22
Q

what are the diagnostic tool for hypothyrodism

A

xray/ct scan/mri

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23
Q

what are the safety consideration for hypothyroidism

A

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

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24
Q

what are the lab test for hypothyrodism

A

t3
t4
thyroid deficiencies
cholesterol
hgb
hct
rbc

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25
Q

suddenly stopping levothyroxine can lead to what?

A

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

26
Q

what is the worst thing that could happen with hypothyrodism

A

myxedema coma - life threathening , impacted by stress

27
Q

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

A

decrease in gastrointestinal motility

27
Q

what is hyperthyroidism :

A

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

28
Q

what is the alterations in diagnosis of hyperthyrodism :

A

activity intolerance
impaired nutrional status
risk of impaired electrolyte balance

29
Q

what is the health promotion/disease prevention

A

avoiding caffeine
reducing stress
smoking cessation

30
Q

what is the risk factors for hyperthyrodism

A

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

31
Q

what is the expected findings for hyperthyrodism

A

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

32
Q

what could happen after thyroidectomy ?

A

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

33
Q

what is exophathalmus

A

potential corneal injury related to dryness + irritation

34
Q

nursing care for hyperthyrodism

A

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

35
Q

what is the diet we should give hyperthyrodism

A

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

36
Q

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

A

tsh levels
t3 and t4 levels
thyroid antibody levels

37
Q

what is the diagnostic procedures

A

raiu test
thyroid scan
thyroid ultrasound

38
Q

what are some interventions we could do with hyperthyroidism

A

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

39
Q

complications for hyperthyrodism

A

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

40
Q

what should the position for a hyperthyroidism patient be ?

what should u do before surgery ( thyroidectomy )?

what should u encourage the pt ?

A

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

41
Q

what is diabetes mellitus

A

partial or complete metabolic deficiency of insulin by destruction of pancreatic beta- type 1

arises when body fails to use insulin theraphy - type 2

42
Q

alterations in heath when it comes down to diabetes mellitus

A

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 )

43
Q

what are the risk factors for dm

A

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

44
Q

when do we restrict exercise for dm

A

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

45
Q

what is the health promotion and disease prevention

A

bg levels/exercise regimen/diet pattern

46
Q

what is the laboratory test for diabetes mellitus

A

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

47
Q

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

A

true it is good

48
Q

nursing care for dm :

A

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

49
Q

what is the complications when it comes down to dm

A

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

50
Q

what is addison’s disease?

A

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

51
Q

recall that addison’s disease : decrease production of adrenal hormones, decrease in cortisol production initially followed by aldosterone

both of which will what ?

A

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

52
Q

true or false. addison disease can be prevented

A

false it cannot be prevented

53
Q

risk factors for addison’s disease

A

type 1 diabetes
pernicious anemia
testicular dysfunction
graves disease
mysastenia gravis

54
Q

what is the expected findings for addisions

A

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

55
Q

what are the laboratory test for Addison disease

A

cortisol
acth
aldosterone
renin
electrolytes
renin
bun
creatine
glucose
crh

56
Q

what is the diagnostic tests for addison’s disease

A

abdominal ct
xray

57
Q

what is the safety consdierations for addison’s disease

A

risk infection
risk fluid imbalance
risk for electrolyte imbalance

58
Q

what is the nursing care for addison’s disease

A

monitor i and o
administer iv
monitor electrolytes
administer meds

59
Q

what should we teach the patient for addison’s

A

high sodium
high caloric
low potassium
monitor fluids/med compliance

60
Q

what are the complications for addison’s disease

A

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

H & Illness 4: A & C illness (21 decks)

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