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Hesi PN > endocrine > Flashcards

endocrine Flashcards

(104 cards)

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1
Q

what hormones are produced by the thyroid

A

T3, T4 and calcitonin

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2
Q

what does calcitonin do

A

decreases serum calcium levels by taking calcium out of blood and pushing it into the bone

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3
Q

what do you need to make thyroid hormones

A

iodine

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4
Q

what do thyroid hormones give

A

energy

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5
Q

what disease is hyperthyroid

A

graves disease

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6
Q

signs and symptoms of graves disease

A

nervous
irritable
low attention span
increased appetite
decreased weight
sweaty
exophthalmos (bulging eyes)
Fast GI
BP and pulse increase

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7
Q

what are T4 levels in graves disease

A

increase

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8
Q

what are TSH levels in graves disease

A

decreased

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9
Q

what must pt do prior to thyroid scan

A

discontinue iodine containing meds 1 week prior and wait 6 weeks to restart

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10
Q

why does amiodarone affect thyroid function

A

it contains large amounts of iodine

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11
Q

types of antithyroid meds

A

methimazole
propylthiouracil

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12
Q

what do anti-thyroids do

A

stop the thyroid from making thyroid hormones
used pre-op to stun thyroid

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13
Q

name an iodine compund

A

potassium iodine

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14
Q

what does potassium iodine do

A

decrease the size and vascularity of the gland

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15
Q

what do you give potassium iodine with? why?

A

milk or juice and use a straw. it stains teeth

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16
Q

what do beta blockers do

A

decrease myocardial contractility
could decrease cardiac output
decreases hr pb
decreases anxiety

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17
Q

how do you provide radioactive iodine therapy

A

1 PO dose

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18
Q

what does radioactive iodine therapy do

A

destroys thyroid cells

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19
Q

precautions for radioactive iodine

A

avoid babies for 1 week
dont kiss anyone for 1 week

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20
Q

thyroidectomy post op priority

A

hemorrhage ( feeling of pressure in neck, bleeding or swelling)
check for bleeding at incision site or pooling back of neck.

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21
Q

how do you assess for recurrent laryngeal nerve damage

A

listening for hoarseness and weak voice

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22
Q

what can laryngeal nerve damage lead to

A

vocal cord paralysis

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23
Q

what happens if there is paralysis of both cords

A

airway obstruction, trach needed

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24
Q

signs parathyroid was removed

A

PTH decreased
hypocalcemia

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25
signs of hypothyroid
no energy fatigue no expression slow slurred speech weight gain slow gi cold amenorrhea (similar to depression)
26
diagnosis of hypothyroid
low t4 increased TSH
27
treatment of hypothyroid
levothyroxine, liothyronine
28
what does parathyroid do
secrete TSH
29
what does PTH do
pull calcium from bone and place in blood, causes serum calcium to go up
30
what happens if you do not have any parathyroid ormone in your body
serum calcium goes down
31
signs of hyperparathyroidism
too much OTH serum calcium is high, phosphorus is low sedated
32
treatment of hyperparathyroid
partial parathyroidectomy monitor for bottoming out, tight rigid muscles
33
signs of hypoparathyroidism
not enough PTH serum calcium is low phosphorus is high not sedated
34
treatment of hypoparathyroid
IV calcium phosphorus binding drugs
35
steroids created by adrenal cortex
glucocorticoids mineral corticoids sex hormones
36
what do glucocorticoids do
change mood (depressed, psychotic, euphoric insomnia alter defense mechanism (immunosuppressed break down fats and proteins inhibit insulin
37
what do mineral corticoids (aldosterone) do
make you retain sodium and water make you lose potassium
38
too many sex hormones
hirsutism (excess hair) acne irregular menstrual cycle
39
not enough sex hormones
decreased axillary/ pubic hair decreased libido
40
adrenal cortex problems
not enough steroids shock hyperkalemia hypoglycemia
41
what is Addisons disease
adrenocortical insufficiency (not enough steroids)
42
signs and symptoms of Addisons disease
extreme fatigue nausea, vomiting, diarrhea anorexia hypotension confusion decreased sodium, increased potassium and hypoglycemia hyperpigmentation white patchy area of depigmented skin
43
treatment of addisons
increase sodium in their diet processed fruit juice have sodium I&O daily weight BP probably low probably lose weight fluid volume deficent
44
how are corticosteroids given
2/3 in the morning, 1/3 at night because that is how the body naturally secretes
45
what is fludrocortisone
synthetic aldosterone
46
examples of corticosteroids
predinisone hydrocortisone (must be tapped off)
47
how much weight fluctuation with medication is ok
2-3 pounds a day <5 a week
48
What is cushings
too many steroids
49
signs and symptoms of too many glucocorticoids
growth arrest thin extremities/skin increased risk of infection hyperglycemia psychosis to depression moon faced truncal obesity buffalo hump
50
signs and symptoms of too many sex hormones
oily skin/acne women with male traits
51
signs and symptoms of too many mineral corticoids (aldosterone)
high BP CHF weight gain FVE
52
what happens to potassium with too much mineral corticoid
decreases
53
what happens to cortisol levels with too much mineral corticoids
high
54
treatment of cushings
adrenalectomy quiet environment (can't handle stress)
55
Cushing diet pretreatment
^K low NA ^protein ^CA
56
what is type 1 diabetes
little to no insulin diagnosed in childhood autoimmune response or idiopathic first sign usually DKA appears abruptly, despite years of beta cell destruction 3p's
57
what happens to blood with uncontrolled diabetes
blood becomes hypertonic and pulls fluid into vascular space, kidneys filter excess glucose and fluids, cells breakdown protein and fat for energy because they are starving creating ketones and metebolic acidosis
58
signs of diabetes
polyuria polydipsia polyphasic
59
diabetes type two pathophysiology
not enough insulin or insulin is no good usually over weight can't make enough insulin to keep up with glucose not as abrupt found by accident, wounds that dont heal, repeated vaginal infection
60
what should those with type 2 diabetes be evaluated for
metabolic syndrome
61
what does metabolic syndrome do
increase the risk for developing type 2 diabetes and cardiovascular disease
62
features of metabolic syndrome
Waist >40 in men, >35 women triglycerides >150 HDL <40 males <50 females blood pressure >135/85 FBS >100 myst have 3 or more
63
treatment for diabetes type 2
diet, exercise, oral agents some may need insulin
64
what is gestational diabetes
resembles type 2 diabetes mom needs 2-3 types insulin than normal screen at 1st visit if diabetes screen all at 24-28 weeks baby may have increased birth weight and hypoglycemia
65
diet for diabetes
45% carbs 30-40%fat 15-20 % protein
66
why worry about carbohydrates
sugar destroys vessels like fat
67
what does high fiber do
slows down glucose absorption in the intestines eliminating the Sharp rise and fall in blood sugar
68
what does metformin do
reduces glucose production and enhances how glucose enters the cell
69
what should patients on metformin do before surgery
discontinue metformin until 48 hours after if kidney function returns and creatinine level is normal
70
what color is regular (short) insulin
clear
71
what color is NPH
cloudy
72
when administering regular and NPH which one do you draw up first
Clear
73
what color are long acting insulin, what can you mix it with
they are clear and you can't mix them with anything
74
what do you want the before meal glucose to be
80-130
75
what is the most common method of daily dosing insulin
basal bulus
76
what is the dotal daily dose of insulin with the basal/bolus method
combination of long acting and a rapid acting
77
when should clients eat
when insulin is at its peak
78
when insulin is at its peak BS is at its
lowest
79
when should someone with diabetes exercise
when blood sugar normalizes
80
what should they do pre-exercise to prevent hypoglycemia
eat
81
when should they exercise
when blood sugar is at its highest
82
what does a glycosylated hemoglobin (HBA1C) test
gibes an average of what your blood sugar has been over past 3-4 months
83
what happens to blood sugar when you are sick or stressed
increases
84
HBA1c for diagnostic puposes
>6.5
85
HBA1C for people with diabetes
<= 7
86
normal non diabetes HBA1C
<=5.7
87
what insulin can be given IV or in an infusion pump
Rapid acting
88
signs and symptoms of hypoglycemia
cold and clammy confusion shaky headache nervous nausea hunger increased pulse
89
what do you do if hypoglycemic
eat 15 grams of carbs
90
what is the 15-15-15 rule
15g carbs wait 15 minutes if still low eat 15 more
91
what delays glucose absorption
fatty foods
92
what should you do once blood sugar is back up
eat a complex carb or protein
93
what fluid do you use for a hypoglycemic emergency
D50W large bore IV
94
hypoglycemia client education
eat take insulin regularly know signs of hypoglycemia check BS regularly
95
What can throw a client into DKA
illness infection skipping insulin
96
patho for DKA
inadequate insulin extremely high BS 3P fat breakdown kussmaul respirations metabolic acidosis low LOC
97
treatment of DKA
find cause
98
hyperosmolar hyperglycemic non ketosis (HHNK) or hyperglycemic hyperosmolar state (HHS) happens in what type of patients
type 2 diabetes
99
how does HHNK or HHS differ from DKA
no acidosis just enough insulin they dont break down fat no ketones no kussmaul repirations
100
what happens to vessels in diabetic patients
poor circulation due to damage caused by sugar accumulation decreasing blood flow leads to diabetic retinopathy nephropathy
101
neuropathy symptoms
impotance/decreased sensation foot leg problems pain/parathesia/numbness neurogenic bladder gastroparesis
102
what is included in diabetic foot care
cut nails straight across not to short dry between toes well fitting shoes daily inspections no harsh chemicals
103
what is a neurogenic bladder
the bladder does not empty properly the bladder may empty spontaneously may not empty at all
104
what is gastroparesis
stomach emptying is delayed so there is an increased risk for aspiration

Hesi PN (24 decks)

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