Endocrine 3

juniperk's version from 2018-04-02 04:18


Question Answer
Hyperthyroidism. medicationsPotassium iodide, methimazole and propylthiouraci (PTU)
Hyperthyroidism. What medications should you avoid with radioactive iodine?No OTC drugs like cough supp, bronchodilator, salt substitutes (Amiodarone)
If the patient has decreased parathyroid hormone after thyroidectomy, what should we monitor for and prevent?Prevent tetany. Monitor labs for hypocalcemia.
Name some ways to comfort pt after thyroidectomySemifowlers. Neck and head support by pillow. Ice collar for comfort and reduce edema. HOB elevated.
After a thyroidectomy, what should we have readily available?Monitor resp distress. Have oral and sterile suction and trach tray readily available
What type of hypersensitivity is hypothyroidism?Type 4 cell mediated. Could be a type 2.
What is the most common assessment finding with hypothyroidism?Everything decreases except weight. Lethagy, weakness, muscle aches, CHF, dry skin, weight gain.
What is the cause of myxedema coma?Extreme or prolonged myxedema- low thyroid production
What assessment finding would you see with myxedema coma?Hypotension, hypoglycemia, hypothermia, and bradycardia. Lactic acidosis.
What kind of edema is noted with myxedema?Non pitting. Proteins in interstitial spaces.
Prolonged hypothyroidism for a long time can leave deposits in the body which can lead to what?Deposits in body can lead to increased cholesterol and coronary artery disease.
What is primary hyperparathyroidism?Due to hyperplasia or tumor on one of the parathy glands.
The parathyroid tumor will secrete high level of the hormone and cause what?It will increase the absorption of calcium and cause high levels of calcium. (More Ca will be circulating in the system)
What is secondary hyperparathyroidism? What is it due to?Gland enlargement. Most commonly due to chronic hypocalcemia. Gland enlarges to keep up with the demand of low Ca.
Tertiary hyperparathyroidism. What is it? What is it due to?Gland is enlarged and not responding the way it should. Neg feedback doesn't work. Associated with chronic renal failure.
What are some of the nursing precautions for Thyroxine?Tricyclic antidepressants may increase the effect. thyroxine may increase glucose, increase digoxin, anticoagulant and dilantin.
Hyperparathyroidism may make the body go into what metabolic state?Metabolic acidosis. Kidneys increase the excretion of HCO3 and decrease excretion of acid.
Hyperparathyroidism . PathoIncreased resorption of Ca. Increased excretion of phoshate. Bones increase rate of Ca and Phosphorus release (bone decalcification) 4. Hypercalcemia and hypokalemia
Hyperparathyroidism. Clinical manifestationPolyuria (early sign) 2. s/s of hypercalcemia 3. CNS signs Bones Groans Stones and psychic overtones
Hyperparathyroidism Common assessment findingsFatigue 2. wt loss 3. Fractures 4. HTN 5. Joint pain 6. polyuria 7. renal calculi
What 2 tests will be positive with Hypoparathyroidism ?Chvostek and Trousseaus
Hyperparathyroidism. therapeutic mgmt Decrease serum level of Ca - IV NS, diuretics, and phosphate replacement. 2. Surgery to remove 3. Weight bearing exercises 4. Strain urine 5. 2-3L daily 6. high fiber diet.
Hyperparathyroidism. Which medication should you avoid?Thiazide. this will increase the excretion of Ca
What is the key sign of Hypoparathyroidism and why?carpopedal spasms indicate neuromuscular irritability- sign of decreased Ca levels
What is adrenal hyperfunction called?Cushing's syndrome
What is adrenal hypofunction called?Addison's disease
When there is excessive cortisol hormone release, how will that disrupt your body's cicadian rhythm?You'll lose cicadian rhythm release of ACTH. No longer can release ACTH or cortisol to respond to environmental or internal stress.
What is the patho for cushings?Prolonged exposure to glucocorticoids. 2. Results in anti-inflammatory effects 3. Excessive catabolism of protein and peripheral fat
What would the labs be for cushings?Hyperglycemia 2. increased aldosterone 3. Hypokalemia and hypernatremia 4. HTN 5. GI distress 6. Osteoporosis
What diet should the pt be on for cushings?Increase protein, Ca, and Vit D.
Cushing syndrome. Therapeutic mgmtRadiation (pit gland) 2. Drug therapy 3. Surgery
What can cause Addison's disease?rapid removal of exogenous glucocortoids (steroids). 2. trauma 3. infection 4. hemorrhage into gland 5. sudden stress 6. autoimmune mechanisms

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