WEEK 8: Endocrine System Flashcards
Goiter
An abnormal enlargement of the thyroid gland, often due to iodine deficiency, hormonal imbalance, or autoimmune disorders such as Hashimoto’s thyroiditis or Graves’ disease.
Myxedema Coma
A life-threatening complication of severe hypothyroidism characterized by hypothermia, bradycardia, hypoglycemia, and respiratory depression.
Cretinism
A congenital hypothyroid condition resulting from iodine deficiency or thyroid gland dysfunction in infancy, leading to stunted growth and intellectual disability.
Hyperglycemia
A condition where blood glucose levels are elevated above normal, often due to insulin deficiency or resistance.
Ketosis
A metabolic state in which the body burns fat for energy due to insufficient glucose availability, producing ketone bodies.
Glycosuria
The presence of glucose in the urine is typically due to elevated blood glucose levels exceeding renal reabsorption capacity.
Polyuria
Excessive urination, often a symptom of diabetes mellitus due to osmotic diuresis.
Polydipsia
Excessive thirst, commonly associated with diabetes due to fluid loss from polyuria.
Polyphagia
Excessive hunger, often a symptom of uncontrolled diabetes due to the body’s inability to utilize glucose properly.
Lipodystrophy
Abnormal or degenerative conditions of the body’s adipose tissue, often seen at insulin injection sites due to repeated use.
Ketonuria
The presence of ketone bodies in the urine indicates fat metabolism due to glucose deficiency, as seen in diabetes mellitus.
Hypothyroidism
A condition in which the thyroid gland produces insufficient thyroid hormones, leading to fatigue, weight gain, cold intolerance, and bradycardia.
Hyperthyroidism
A condition in which the thyroid gland produces excessive thyroid hormones, causing weight loss, tachycardia, heat intolerance, and nervousness.
Cushing’s Syndrome
A disorder caused by prolonged exposure to high cortisol levels, leading to symptoms such as moon face, buffalo hump, central obesity, and fragile skin.
Addison’s Disease
A disorder where the adrenal glands produce insufficient cortisol and aldosterone, resulting in fatigue, hypotension, and hyperpigmentation.
Adrenal Insufficiency
A condition where the adrenal glands fail to produce adequate hormones, leading to weakness, dehydration, and electrolyte imbalances.
Diabetes Insipidus
A disorder characterized by insufficient antidiuretic hormone (ADH), leading to excessive thirst and large volumes of dilute urine.
Diabetes Mellitus
A metabolic disorder characterized by hyperglycemia due to insulin deficiency or resistance, classified as Type 1 (autoimmune destruction of insulin-producing cells) or Type 2 (insulin resistance).
Giantism
This condition is caused by excess growth hormone secretion before the closure of growth plates, leading to abnormal height and growth.
Describe hypothyroidism, including pathophysiology and manifestations.
-Hypothyroidism occurs when the thyroid gland fails to produce adequate thyroid hormones (T3, T4), leading to a slow metabolic rate.
-Causes include autoimmune thyroiditis (Hashimoto’s), iodine deficiency, and post-thyroidectomy states.
-Manifestations include fatigue, cold intolerance, dry skin, weight gain, constipation, depression, and bradycardia.
List diagnostic tests used for hypothyroidism
-Serum TSH (elevated in primary hypothyroidism)
-Free T4 (low)
-thyroid antibodies for autoimmune causes.
Who is more likely to suffer from hypothyroidism, men or women?
Women, especially those over 50.
Outline nursing care for the client who has hypothyroidism.
Monitor for signs of myxedema coma, administer prescribed levothyroxine, encourage a balanced diet, and provide patient education on lifelong therapy.
Describe the causes, signs, and symptoms of cretinism.
Congenital hypothyroidism due to iodine deficiency or thyroid gland defects leads to stunted growth, developmental delays, a large tongue, and poor feeding.
Describe the screening process for cretinism.
Newborn screening via TSH and T4 testing.
Describe hyperthyroidism, including pathophysiology and manifestations.
Overproduction of thyroid hormones increases metabolism. Causes include Graves’ disease, toxic multinodular goiter, and excessive iodine intake. Symptoms include weight loss, heat intolerance, tachycardia, irritability, and goiter.
List diagnostic tests used for hyperthyroidism
-Serum TSH (low in primary hyperthyroidism)
-Free T4 (elevated)
-radioactive iodine uptake test.
Describe Graves’ Disease.
An autoimmune disorder causing hyperthyroidism due to thyroid-stimulating antibodies.
Outline nursing care for the client who has hyperthyroidism.
Monitor for thyroid storm, administer antithyroid drugs (methimazole, PTU), beta-blockers, and iodine preparations.
Outline the effects of hypothyroidism and hyperthyroidism on each body system: the Endocrine, Respiratory, Neurologic, Reproductive, and Integumentary Systems.
-Endocrine: Hormonal imbalance.
-Respiratory: Dyspnea (hyperthyroidism), slow breathing (hypothyroidism).
-Neurologic: Anxiety and tremors (hyperthyroidism), sluggish reflexes (hypothyroidism).
-Reproductive: Menstrual irregularities.
-Integumentary: Dry skin (hypothyroidism), warm, moist skin (hyperthyroidism).
Define Cushing’s Syndrome and describe its main manifestations.
Excess cortisol leads to truncal obesity, moon face, striae, hypertension, and muscle weakness.
List diagnostic tests used for Cushing’s syndrome
24-hour urinary cortisol, dexamethasone suppression test.
Outline the nursing care for a client with Cushing’s Syndrome.
Monitor blood glucose, promote a balanced diet, and manage electrolyte imbalances.
Indicate the cause of Addison’s Disease and outline its manifestations.
Autoimmune destruction of the adrenal cortex leads to fatigue, weight loss, hyperpigmentation, and hypotension.
Describe what is meant by an Addisonian Crisis.
Life-threatening acute adrenal insufficiency causing severe hypotension, hyperkalemia, and shock.
List diagnostic tests used for Addison’s Disease.
ACTH stimulation test, serum cortisol levels.
List the common treatments for Addison’s Disease.
Hormone replacement with hydrocortisone and fludrocortisone.
Clients with Type 1 DM must use ________________, while those with Type 2 DM usually can control glucose levels with ________________.
Type 1 DM requires insulin, while Type 2 DM can be controlled with oral medications, diet, and exercise.
Define diabetes mellitus and explain the pathophysiology of Type I and Type 2 DM with the related manifestations.
Type 1: The Autoimmune destruction of beta cells leads to absolute insulin deficiency.
Type 2: Insulin resistance and relative deficiency.
Polydipsia, polyuria, polyphagia, weight loss, fatigue
Identify the diagnostic tests used to diagnose and monitor self-management of DM.
Fasting blood glucose, HbA1c, oral glucose tolerance test.
List the types of insulin available under the following headings and indicate the onset, peak, and duration of action for each.
-rapid-acting insulin
-short-acting insulin
-intermediate –acting insulin
-long-acting insulin
Rapid-acting: Onset: 10-30 min, Peak: 30-90 min, Duration: 3-5 hrs.
Short-acting: Onset: 30-60 min, Peak: 2-3 hrs, Duration: 5-8 hrs.
Intermediate-acting: Onset: 1-2 hrs, Peak: 4-12 hrs, Duration: 18-24 hrs.
Long-acting: Onset: 1-2 hrs, Peak: None, Duration: 24 hrs.
Treatment of DM depends on the type (Type 1 or Type 2).- complete the following sentences:
Outline the use of an insulin pump. Indicate the advantages/disadvantages of its use.
Continuous insulin delivery with flexibility; disadvantages include cost and infection risk.
Describe how to use an insulin pen.
- Prepare the Pen: Wash hands, check insulin type/expiration, roll mixed insulin (if applicable), and remove the cap.
- Attach a Needle: Secure a new needle, removing both caps.
- Prime the Pen: Select two units, hold it upright, and press until a drop appears.
- Set the Dose: Turn the dial to the prescribed amount.
- Choose an Injection Site: Use the abdomen, thighs, upper arms, or buttocks; clean skin if needed.
- Inject: Pinch the skin (if necessary), insert the needle at 90° (or 45° for thinner areas), press the button, and hold for 5-10 seconds.
- Dispose of Needle: Remove and discard in a sharps container
On a diagram of the human body, locate the correct sites to use for insulin injection.
-Abdomen (best absorption; at least 2 inches away from the navel)
-Upper outer thighs
-Upper arms (back of the arm, fatty tissue)
-Buttocks (upper outer quadrant)
State why it is necessary to rotate the sites of insulin injections.
Rotating sites is essential to prevent lipodystrophy, which includes:
-Lipohypertrophy: Thickened, fatty lumps under the skin due to repeated injections in the same spot.
-Lipoatrophy: Fat loss causing pitted or hollow areas in the skin.
Proper rotation ensures consistent insulin absorption and reduces skin complications.
Can different types of insulin be mixed together? Elaborate.
Yes, but only specific types:
-Short-acting (Regular) insulin can be mixed with intermediate-acting (NPH) insulin in the same syringe.
-Rapid-acting insulins (e.g., Lispro, Aspart) should NOT be mixed with long-acting insulins like Glargine (Lantus) or Detemir (Levemir).
Mixing sequence (“Clear before Cloudy”):
-Draw up the clear (fast-acting) insulin first.
-Draw up the cloudy (NPH) insulin second.
This prevents contamination of short-acting insulin with NPH.
Elaborate on the guidelines for the client with diabetes to follow when meal planning. Following these guidelines, develop an appropriate breakfast, lunch, and dinner menu and snacks. For more information, visit the Canadian Diabetic Association’s website at http://www.diabetes.ca/ and look under nutrition. You do not need to submit your menus.
The goal is to maintain stable blood glucose levels with balanced meals. Consider:
-Carbohydrate counting: Focus on complex carbs (whole grains, vegetables) rather than refined sugars.
-Glycemic Index (GI): Choose low-GI foods to prevent blood sugar spikes.
-Protein & Fiber: Help slow digestion and improve satiety.
-Healthy Fats: Use unsaturated fats (avocados, nuts, olive oil).
-Portion Control: Prevents overeating and helps maintain weight.
Outline the importance of exercise in managing DM.
Exercise helps:
-Lower blood sugar levels by increasing insulin sensitivity.
-Improves cardiovascular health, reducing risks of complications.
-Aid in weight management.
-Reduce stress, which can otherwise spike glucose.
Describe the following complications of DM, including etiology (cause) and treatment:
-Diabetic Ketoacidosis (DKA)
-Hyperosmolar Hyperglycemic State (HHS)
-Hypoglycemia
-Diabetic retinopathy
-Diabetic neuropathy
-Diabetic Ketoacidosis (DKA)
Cause: Severe insulin deficiency, leading to fat breakdown and acid buildup.
Symptoms: Fruity breath, Kussmaul respirations, nausea, vomiting.
Treatment: IV insulin, fluids, and electrolyte correction.
-Hyperosmolar Hyperglycemic State (HHS)
Cause: Extreme hyperglycemia without ketones (mainly in Type 2 DM).
Symptoms: Severe dehydration, altered mental state.
Treatment: IV fluids, insulin therapy.
-Hypoglycemia
Cause: Too much insulin, too little food, or excessive exercise.
Symptoms: Sweating, confusion, tremors, dizziness.
Treatment: 15g fast-acting carbs (e.g., juice, glucose tablets).
-Diabetic Retinopathy
Cause: Chronic high blood sugar damaging retinal blood vessels.
Symptoms: Vision loss, blurry vision, floaters.
Treatment: Blood sugar control, laser therapy.
-Diabetic Neuropathy
Cause: Nerve damage from prolonged high glucose levels.
Symptoms: Numbness, tingling, pain (especially in feet).
Treatment: Blood sugar control, pain management (Gabapentin, Lyrica).
