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Flashcards in endocrine Deck (52)
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1

thyroid gland

think iodine
produces T3 T4 an calcitonin
gives us energy
calcitonin decreases serum Ca by taking Ca out of the blood and pushing it back into the bone

2

hyperthyroid s/s

TOO MUCH ENERGY
aka Graves'
nervous
irritable
decreased attention span
increased appetite
decreased weight
sweaty/hot
exopthalomos (bulging eyes)
increased GI
increased BP and pulse
arrhythmia/palpitations
increased thyroid size

3

hyperthyroid diagnosis

increased T4
decreased TSH
thyroid scan
discontinue iodine containing meds 1 wk prior to scan and wait 6wks to restart meds
ultrasound/MRI/CT

4

hyperthyroid treatment

Methimazole and Prophlthiouracil (PTU): stops thyroid from making hormones, used preop

potassium iodine: decrease size and vascularity of the gland, ALL endocrine glands are vascular (high risk for bleeding), give in milk/juice and use straw

beta blockers "lol": decreases myocardial contractility, could decrease CO, decrease HR and BP, decrease anxiety

radioactive iodine therapy: 1 dose, PO, *** rule out pregnancy, destroys thyroid cells (hypothyroidism), stay away from babies for 1 wk and don't kiss anyone for 1 week, watch for thyroid storm (thyrotoxicosis and thyrotoxic crisis-- hyperthyroidism x100

5

thyroidectomy

post op priority (hemorrhage): report of feeling pressure and check for bleeding at incision site and behind the neck

hoarseness and weak voice (laryngeal nerve damage): can lead to vocal cord paralysis and require immediate trach

trach at bedsite r/t swelling, recurrent laryngeal nerve damage, hypocalcemia (assess for parathyroid removal and s/s of hypocalcemia)

support neck
personal items close to them
increase HOB
increased cals post op

6

hypothyroid s/s

no energy
fatigue
no expression
slow and slurred speech
increased weight
decreased GI
cold
amenorrhea

7

hypothyroid diagnosis

T4 decreased
TSH increased

8

hypothyroid treatment

levothyroxine: take on empty stomach, worry about MI when starting (BP and HR increase), take forever

9

parathyroid gland

think calcium
secrete PTH
pulls Ca from bones and place in blood so serum Ca goes up
increased PTH=increased serum Ca
decreased PTH=decreased serum Ca

10

hyperparathyroidism s/s

aka hypercalcemia
aka hypophosphatemia
too much PTH
serum Ca is high
serum phosphorus is low
look sedated

11

hyperparathyroidism treatment

partial parathyroidectomy
PTH secretion decreases
monitor for tight rigid muscles and tetany after (hypocalcemia)

12

hypoparathyroidism s/s

aka hypocalcemia
aka hyperphosphatemia
not enough PTH
serum Ca low
serum phosphorus high
won't look sedated

13

hypoparathyroidism treatment

IV calcium
phosphorus binding drugs

14

adrenal glands

need to handle stress
adrenal medulla and adrenal cortex

15

adrenal medulla

epinephrine and norepinephrine
s/s: increase BP and HR, increase palpitations, flushing, sweaty, headache

diagnosis: catecholamine levels (VMA and MN), 24 hr urine specimen, avoid stress

treatment: surgery to remove tumor

*** avoid palpating the abdomen

16

adrenal cortex

glucocorticoids, mineralocorticoids, sex hormones

17

glucocorticoids

changes mood
altered defense mechanisms (immunosuppressed)
breakdown fat and proteins
inhibit insulin (hyperglycemic, blood glucose monitoring)

18

mineralocorticoids

aldosterone
retain sodium and water
lose potassium

19

sex hormones

testosterone, estrogen, and progesterone
too many: hirsutism (facial hair for females), acne, irregular menstrual

not enough: decreased hair, decreased libido

increased ACTH = increased cortisol level

20

adrenal cortex issues

not enough steroids
shock
hyperkalemia
hypoglycemia

addison's disease (not enough steroids)

21

adrenal cortex s/s

fatigue
N/V/diarrhea
anorexia/weight loss
hypotension
confusion
decreased Na
increased potassium
hypoglycemia
hyper pigmentation (bronze color skin)
white patchy area of depigmented skin (vitiligo)

22

adrenal cortex treatment

combat shock (losing sodium and water)
increase Na in diet (processed fruit/broth)
i and o
daily weight
BP decreased
losing weight
FVD

23

adrenal cortex meds

prednisone
hydrocortisone
cortisone

corticosteroids given 2/3 in Am and 1/3 dose in PM

daily weights and BP

****don't stop taking abruptly

24

cushing's s/s

too many steroids

glucocorticoids
growth arrest
think skin
infection
hyperglycemia
psychosis
moon face
truncal obesity
buffalo hump

sex hormones
oily skin
woman have male traits

mineralocorticoids (aldosterone)
high BP
CHF
weight gain
FVE
decreased serum K
high cortisol levels

25

cushings treatment

adrenalectomy
quiet environment
avoid infection
increase K
decrease Na
increase protein
increase Ca

26

type 1 diabetes

little or no insulin
causes: autoimmune response or idiopathic

first sign: DKA
appears abrupt

polyuria, polydipsia, polyphagia

27

normal blood glucose w/o diabetes

70-99

28

normal blood glucose w/ diabetes

80-130
less than 140

29

type 1 patho

no insulin
glucose builds up in the blood
blood becomes hypertonic and pulls fluid into vascular space
kidneys filter excess glucose and fluids
cells are starving so protein breakdown and fat breakdown for energy
get ketones when you break down fat
then they are metabolic acidotic
Kussmaul respirations

30

type 1 s/s

polyuria (think shock first)
polydipsia
polyphagia

hyperglycemia = 3 Ps