Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

From Flashcardlet > (2) Exam 2- Adrenal Cortex > Flashcards

(2) Exam 2- Adrenal Cortex Flashcards

0
Q

What is the precursor for steroid hormone synthesis

A

Cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are the three main classifications of the adrenal cortex steroid hormones

A

Glucocorticoids

Mineralocorticoids

Androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the primary glucocorticoid

A

Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do glucocorticoids do

A

Increase blood glucose levels

Regulate metabolism

Psychologic stress response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the primary mineralocorticoids

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Mineralocorticoids regulate

A

Sodium and potassium balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most abundant and potent glucocorticoid, and is necessary to maintain life and protect the body from stress

A

Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

One major function of Cortisol is the regulation of

A

Blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cortisol levels are increased by

A

Stress, burns, infection, fever, acute anxiety, and hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Androgynous contribute to

A

Growth and development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does the term corticosteroid refer to

A

Anyone of the three types of hormones produced by the adrenal cortex
(glucocorticoids, mineralocorticoids, and androgens)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the clinical condition that results from chronic exposure to access corticosteroids, particularly glucocorticoids

A

Cushing syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sodium and potassium levels in Cushing syndrome

A

⬆️sodium

⬇️potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the causes of Cushing syndrome

A

Exogenous corticosteroids

ACTH – secreting pituitary adenoma

Adrenal tumors

Ectopic ACTH production by tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common cause of Cushing’s syndrome

A

administration of exogenous corticosteroids (prednisone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical manifestations of Cushing Syndrome

What are the first indications of Cushing’s syndrome

A

Truncal obesity or generalized obesity

“Moon face”

Purplish red striae

Hirsutism in woman

Menstrual disorders

Hypertension

Unexplained hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Clinical manifestations of Cushing Syndrome

Where do you usually find purplish red striae on patients with Cushing syndrome

A

Usually depressed below the skin surface on the abdomen, breast, or buttocks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Clinical manifestations of Cushing Syndrome

What is the general appearance of A patient with excess glucocorticoids

A

Truncal obesity, thin extremities, rounding of the face (moon face), fat deposits on back of neck and shoulders (buffalo hump)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Clinical manifestations of Cushing Syndrome

Integumentary changes with excess glucocorticoids

A

Thin and fragile skin

purplish red striae

Acne

petechial hemorrhages

bruises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical manifestations of Cushing Syndrome

Cardiovascular changes with excess Glucocorticoid

A

Hypervolemia

Hypertension

Edema of the lower extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Clinical manifestations of Cushing Syndrome

Musculoskeletal changes with excess Glucocorticoid

A

Muscle wasting in extremities (weakness)

Loss of bone (osteoporosis, back pain)

Fractures

Awkward gate

Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Clinical manifestations of Cushing Syndrome

Immune changes with excess Glucocorticoid

A

Inhibition of immune response

Suppression of allergic response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Clinical manifestations of Cushing Syndrome

Metabolic changes with excess Glucocorticoid

A

Hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical manifestations of Cushing Syndrome

Emotional changes with excess Glucocorticoid

A

Irritability

anxiety

euphoria

psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Clinical manifestations of Cushing Syndrome

Mineralocorticoid excess may cause what cardiovascular and fluid and electrolyte changes

A

Fluid retention which leads to hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Clinical manifestations of Cushing Syndrome

Integumentary changes with excess androgens

A

Hirsutism

Severe acne

Hyperpigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Clinical manifestations of Cushing Syndrome

Reproductive changes with excess androgens

A

Menstrual irregularities

Virilization in woman

Feminization in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diagnosis for Cushing syndrome

What diagnostic studies are done to diagnose Cushing syndrome

A

Serum cortisol

24 hour urine collection for free cortisol

Low-dose dexamethasone suppression test

ACTH levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diagnosis for Cushing syndrome

Serum cortisol level is measured in daily variations. What results indicates Cushing syndrome?

A

Elevated levels of serum cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Diagnosis for Cushing syndrome

What are the normal serum cortisol levels at 8 AM and 4 PM?

A

8 AM (5 - 23 mcg/dL)

4 PM (3 - 16 mcg/dL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Diagnosis for Cushing syndrome

With a 24 hour urine collection for free cortisol, what urine cortisol levels indicate Cushing syndrome

A

Elevated levels of urine cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Diagnosis for Cushing syndrome

In a 24 hour urine collection for free court is all what is The normal range for urine cortisol?

A

80 - 120 mcg/24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Diagnosis for Cushing syndrome

With a low-dose dexamethasone suppression test, what can cause false positive results?

A

Depression

Medications- phenytoin (Dilantin), rifampicin (Rifadin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Diagnosis for Cushing syndrome

To suppress ACTH in a dexamethasone suppression test, low or high dose dexamethasone is given at what time?

A

11 PM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Diagnosis for Cushing syndrome

At 8 AM, what is the normal response of cortisol to a dexamethasone suppression test?

A

Cortisol should be down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Diagnosis for Cushing syndrome

High or normal ACTH levels indicate

A

Cushing disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Diagnosis for Cushing syndrome

Low or undetectable ACTH levels indicate

A

Adrenal or medication etiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Collaborative care for Cushing syndrome

What is the primary goal of treatment?

A

To normalize hormone secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Collaborative care for Cushing syndrome

What are the types of surgical management?

A

Hypophysectomy

Adrenalectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Collaborative care for Cushing syndrome

Hypophysectomy is indicated when Cushing syndrome is caused by

A

Pituitary adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Collaborative care for Cushing syndrome

An adrenalectomy is indicated when Cushing syndrome is caused by

A

Adrenal tumors or hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Collaborative care for Cushing syndrome

When the patient is a poor candidate for surgery or prior surgery has failed, then direct therapy may be attempted. The goal of drug therapy is to suppress the synthesis and secretion of cortisol from the

A

Adrenal gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Collaborative care for Cushing syndrome

Why are the medications used to suppress the synthesis and secretion of cortisol from the adrenal gland, used cautiously?

A

The dosages needed to reduce cortisol secretion are often toxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Collaborative care for Cushing syndrome

What medications may be needed to avoid adrenal insufficiency

A

Prednisones or hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Collaborative care for Cushing syndrome

Gradual tapering of corticosteroids is necessary to avoid

A

Potentially life-threatening adrenal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Collaborative care for Cushing syndrome

What is used for endogenous cortisol replacement

A

Prednisone or Hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Collaborative care for Cushing syndrome

When prednisone is used for endogenous cortisol replacement, what dosage is given and at what time

A

2/3 dose in AM

1/3 dose in PM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Collaborative care for Cushing syndrome

When prednisone is used for endogenous cortisol replacement, what should the patient be taught about stopping the medication

A

Do not stop abruptly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Collaborative care for Cushing syndrome

When prednisone is used for endogenous cortisol replacement, what should the patient be instructed to keep with them

A

Hydrocortisone emergency kit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Collaborative care for Cushing syndrome

When prednisone is used for endogenous cortisol replacement, what should be checked

A

Blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Nursing Diagnosis for Cushing Syndrome

What are priority nursing diagnoses for the patient with Cushing syndrome?

A

Risk for infection

Imbalanced nutrition

Disturbed body image

Impaired skin integrity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Acute interventions for Cushing Syndrome

Because the therapy has many side effects, assessment focuses on signs and symptoms of

A

hormone and drug toxicity and complicating conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Acute interventions for Cushing Syndrome

Assess and monitor

A 
Vital signs
Daily weight
Glucose
Signs of inflammation/ infection
Pain
Sudden cardiac symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Acute interventions for Cushing Syndrome

To give emotional support, reassure the patient that the physical changes and much of the emotional lability will resolve when

A

hormone levels return to normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Preoperative care for Cushing Syndrome

What must be controlled before surgery

A

Hypertension

Hyperglycemia

Hypokalemia

Protein depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Preoperative care for Cushing Syndrome

To prevent sudden drop during surgery, what additionally is the patient given before surgery

A

Glucocorticoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Preoperative care for Cushing Syndrome

What type of diet is recommended before surgery?

A

⬆️calorie

⬆️protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Preoperative care for Cushing Syndrome

How is hypokalemia corrected

A

With diet and potassium supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Postoperative care for Cushing Syndrome

After surgery, why is the patient at an increased risk for hemorrhage

A

Because the adrenal glands are vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Postoperative care for Cushing Syndrome

Postoperatively, BP, fluid balance, and electrolyte levels may be unstable due to

A

Hormone fluctuations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Postoperative care for Cushing Syndrome

What is administered IV during surgery and for several days afterward to ensure adequate responses to the stress of the procedure

A

High doses of corticosteroids

61
Q

Postoperative care for Cushing Syndrome

After corticosteroids are withdrawn, why is the IV line kept open?

A

For quick administration of corticosteroids or vasopressors

62
Q

Postoperative care for Cushing Syndrome

What do you want to prevent in the patient with Cushing syndrome

A

Skin injury

Pathologic fractures

G.I. bleeding

Infections

63
Q

Postoperative care for Cushing Syndrome

When you look under the patient for bleeding, what are you assessing for?

A

Hemorrhage

64
Q

Postoperative care for Cushing Syndrome

Because excess cortisol destroys the lining of the stomach, what do you want to monitor for?

A

GI bleed

65
Q

Postoperative care for Cushing Syndrome

What may develop if corticosteroid dosage is tapered to rapidly after surgery

A

Acute adrenal insufficiency

66
Q

Postoperative care for Cushing Syndrome

What are the signs and symptoms indicate hypocortisolism

A

Vomiting, weakness, dehydration, hypotension

Painful joints, pruritus, peeling skin, emotional disturbances

67
Q

Postoperative care for Cushing Syndrome

How long after surgery is the patient usually kept on bed rest

A

Until the BP stabilizes

68
Q

Postoperative care for Cushing Syndrome

Be alert for subtle signs of postoperative infection because

A

Usual inflammatory responses are suppressed

69
Q

Discharge Teachings for Cushing Syndrome

When prednisone is used for endogenous cortisol replacement, what should the patient be instructed to wear and have with them at all times?

A

A medic alert bracelet

Medical identification and instructions in a wallet or purse

70
Q

Discharge Teachings for Cushing Syndrome

Because stress may produce or precipitate acute adrenal insufficiency, teach the patient to avoid

A

exposure to extreme temperatures

infections

emotional disturbances

71
Q

Discharge Teachings for Cushing Syndrome

Teach the patient to adjust their corticosteroid replacement therapy in accordance with

A

Their stress levels

72
Q

Discharge Teachings for Cushing Syndrome

How long should the patient be prepared for it to take to adjust to the hormone?

A

Several months

73
Q

Discharge Teachings for Cushing Syndrome

Recommended diet upon discharge

A

⬆️Protein, calcium, potassium, vit D

⬇️sodium, calories, carbs

74
Q

Discharge Teachings for Cushing Syndrome

When should the patient be taught to contact the healthcare provider

A

Unable to adjust his/her own medications

Fainting

Fever

Nausea and vomiting

Weakness

75
Q

Evaluation for Cushing Syndrome

What are the expected outcomes for the patient with Cushing’s syndrome

A

Experience no s/s of infection

Attain weight appropriate for height

Verbalize acceptance of appearance and treatment regimen

Demonstrate healing of skin and maintenance of intact skin

76
Q

Etiology and Pathophysiology of Adrenocortical Insufficiency

What is the primary cause of adrenocortical insufficiency?

A

Addison’s disease

77
Q

Etiology and Pathophysiology of Adrenocortical Insufficiency

What causes adrenocortical insufficiency?

A

Disease of adrenal cortex

Insufficient secretion of ACTH from pituitary

Autoimmune response

Sudden reduction of exogenous steroids

78
Q

Etiology and Pathophysiology of Adrenocortical Insufficiency

What is a secondary causes of adrenocortical insufficiency?

A

Lack of pituitary ACTH secretion

79
Q

Etiology and Pathophysiology of Adrenocortical Insufficiency

In Addison’s disease what classes of adrenal corticosteroids are reduced

A

All three (glucocorticoids, mineralocorticoids, androgens)

80
Q

Etiology and Pathophysiology of Adrenocortical Insufficiency

In secondary Adrenocortical insufficiency, which corticosteroid is really deficient

A

Mineralocorticoids (aldosterone)

81
Q

Etiology and Pathophysiology of Adrenocortical Insufficiency

What is the most common cause of Addison’s disease in the United States

A

And autoimmune response.

Adrenal tissue is destroyed by antibodies against the patient own adrenal cortex

82
Q

Etiology and Pathophysiology of Adrenocortical Insufficiency

What causes Addison’s disease worldwide, but is now an uncommon cause in the United States

A

Tuberculosis

83
Q

Clinical Manifestations of Adrenocortical Insufficiency

What percentage of the adrenal cortex is destroyed before manifestations become evident

A

90%

84
Q

Clinical Manifestations of Adrenocortical Insufficiency

Manifestations have a slow onset and include what progressive primary features?

A

Weight loss

Anorexia

Weakness

Fatigue

85
Q

Clinical Manifestations of Adrenocortical Insufficiency

Increased ACTH causes what feature?

A

Bronze colored skin hyperpigmentation

86
Q

Clinical Manifestations of Adrenocortical Insufficiency

What manifestations of adrenal insufficiency may occur in primary adrenal hypofunction?

A 
Bronze colored skin
Orthostatic hypotension
Hyponatremia
Salt cravings
Hyperkalemia
Nausea and vomiting
Diarrhea
87
Q

Clinical Manifestations of Adrenocortical Insufficiency

What behavioral/emotional manifestations occur in primary adrenal hypofunction?

A

Confusion
Delusions
Irritability
Depression

88
Q

Clinical Manifestations of Adrenocortical Insufficiency

Primary and secondary Adrenocortical hypofunction share many similar s/s, but because ACTH levels are low, which manifestation is not present with secondary Adrenocortical hypofunction as it is in primary?

A

Secondary does not have hyperpigmented skin

89
Q

Complications of Adrenocortical Insufficiency

What life-threatening medical emergency are patients with adrenocortical insufficiency at risk for?

A

Acute adrenal insufficiency (addisonian crisis)

90
Q

Complications of Adrenocortical Insufficiency

What causes and addisonian crisis?

A

Insufficient or sharp decrease in cortisol

91
Q

Complications of Adrenocortical Insufficiency

What triggers and addisonian crisis?

A

Stress

Sudden withdrawal of corticosteroid hormone therapy

Adrenal surgery

Sudden pituitary gland distraction

92
Q

Complications of Adrenocortical Insufficiency

What severe manifestations will the patient exhibited during acute adrenal insufficiency?

A

Severe shock (Hypotension, tachycardia)

Hyponatremia, Hypoglycemia, Hyperkalemia

Fever, abdominal pain, N&V, Weakness

Confusion

Dehydration

93
Q

Complications of Adrenocortical Insufficiency

As a manifestation of acute adrenal insufficiency, what can hypotension lead to?

A

Shock

94
Q

Diagnostic studies of Adrenocortical Insufficiency

Adrenal insufficiency is characterized by which depressed levels

A

Serum and urinary cortisol levels

95
Q

Diagnostic studies of Adrenocortical Insufficiency

ACTH levels are increased in primary adrenal insufficiency indicating that the kidneys

A

Can’t respond

96
Q

Diagnostic studies of Adrenocortical Insufficiency

ACTH levels are decreased in secondary adrenal insufficiency indicating that the kidneys

A

Are responding

97
Q

Diagnostic studies of Adrenocortical Insufficiency

What diagnosis is confirmed when cortisol levels fail to rise?

A

Primary adrenal insufficiency

98
Q

Collaborative care of Adrenocortical Insufficiency

What is the treatment of adrenocortical insufficiency focused on?

A

Management of the underlying cause when possible

99
Q

Collaborative care of Adrenocortical Insufficiency

What is the mainstay of treatment for adrenocortical insufficiency?

A

Hormone therapy

100
Q

Collaborative care of Adrenocortical Insufficiency

What is the most commonly used form of hormone therapy and has both glucocorticoid and mineralocorticoid properties?

A

Hydrocortisone

101
Q

Collaborative care of Adrenocortical Insufficiency

During stressful situations what is increased to prevent addisonian crisis?

A

Glucocorticoid dosage

102
Q

Collaborative care of Adrenocortical Insufficiency

What is treatment for addisonian crisis directed toward?

A

Shock management and High dose hydrocortisone replacement

103
Q

Collaborative care of Adrenocortical Insufficiency

What is administered to reverse hypertension and electrolyte imbalances?

A

Large volumes of D5NS (0.9% saline solution and 5% dextrose)

104
Q

Collaborative care of Adrenocortical Insufficiency

What steps are taken to manage addisonian crisis?

A

Correct volume depletion – large volumes D5NS

High dose glucocorticoid replacement

Correct metabolic abnormalities

Treat underlying cause

105
Q

Acute interventions for Adrenocortical Insufficiency

What drugs could potentially interact with corticosteroids?

A

Oral hypoglycemics

Cardiac glycosides

Oral contraceptives

Anticoagulants

NSAIDS

106
Q

Acute interventions for Adrenocortical Insufficiency

What to assess for adrenocortical insufficiency

A

VS, weight, glucose, signs of inflammation/infection, pain, sudden cardiac symptoms (DVT or PE), medication history

107
Q

Acute interventions for Adrenocortical Insufficiency

What do you want to monitor for in patient with Adrenocortical insufficiency?

A

Dehydration, electrolytes, mental status

108
Q

Acute interventions for Adrenocortical Insufficiency

What type of environment is needed to protect the patient?

A

Free from noise, light, and environmental temperature extremes

109
Q

Discharge teachings for Adrenocortical Insufficiency

When teaching about hormone therapy, explain how long will it be needed

A

Hormone therapy is lifelong

110
Q

Discharge teachings for Adrenocortical Insufficiency

Explain that glucocorticoids are usually given in divided doses. What is the dose given and when is it administered?

A

2/3 in the AM

1/3 in the PM

111
Q

Discharge teachings for Adrenocortical Insufficiency

How often are Mineralocorticoids given and what is the preferred time of day?

A

Once daily, preferably in the morning

112
Q

Discharge teachings for Adrenocortical Insufficiency

What does the corticosteroid schedule reflect in order to decrease the side effects associated with corticosteroid therapy?

A

It reflects normal circadian rhythm

113
Q

Discharge teachings for Adrenocortical Insufficiency

Teach the patient with Addison’s disease that they are unable to tolerate physical or emotional stress without additional

A

Exogenous corticosteroids

114
Q

Discharge teachings for Adrenocortical Insufficiency

Give examples of situations requiring corticosteroid adjustment

A

Fever, influenza, extraction of teeth, and rigorous physical activity

115
Q

Discharge teachings for Adrenocortical Insufficiency

What should the patient be taught to do if vomiting or diarrhea occurs?

A

Notify the healthcare provider immediately

116
Q

Discharge teachings for Adrenocortical Insufficiency

Why must the patient report signs and symptoms of corticosteroid deficiency and excess to their healthcare provider?

A

So the dose can be adjusted

117
Q

Discharge teachings for Adrenocortical Insufficiency

So that appropriate therapy can be initiated in case of an emergency what must the patient be taught?

A

Where an identification bracelet (medic alert) and carry a card in wallet stating that patient has Addison’s disease

118
Q

Discharge teachings for Adrenocortical Insufficiency

How do you teach the patient about medications that can cause I need to increase or decrease glucocorticoid dosage?

A

Provide verbal instructions and handouts

119
Q

Discharge teachings for Adrenocortical Insufficiency

What instructions should be given to patients using mineralocorticoid therapy?

A

How to take their blood pressure

Increase salt intake

Report any significant changes to HCP

120
Q

Discharge teachings for Adrenocortical Insufficiency

What should the patient be instructed to carry with them at all times?

A

An emergency kit

121
Q

Discharge teachings for Adrenocortical Insufficiency

What should be included in the emergency kit that patients with Addison’s disease carry with them?

A

100 mg of IM hydrocortisone

Syringes

Instructions for use

122
Q

Discharge teachings for Adrenocortical Insufficiency

In case hormone therapy cannot be taken orally, what instruction should the patient and significant others be taught?

A

How to give and IM injection

123
Q

Corticosteroid Therapy

Why should corticosteroid therapy be reserved for diseases that have a high risk of death or permanent loss of function?

A

Long term administration of corticosteroids in therapeutic doses often lead to serious complications and side effects

124
Q

Corticosteroid Therapy

What complications can occur with corticosteroid therapy?

A

Increased risk of infection

Decreased immune response

125
Q

Corticosteroid Therapy

What should the patient be taught about corticosteroid use?

A

Instruct patient not to abruptly discontinue these drugs

Monitor for signs of infection

Instruct patient with diabetes to closely monitor blood glucose

126
Q

Corticosteroid Therapy

To decrease gastric irritation, what instructions should be given to the patient about administration of corticosteroids?

A

Take once daily or once every other day, early in the morning, and with food

127
Q

Corticosteroid Therapy

How long are corticosteroids taken before it will suppress adrenal production and had the need to be tapered?

A

One week

128
Q

Corticosteroid Therapy

What is an important concern for patients who receive corticosteroid treatment for prolonged periods (longer than 3 months)

A

Corticosteroid induced Osteoporosis andincreased risk of fractures

129
Q

Corticosteroid Therapy

Because of excess blood volume and potentiation of vasoconstrictor affects what happens to the patient’s blood pressure?

A

Blood pressure is increased

130
Q

Hyperaldosteronism

What is another name for hyperaldosteronism?

A

Conn’s syndrome

131
Q

Hyperaldosteronism

What are the hallmark symptoms of hyperaldosteronism?

A

Hypertension

Hypokalemic alkalosis (loss of K+ & H+ ions)

Sodium retention

132
Q

Hyperaldosteronism

What is primary hyperaldosteronism commonly caused by?

A

Adrenocortical adenoma (solitary or bilateral)

133
Q

Hyperaldosteronism

What is secondary hyperaldosteronism commonly caused by?

A

In response to a non-adrenal cause

134
Q

Hyperaldosteronism

What is the preferred treatment for primary hyperaldosteronism?

A

Surgical removal of adenoma (adrenalectomy)

135
Q

Hyperaldosteronism

To normalize serum potassium levels and BP, what medications should the patient be treated with before surgery?

A

Antihypertensives

Potassium sparing diuretics (Spironolactone and Eplederone)

136
Q

Hyperaldosteronism

What medication increases the excretion of sodium and water and the retention of potassium?

A

Potassium sparing diuretics (Spironolactone and Eplederone)

137
Q

Hyperaldosteronism

What may be given but should not be started simultaneously with potassium sparing diuretics?

A

Oral potassium supplements

138
Q

Hyperaldosteronism

What restrictions may be necessary for primary hyperaldosteronism?

A

Sodium restrictions

139
Q

Hyperaldosteronism

What should the patient be taught to avoid when taking Eplerenone?

A

Avoid grapefruit juice

140
Q

Hyperaldosteronism

Instruct the patient about the possible side effects of receiving maintenance therapy with Spironolactone or Amiloride.

A

Gynecomastia

Impotence

Menstrual disorders

S/S of hypo and hyperkalemia

141
Q

Hyperaldosteronism

Due to the symptoms of hypertension, what should the patient be taught?

A

How to monitor their own BP and the need for frequent monitoring

142
Q

Disorders of the Adrenal Medulla

Secondary to excessive production of epinephrine from tumor, what is the most striking clinical feature of Pheochromocytoma?

A

Severe episodic hypertension

143
Q

Disorders of the Adrenal Medulla

What classic manifestations accompany severe episodic hypertension?

A

Severe pounding headache

Tachycardia with palpitations

Profuse sweating

Chest pain

144
Q

Disorders of the Adrenal Medulla

What measurements are the most reliable diagnostic test for Pheochromocytoma?

A

Urinary catecholamines

Creatinine

145
Q

Disorders of the Adrenal Medulla

What physical assessment should be avoided in patients with suspected Pheochromocytoma?

A

Palpating the abdomen

146
Q

Disorders of the Adrenal Medulla

Why would palpating the abdomen be avoided in patients with suspected Pheochromocytoma?

A

It may cause the sudden release of catecholamines and severe hypertension

147
Q

Management of Pheochromocytoma

What is the primary treatment of Pheochromocytoma?

A

Laparoscopic removal of the tumor

148
Q

Management of Pheochromocytoma

What side affect warning needs to be taught about in the patient taking Metyrosine

A

Orthostatic hypotension – instruct patient to rest lately and hold onto a secure object

149
Q

Management of Pheochromocytoma

To control blood pressure and prevent an intraoperative hypertensive crisis, what medications are required preoperatively?

A

a & B-Adrenergic receptor blockers

150
Q

Management of Pheochromocytoma

What needs to be monitored postoperatively

A

Blood glucose levels

From Flashcardlet (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions