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Endocrine 2

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juniperk's version from 2018-03-30 04:02

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Question Answer
What assessment findings are common in atnerior hypopituitarism?Mainly affects thyroid, adrenal, and gonadal function. Atrophy of all endocrine glands, hair loss, impotence, amenorrhea, and hypoglycemia
What are the usually orders for administering a GH injection? why?Inject at night 2-3 times a week. This mimics the body hormone increased release at night.
What hormone is under secreted with DI? What gland is affected?ADH (vasopressin) from the posterior pituitary
Why does diabetes insipidus result in excess urine production?ADH promotes resorption of fluid in distal tubules. Without resorption, massive amounts of urine are excreted.
What is the patho of DI?ADH is decreased or not responded to properly. 2. Less water is reabsorbed by the kidneys. 3. Excessive urine is produced
5 Clinical manifestations of DI?Polyuria 2. Polydipsia 3. Low urine specific gravity 4. hypotension 5. hypernatremia 5. <300 urine osmololity
DI. Nursing dxFluid volume deficit
DI. Therapeutic mgmtTreat underlying cause 2. Vasopressin- very painful inj. q 48-72h. suspended in oil
What is the main side effect of Vasopressin )DDAVPabdominal cramps
What is the diet for both nephrogenic and neurogenic DI?Low salt and low protein
What is the opposite disorder of DI?SIADH- increase secretion of ADH
With SIADH what is the result of over secretion of ADH?Excessive water conservation and hyponatremia
Lung cancer is the most common cause for what disorder?SIADH
What classification of meds can cause SIADH?antidepressants. 2 NSAIDS 3. chemos
What type of IV fluid is used to treat SIADH?3% NS
SIADH. Patho1. Normal mechanisms of feedback fail 2. Excess secretion of ADH 3. Excess water retention 4. Hypervolemic hyponatremic state
SIADH. Clinical manifestationEarly- thirst anorexia fatigue and lethargy Late- weight gain 2. edema 3. decreased urine output 4. neuro symptoms (restlessness, confusion, decreased reflexes...)
SIADH and DI are the result of a malfunction of what endocrine gland?Posterior pituitary
SIADH. dx and lab findingsHigh urine osmololaty and specific gravity > 1.032. Decreased hematocrit, BUN, and serum sodium.
SIADH. Nursing dxExcessive fluid volume
SIADH. Therapeutic mgmt1. Limit fluid intake incl ice chips 800/day Flush with NS. 2. Accurate I&O 3. Daily weights -2lbs=1L 4. Supplement sodium intake.
SIADH. MedicationIV hypertonic saline 3% 2. Demeclocycline 3. Diuretics
What can cause thyroid storm?Uncontrolled hyperthyroid, surgery, infection
What type of hypersensitivity is Graves disease?Type 2 antibody mediated. Autobodies are produced and attach and directly TSH receptors. This causes the thyroid to make more thyroid hormone. T4 is elevated.
What are the immediate interventions for a thyroid storm?Cooling blankets, oxygen, fluids. Tylenol
Why should you never admin aspirin to a client in a thyroid storm?It can increase thyroid hormone levels
What will be the effect of Ca levels with hyperthyroidism?Hypocalcemia
What will be the effect of Ca levels with hypothyroidism?Hypercalcemia due to the decrease of thyrocalcitonin
What are the clinical manifestations of hyperthyroidism?Everything increases except weight. TSH decreased
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