ENDOCRINE DISORDERS 2

Question 1

Decreased ADH

Answer 1

DI

Question 2

DI: Causes:

Answer 2

Head trauma with increased ICP
Cerebral Injury
Brain tumors or infections

Question 3

ICP signs and symptoms

Answer 3

Cushings triad
Anisocoria
Diplopia
Projective vomiting
Dolls eye sign

Question 4

DI: If caused by cerebral injury, symptoms commonly appear _________ after initial injury and last ____________.

Answer 4

3-5 days; 7-10 days

Question 5

DI: CLINICAL MANIFESTATIONS

Answer 5

Polyuria
Diluted Urine
Polydipsia
Decreased Skin turgor

Question 6

DI: SPECIFIC GRAVITY:

Answer 6

Decreased (<1.010)

Question 7

DI: CONFIRMATORY DIAGNOSTIC TEST:

Answer 7

WATER DEPRIVATION TEST

Question 8

WDT: withhold fluid intake for __________ if no increase in urine concentration or specific gravity

Answer 8

4-18 hours

Question 9

DI: SERUM ELECTROLYTES:

Answer 9

Hypernatremia

Question 10

DI: NURSING INTERVENTIONS

Answer 10

Monitor I&O
Avoid Alcohol
Increase fluids
Daily weight
Manage Skin turgor

Question 11

DI : IV fluids

Answer 11

Hypotonic

Question 12

DI: DOC

Answer 12

Desmopressin acetate

Question 13

Increased ADH

Answer 13

SYNDROME OF INAPPROPRIATE ADH SECRETION

Question 14

SIADH: Causes

Answer 14

Malignant tumors (Pituitary gland)
Head Injury
Use of medications - TCA, Diuretics

Question 15

SIADH: CLINICAL MANIFESTATIONS

Answer 15

Weight gain
Edema
Disorientation and Confusion
Headache
Hyponatremia

Question 16

SIADH : IV fluids

Answer 16

normal saline or
hypertonic

Question 17

HYPERTONIC

Answer 17

to shrink the cells

Question 18

SIADH: DOC

Answer 18

Demeclocyline (Demlomycin)
Diuretics: Furosemide

Question 19

In using Demeclocyline:

Answer 19

o No calcium containing foods
o No milk/antacids – affects absorption

Question 20

In using diuretics:

Answer 20

o WOF: Decreased K+
o Administer slowly to prevent transient hearing loss

Question 21

ADDISONS: Causes

Answer 21

o Autoimmune
o PGT- Pituitary Gland Tumor
o TB, AIDS

Question 22

ADDISONS: S/Sx

Answer 22

Everything is LOW except K+, Ca+ and PR ; Dark skin

Question 23

ADDISON: INITIAL MANIFESTATION:

Answer 23

Fatigue

Question 24

ADDISONS: Recommended Diet:

Answer 24

Low K+, Low Ca+, High Salt, High Carbs

Question 24

ADDISONS: Encourage oral fluid intake of ___________ and increased salt intake

Answer 24

3-4 L/day

Question 24

CARDIAC RYTHMS: Increased K+

Answer 24

Peak T wave, Prolonged PR interval, Wide QRS complex

Question 24

STEROID: VS _________ and weight

Answer 24

four times a day

Question 25

steroids is given________.

Answer 25

after meals

Question 25

STEROID DOSE:

Answer 25

2/3 in AM, 1/3 in PM

Question 26

STEROID: Monitor electrolyte levels

Answer 26

Hypokalemia, Hypocalcemia, Hypernatremia

Question 26

Monitor for___________ stressors

Answer 26

increased

Question 26

STEROIDS: S/E

Answer 26

Immunosuppressant Poor wound healing Easy bruising, thinning of skin Increased protein metabolism

Question 26

STEROID: Monitor urine and blood glucose levels and urine ketones.

Answer 26

R: Prone to HPN, Heart Disease

Question 27

SIDE EFFECTS OF STEROIDS: FBEQ

Answer 27

Mood swings Easy bruising Hirsutism Acne Altered fat metabolism (truncal obesity with thin arms and legs, buffalo hump)

Question 27

STEROID: Dose should be ____________

Answer 27

tapered and not stopped abruptly

Question 28

STEROIDS: Report the ff. to the physician:

Answer 28

Dizziness on sitting and standing, N/V, Malaise

Question 28

ADDISONIAN CRISIS: TRIGGERS/STRESSORS: sisa

Answer 28

o Stress o Infection o Surgery o Abrupt withdrawal of steroid use

Question 29

ADDISONIAN CRISIS: BED REST?

Answer 29

STRICT BED REST

Question 29

ADDISONIAN CRISIS: MANIFESTATIONS

Answer 29

§ Severe HA § Generalized weakness § SV/D § Hypotension § Irritability and Confusion

Question 29

ADDISONIAN CRISIS: DOC

Answer 29

Glucocorticoids per IV then orally (solu-cortef, hydrocortisone sodium succinate)

Question 30

CUSHING’S SYNDROME : CAUSES

Answer 30

o pituitary adenoma or adrenal adenoma o prolonged steroid therapy

Question 31

Cushing: DIET

Answer 31

Low sodium, High K+, High Ca+

Question 32

HYPERPITUITARISM: CAUSES:

Answer 32

Benign pituitary adenoma

Question 33

Benign pituitary adenoma; may result from

Answer 33

Hyperplasia of pituitary tissues

Question 33

HYPOPITUITARISM: CAUSES:

Answer 33

q Tumors q Trauma q Autoimmunity q Stroke, surgery/ radiation of pituitary gland