Endocrine Emergencies Flashcards
(15 cards)
What is a myxedema coma?
An Exasterbation of hypothyroidism
Explain the pathophysiology of a myxedema coma
Decreased metabolism causes heart muscle to become flabby= decreased CO= decreased perfusion to the brain and other organs= tissue and organ failure
Signs and symptoms of myxedema coma
Edema Non-pitting edema appears everywhere esp eyes, hands, feet and shoulder blades Tongue thickens, edema in larynx, husky voice- symptom of untreated and normal hypothyroidism Coma Respiratory failure Hypotension Hyponatreimia Hypoglycaemia- slowed/ no glucogenesis
What is the treatment for myxedema coma?
Patent airway Replace fluids with IV Levothyroxine sodium IV Glucose IV Corticosteroids Check temp and BP hourly Monitor LOC hourly Aspiration precautions Keep warm
What is Cushing syndrome?
Hyper production of cortisol
What are the signs and symptoms of Cushing syndrome?
Personality changes Moon face Hyperglycaemia CNS irritability Thin extremities GI distress- increased acid Thin skin Purple striae Bruises and petechaie Osteoporosis Fat deposits on back Increased susceptibility to infection Amennorhea and histutism Gynecomastia
What are the signs and symptoms of Addison’s disease?
Bronze pigmentation of the skin Changes in body hair distribution GI disturbances Weakness Weight loss Hypoglycaemia Postural hypertension
Explain the pathophysiology of an adrenal crisis due to addisons or Cushings disease
Cortisol absent or low- liver decrease in hepatic glucose output- hypoglycaemia- profound hypoglycaemia- brain coma and death
Cortisol absent or low- stomach decreases in digestive enzymes- vomiting, cramps and diarrhoea- hypovolemia and hypotension- shock- brain coma and death
Adrenal gland destruction of adrenal cortex= rapid decline in hormone levels- aldosterone and cortisol absent or low- kidney sodium and water loss with K+ retention= decreased CO- hypovolemia and hypotension- shock
What are the manifestations of an adrenal crisis?
Muscle weakness Anorexia GI symptoms Dark pigmentation of the skin and mucosa Hypotension Low BP Decreased sodium serum Increased serum K+ Mental changes Apathy Emotional liability Confusion Addisons: circulatory collapse
What are the diagnostic tests for adrenal crisis?
Adrenocortical hormone levels, ACTH levels (adrenocorticotropic hormone), ACTH stimulation test
What is the medical management for an adrenal crisis?
Immediate Reverse shock Restore blood circulation Antibiotics if infection Identify cause Supplement glucocorticoids during stressful procedures and significant illness
What is the nursing management for an adrenal crisis?
Assess fluid balance Monitor obs closely Good skin assessment Limit activity Provide quiet, non-stressful environment
What are the signs and symptoms of hyperglycaemia and justifications?
Extreme thirst due to excess need to excrete glucose
Frequent urination
Dry skin due to increased urination and loss of fluid
Hunger due to body not taking up glucose = decreased energy
Blurred vision
Decreased healing due to increased glucose in plasma= thicker= decreased circulation= decreased perfusion= decreased healing
Drowsiness due to above resulting in decreased circulation to brain
What are the causes of hyperglycaemia?
Too much food
Too little insulin or diabetic medicine
Illness
Stress
What are the signs and symptoms of hypoglycaemia?
Shaking Fast HR Sweating Dizziness Anxiety Hunger Impaired vision Weakness/fatigue Headache Irritability
