Endocrine Flashcards
(131 cards)
1
Q
thyroid gland produces what 3 hormones:
A
T3, T4, calcitonin
2
Q
calcitonin decreased serum calcium levels how?
A
by taking calcium out of the blood and pushing it back into the bone
3
Q
you need _____ to make thyroid hormones
A
dietary iodine
4
Q
thyroid hormone gives us _____
A
energy
5
Q
hyperthyroidism AKA
A
graves disease
6
Q
sx of hyperthyroidism
A
nervous irritable decreased attention span increased appetite decreased weight sweaty/hot exopthalamos increased GI motility increased BP and Pulse
7
Q
T4 and TSH level with hyperthyroidism
A
T4 increased
TSH decreased
8
Q
the client must discontinue any iodine containing medications ____ week prior to the thyroid scan and must wait _____ weeks to restart medications
A
1 week
6 weeks
9
Q
treatment for hyperthyroidism
A
anti-thyroid meds iodine BBs radioactive iodine therapy surgery
10
Q
example of anti-thyroid meds
A
PTU and methimazole
11
Q
anit-thyroid meds are used to ?
A
stun the thyroid pre-op
12
Q
decrease the size and the vascularity of the gland
A
iodine compounds
13
Q
why do you give iodine compounds through a straw?
A
stains teeth
14
Q
decreases myocardial contractility
could decrease CO
decreases HR and BP
decreased anxiety
A
Beta Blocker
propranolol
15
Q
do not give beta blockers to _____ or ____
A
diabetics or asthmatics
16
Q
radioactive iodine therapy is given _____ to destroy the thyroid cells
A
PO
17
Q
what is the expected outcome after radioactive iodine therapy
A
they will become hypothyroid
18
Q
post-op priority for thyroidectomy
A
hemorrhage
19
Q
post-op thyroidectomy we should tell our patients to report feelings of ______
A
pressure
20
Q
where to check for bleeding post-op thyroidectomy
A
back of the neck
21
Q
assess for recurrent laryngeal nerve damage by listening for ______ post-op thyroidectomy
A
hoarseness
22
Q
if their parathyroid was removed would you monitor for hypo or hypercalcemia?
A
hypo
23
Q
hypothyroid symptoms?
A
no energy fatigue no expression slowed speech weight gain slowed GI motility cold amenorrhhea
24
Q
T4 and TSH levels with hypothyroid
A
decreased T4
increased TSH
25
treatment for hypothyroid
levothyroxine
26
people with hypothyroidism tend to have ____
CAD
27
the parathyroids secrete ____, which makes you pull calcium from the ___ and place it into the blood
PTH
bones
28
when PTH is secreted...serum calcium goes up or down?
up
29
if you have too much PTH in your body, the serum calcium level will be ___-
high
30
if you do not have any PTH in your body, the serum calcium level will be ___-
low
31
hyperparathyroidism is the same thing as which other 2 diseases?
hypercalcemia
| hypophosphatemia
32
sx of hyperparathyroidism
too much PTH
serum Ca+ increased
serum phosphorus decreased
sedation!!!!!
33
treatment for hyperparathyroidism
partial parathyroidectomy
34
what do monitor for post op parathyroidectomy
sx of hypocalcemia (rigid muscles)
35
hypoparathyroidism is the same as which two other diseases?
hypocalcemia
| hyperphosphatemia
36
sx of hypoparathyroidism
not enough PTH
serum Ca low
Serum Phosphorus high
NOT sedated!!!
37
tx of hypoparathyroidism
IV calcium
| phosphorus binding drugs
38
you need your adrenal glands to handle _____
stress
39
the adrenal medulla secrete _____ and _____
epinephrine and norepinephrine
40
benign tumors that secrete epi and norepi in boluses
tend to be familial
pheochromocytoma
41
sx of adrenal medulla problems
increased BP and HR
heart palpitations
flushing
HA
42
how to diagnose an adrenal medulla problem?
vanillylmandelic acid test
43
foods that alter the vanillylmandelic acid test
```
anything with vanilla in it
caffeine
vitamin B
fruit juices
bananas
```
44
treatment for adrenal medulla problems
surgery to remove tumor
45
avoid palpating the abdomen of a client with a suspected pheochromocytoma as it may cause sudden release of ____ and severe _____
catecholamines and severe HTN
46
the adrenal cortex secretes which 3 steroids?
glucocorticoids
mineralocorticoids
sex hormones
47
4 functions of glucocorticoids
change your mood
alter defense mechanisms
breakdown fats and proteins
inhibit insulin
48
the most common minearlocorticoid secreted by the adrenal cortex
aldosterone
49
aldosterone makes you retain ___ and ____
Na and Water
50
aldosterone makes you lose ____
potassium (K+)
51
too much aldosterone = fluid volume ____
excess
52
too much aldosterone makes serum K+ go down or up?
down
53
not enough aldosterone is fluid volume ____
deficit
54
not enough aldosterone makes serum K+ go down or up?
up!
55
too many sex hormones
hirsutism
acne
irregular menstrual cycle
56
not enough sex hormones
decreased axillary/pubic hair
| decreased libido
57
are made in the pituitary and they stimulate cortisol to be made
Adrenocorticotropin hormones (ACTH)
58
increased ACTH =
increased cortisol level
59
4 adrenal cortex problems
hyperkalemia
hypoglycemia
not enough steroids
shock
60
addison's disease has a ______ insufficiency
adrenocortical
61
since you don't have enough aldosterone with addison's you will lose ___ and retain ____
lose Water and Na+
retain K+
62
serum K+ with addison's
increased
63
sx of addison's
```
extreme fatigue
NVD
anorexia/weight loss
hypotension
confusion
bronze skin
vitiligo
```
64
labs with addison's
decreased Na
increased K+
hypoglycemia
65
treatment for addison's disease
combat shock
increase Na+ in diet
drink juice/broth
I/O daily weight
66
addison's is in a fluid volume ___-
deficit
67
meds for addisons
prednisolone
| fludrocortisone
68
how is prednisolone administered?
take 2/3 in the morning
| 1/3 in the evening
69
fludrocortisone is ______
aldosterone
70
report a weight gain of >___ lbs per week
5
71
addisonian crisis can occur with?
infections
emotional stress
physical exertion
stopping steroids abruptly
72
addisonian crisis has severe _____ and ______ collapse
hypotension
vascular
73
cushion's disease has to many _____
steroids
74
since the client with cushion's has too much aldosterone, the serum K+ will be _____
low
75
if you did a 24 hour urine on the client with cushings the cortisol levels would be ____
increased
76
tx of cushing's
adrenalectomy
| quiet environment
77
diet prior to treatment of cushing's dx
increased K+, protein, and calcium
| decreased NA+
78
steroids decrease serum ____ by excreting it through the GI tract
calcium
79
urine from a life long steroid use patient
glucose
| ketones
80
normal BG
70-110
81
in type 1 DM they have little or no ____
insulin
82
first sx of type 1 DM is usually _____
DKA
83
3Ps with type 1 DM
polyuria
polydipsia
polyphagia
84
why do type 1 DM have kussmaul respirations?
compensation for metabolic acidosis
85
with polyuria think ____ 1st!!!
shock!
86
treatment for type 1 DM
insulin only!!!
87
type 2 DM don't have enough ___, or the ___ they gave is no good
insulin
88
type 2 DM is usually found by accident; or the client keeps coming back to the primary healthcare provider for things like?
wounds that won't heal
| repeated vaginal infections
89
individuals with type 2 DM should be evaluated for _____ syndrome
metabolic
90
features of metabolic syndrome
```
Waist circumference >40
triglycerides >150
HDL <50
BP > 130/85
FBS >100
```
91
treatment for type 2 DM
start with diet and exercise and then add oral agents
some need insulin
92
in gestational diabetes the mom needs ___-___ x more insulin than normal
2-3
93
if mom has r/f gestational diabetes, screen her at which visit?
1st
94
screen all moms for gestational diabetes at __-____ weeks gestation
24-48
95
complication for baby with gestational diabetes
increased birth weight
hypoglycemia
96
oral anti-diabetic agents improve 2 things:
how the body produces insulin
| how the body uses insulin and glucose
97
all oral anti-diabetics work to decrease the amount of circulating _____
glucose
98
most widely used oral anti-diabetic
metformin
99
why is metformin a favorite anti-diabetic drug?
reduces glucose production and enhances how glucose enters the cell
100
patients after procedures can resume their dose ___ hrs after contrast dye is used
48
101
insulin dose is initially based on ____
body weight
102
the average adult dose of insulin is ___-___ units/kg/day
0.4-1
103
clear insulin
regular
104
cloudy insulin
NPH
105
only insulin that can be given IV
regular
106
the goal is to keep the before meal glucose near normal at ____-____
70-130
107
the most common method of daily dosing insulin is ___ ____ dosing
basal bolus
108
clients should eat when insulin is at its _____
peak
109
HbA1C gives an average blood sugar over the past ___-___ months
3-4
110
what happens to your BG when you are sick or stressed?
increased
111
HbA1C > ____% is diagnostic for diabetes
6.5%
112
for people with diabetes, the ideal goal for their HbA1c is <
7%
113
which type of insulin is used in infusion pumps
rapid acting
114
sx of hypoglycemia
```
cold
clammy
confused
HA
hungry
increased HR
```
115
if hypoglycemic, what should client do?
eat/drink simple carb
116
snacks should be ____ g of carbohydrates
15
117
glucose absorption is delayed in foods with lots of ___
fat
118
once the blood sugar is up, what should they do?
eat complex carb/protein
119
you enter a diabetic client's room and they are unconscious...treat this as if they are ____
hypoglycemic
120
if they are unconscious give ____ IVP through a large bore IV
D50W
121
for prevention of hypogemia teach our clients what 4 things?
eat
take insulin regularly
sx of hypoglycemia
check BG regularly
122
best choice for low BG
skim milk
apple juice
handful of raisins
123
in DKA you have very little or no insulin and severe ____ which leads to fat breakdown and ____ acidosis
hyperglycemia
| metabolic
124
treatment of DKA
IV insulin
ECG
IVP
125
insulin decreases ____ and ___ by driving them out of the vascular space into the cell
BG and K+
126
fluid replacement with DKA starts with ___ until the BG reaches 250-300 then switch to ___ to prevent hypoglycemia
NS
| D5W
127
HHNK look like DKA without _____
acidosis
128
with the HHNK patient have kussmaul respirations
NO
129
DKA and HHS are both hyperosmolar states caused by _____ and _____
hyperglycemia and dehydration
130
vascular damage in Diabetes causes
diabetic retinopathy
| nephropathy
131
a condition in diabetics in which the stomach emptying is delayed so there is an increased r/f aspiration
gastroparesis
