Endocrine Lecture 1 Flashcards
(105 cards)
0
Q
_________ - Given PO. Oral medication. This blocks the synthesis of thyroid hormones. This medication is more toxic than PTU. This is used to treat what thyroid disorder?
A
Methimazole / Tapazole
Hyperthyroidism
1
Q
In all patients that have adrenal insufficiency or are steroid dependent they are at a high risk for _______.
A
Addisoninan Crisis
Adrenal insufficiency
Hypofunction of adrenal gland
2
Q
The thyroid gland is the only tissue in the body that takes _______ from food and converts it into thyroid hormone.
A
iodine
3
Q
The goal of treatment for the patient will be aimed at restoration of normal and acceptable body appearance.
The patient will not have long-term complications of exogenous cortisol administration.
The patient will have fluid volume balance.
The patient will remain free of injury.
The patient will remain free of infection.
These are the nursing interventions related to the diagnosis of what adrenal gland disorder?
These are the goals of treatment for a patient with what adrenal gland disorder?
A
Cushing’s Disease
Hyper function of adrenal gland
5
Q
__________ is caused by autoimmune disease and the antibody thyroid stimulating immunoglobulin (TSI).
A
Hyperthyroidism
Graves’ disease
6
Q
Secretes T3 which accelerates body processes
Secretes T4 which maintains body metabolism
Together theses have an increased cache choosing effect.
These are the functions of what endocrine gland?
A
Thyroid gland
7
Q
During Post-Op Care the nurse must monitor for hemorrhage, fluid and electrolyte imbalance, and tetany when the patient has this parathyroid disorder?
A
Hyperparathyroidism
Cushing’s Disease
These symptoms are rare.
8
Q
And in adequate amount of thyroid hormone in the field. Can lead to _______ which is due to depression of metabolic activity. Baby will have dwarfism and mental retardation due to improper development of brain and musculoskeletal system.
A
Cretinism
9
Q
Exposure to too much Cortisol.
Exogenous > Cushing’s Syndrome
Endogenous > Cushing’s Disease
These are the signs and symptoms of what adrenal gland disorder?
A
Cushing’s Syndrome
Hyper function of adrenal gland
10
Q
Secretes calcitonin which regulates blood calcium by depositing calcium into the bone
Important for brain development and normal growth
Regulates cellular activity
These are the functions of what endocrine gland?
A
Thyroid gland
11
Q
Fluid volume excess
Risk for injury
Risk for infection
These nursing diagnoses related to what adrenal gland disorder?
A
Cushing’s Disease
Hyper function of adrenal gland
13
Q
Muscle strength Skin dryness Menstrual cycles Weight Cholesterol levels What hormone affects these body systems?
A
Thyroid Hormone
14
Q
Iodine combines with an _______ to create thyroid hormone.
A
amino acid
15
Q
Radioactive Iodine Uptake test checks if the thyroid gland up taking iodine
Fine needle aspiration biopsy into the thyroid gland to determine if there is a malignancy (cancer)
Scans to determine size, location, and function of thyroid gland
These lab tests diagnose what endocrine disorder?
A
Thyroid hormone
Study Tip: Radioactive iodine uptake measures the rate that thyroid gland is picking up iodine. Measure the proportion of the administered dose present in the thyroid gland at a specific time after administration. Hyperthyroidism shows a high uptake of iodine.
16
Q
Make sure patient that is doing the radioactive iodine uptake test hasn’t taken medications or ate a high amount if _______ because that can alter thyroid test results.
A
iodine
17
Q
Do _____ palpate a patient with hyperthyroidism.
A
NOT
18
Q
Assess vital signs
Watch for fluid volume deficit and electrolyte abnormalities -aldosterone
Administer medications ON TIME
Educate patient to anticipate stressful events so that body can respond.
These are the nursing interventions related to treatment of what parathyroid disorder?
A
Addison’s disease
Adrenal insufficiency
Hypofunction of adrenal gland
19
Q
Causes can be congenital often the mother has this as well. The cause can be autoimmune which is called Hashimoto’s disease which appears and 95% of primary thyroid dysfunction cases and issues with the pituitary gland.
This is the cause of what thyroid disorder?
A
Hypothyroidism
21
Q
In adults: Lethargy to extreme fatigue Slow mentation (thought process) Dull blank expression Thick tongue Slow speech Generalized slowing of body functions Hair loss (receding hairline) brittle nails dry skin (coarse and scaly) Apathy (no energy to care) Menstrual disturbances Numbness and tingling in the fingers Facial and eyelid edema (peri-orbital edema) Weight loss - Anorexia Early Signs: Constipated Increased sensitivity to cold These are the signs and symptoms of what thyroid disorder?
A
Hypothyroidism
22
Q
Severe: Below normal body temperature Low pulse rate (bradycardia) Weight gain even in the presence of cachexia Decreased level of consciousness Thick skin Cardiac complications apnea Respiratory muscle weakness Personality changes These are the signs and symptoms of what thyroid disorder?
A
Hypothyroidism
23
Q
This is a life-threatening condition that can be caused by infection, illness, exposure to cold, and untreated hypothyroidism.
These cause what thyroid disorder?
A
Rare form of Severe Hypothyroidism
- Myxedema Coma
24
Q
Keep in mind that both Contrast agents contain and topical agents used in patient care can contain ____.
A
Iodine
24
Q
What 2 complications are commonly seen in a patient with untreated hypothyroidism / Myxedema?
A
High risk for babies born with birth defects and
Heart disease because of high levels of cholesterol
26
Q
If this disorder is over-treated you may run the risk of causing angina or an Myocardial Infarction because we are increasing the metabolic rate you are increasing myocardial oxygen demand. What disorder is this?
A
Hypothyroidism
Myxedema
27
The Goal of treatment is to restore the patient to a normal metabolic state.
Administer Synthroid or Levothroid
This is the treatment for what thyroid disorder?
Hypothyroidism
| Study Tip: These medications are thyroid hormones. If hormone replacement is adequate the symptoms will go away.
28
If the patient has developed CAD when the thyroid level increases so does myocardial oxygen demand if that happens stop the medications and start the mess again later at a lower and slower rate. This can occur during the treatment of what thyroid disorder?
Hypothyroidism
| Myxedema
29
```
Assessment:
History
Physical exam
Weight gain
Mental changes
Fatigue
Slowed speech
Slurred speech
Cold intolerance
Increased skin dryness
Increased thickness of skin
Constipation
Dyspnea
These are what the nurse would assess doing what thyroid disorder?
```
Hypothyroidism
| Myxedema
30
Nursing diagnosis:
Imbalanced nutrition more than body requirements R/T too much calorie intake even though they might have a decreased appetite
Constipation R/T
Impaired memory R/T
Fatigue R/T
These nursing diagnoses related to what thyroid disorder?
Hypothyroidism
| Myxedema
31
Goals:
Patient will experience symptom relief.
Patient will maintain a euthyroid state.
Patient will maintain a positive self image. Patient will comply with lifelong thyroid hormone replacement therapy.
These nursing goals are related to what thyroid disorder?
Hypothyroidism
| Myxedema
32
Interventions:
No consensus on screening - Negative Result
- Screen high-risk patients
Treatment for this is usually outpatient.
Teach about medications and follow up doctors appointments.
Myxedema coma treated inpatient in ICU
May require intubation for mechanical ventilation.
Cardiac monitoring.
These are the nursing interventions related to what thyroid disorder?
Hypothyroidism
| Myxedema
33
Evaluation:
Patient will have symptom relief.
Patient will have a euthyroid state.
Patient will adhere to lifelong therapy.
Patient will have labs within normal limits.
This is the nursing evaluation goal related to what thyroid disorder?
Hypothyroidism
Myxedema
Talk about medication compliance with the patient.
34
______________ may appear after thyroiditis or after excessive ingestion of thyroid hormone?
Graves' disease
| Hyperthyroidism
35
```
Shock
Stress
Infection
Thyroiditis
Excessive ingestion of thyroid hormone
These disorders can cause what thyroid disorder?
```
Graves' Disease
Hyperthyroidism
Barbara Bush had this disease.
36
_________ is also an autoimmune disease so anyone who has a history of autoimmune diseases are at a higher risk for developing this disease.
Graves' disease
| Hyperthyroidism
37
Thyrotoxicosis is more ______ than a thyroid storm.
severe
These are both forms of hyperthyroidism.
38
This has an abrupt onset. This if untreated is almost always fatal. This patient is critically ill. This is severe ________.
hyperthyroidism
Thyrotoxicosis
Thyroid storm
39
Hyperthermia with a temperature above 101.3°F/ 38.5C
Extreme tachycardia with a heart rate above 120 bpm.
Exaggerated symptoms of hyper thyroidismAltered mental state.
These are the signs and symptoms of what thyroid disorder?
Thyrotoxicosis and Thyroid storm
| severe hyperthyroidism
40
```
Nervousness.
Hyperexcitable. (No sleep.)
Irritable.
Apprehensive.
Myocardial Hypertrophy > Heart Failure
Diarrhea.
These are the signs and symptoms of what thyroid disorder?
```
Hyperthyroidism
| Graves Disease
41
```
Palpitations.
Tachycardia.
Inability to sit still.
Poor heat tolerance.
Increased dietary Intake.
Weight loss.
Bruits can be heard over the thyroid arteries with the stethoscope.
Thyroid gland will be large and soft.
These are the signs and symptoms of what thyroid disorder?
```
Hyperthyroidism
| Graves Disease
42
```
Diaphoresis.
Flushed red skin.
Find hand tremor.
Changes in Bowel Habits >Diarrhea
Goiter.
Exophthalmus > Not always reversible.
These are the signs and symptoms of what thyroid disorder?
```
Hyperthyroidism
| Graves Disease
43
The goal with treatment of ________ is to reduce body temperature, reduce heart rate, the nurse must prevent systemic collapse, provide oxygen administer IV fluids with glucose to replace depleted stores and administer medications.
Thyroid storm / Thyrotoxicosis
44
What is the therapeutic classification of the medication Propythiouracil - (PTU)?
Anti Thyroid Medication
45
```
Medication:
-Ketoconazole/Nizoral
-Mitotane/Lysodren
-Metyrapone/Metopirone
These are the nursing interventions related to the treatment of what adrenal gland disorder?
```
Cushing's Disease
| Hyper function of adrenal gland
46
Exophthalmus is caused by the immune system attacks the muscles and tissues around the eye which causes inflammation and increased pressure behind the eye which causes the eyeball to bulge out. Sometimes but rarely Inflammation can become severe enough to compress the optic nerve which can lead to vision loss.
This is a common sign that someone has what thyroid disorder?
Hyperthyroidism
| Graves' disease
47
This disorder has symptoms related to hypocalcemia which include:
Tetany.
Latent tetany including numbness, tingling, and cramps in extremities.
Bronchospasm (deadly), laryngeal spasm, carpopedal spasm, and dysphasia.
Anxiety, irritability, depression, and delirium.
May also cause EKG changes.
These are the signs and symptoms of what parathyroid disorder?
Hypoparathyroidism
| Addison's disease
48
```
Interventions:
Radioiodine Therapy I 131
Administer Beta blockers
Administer Anti-thyroid medications
Surgery
These are the nursing interventions related to what thyroid disorder?
```
Hyperthyroidism
| Graves' disease
50
Interventions:
Patient education both written and verbal. Medications.
Adverse reactions.
Home health referral PRN.
Long term follow up.
These are the nursing interventions related to what thyroid disorder?
Hyperthyroidism
| Graves' disease
51
The antibody _______ attaches to thyroid cells and stimulates production of thyroid hormone causing hyperthyroidism.
thyroid stimulating immunoglobulin (TSI)
51
Other symptoms include: Dry gritty irritated eyes, puffy eyelids, sensitivity to light, and painful eyes, double vision. The eyes might hurt the patient might have trouble moving their eyes around. 30% of patients with Graves' disease develop Exophthalmus which lasts lasts 1-2 years. 2-5% develop it very severely.
These are the signs and symptoms of what thyroid disorder?
Hyperthyroidism
| Graves' disease
52
```
Hair becomes thin and fine
Clubbing
Tremors
Amenorrhea
Localized Edema
Weight loss even though increased intake
Increased Systolic Blood Pressure
Facial Flushing
Enlarged Thyroid
Intolerance to heat
These are the signs and symptoms of what thyroid disorder?
```
Hyperthyroidism
| Graves' disease
53
__________ - Given PO. Oral medication. This blocks the synthesis of hormones the conversion of T3 to T4. Decreases the amount of circulating thyroid hormone.
This is used to treat what thyroid disorder?
Propythiouracil/PTU
Hyperthyroidism
54
____________- This medication suppresses the release of thyroid hormone. Thyroid gland uses iodine. Give this medication with a straw to prevent teeth staining. This is used to treat what thyroid disorder?
Saturated Solution of Potassium Iodide (SSKI)
Hyperthyroidism
56
_________ - This medication is a beta adrenergic blocking agent. It has an ? effect on the cardiac system. This is used to treat what thyroid disorder?
Beta blocker
Hyperthyroidism
57
___________ - Administered PO. Given to destroy the thyroid tissue. The thyroid will collect the radioactive iodine from the blood stream and that gradually destroys the thyroid gland. This is used to treat what thyroid disorder?
Radioactive Iodine I-131
Hyperthyroidism
Study Tip:
Some Drs might give enough to shut down the gland completely or they could only give enough to put the thyroid gland into normal range this can take several treatments. Educate patient that it can take weeks or months to see results.
58
PTU and SSKIs are used most often to treat _______.
Hyperthyroidism
59
NPO after midnight
Stop anti-thyroid meds three days before this treatment.
The patient will go home afterwards.
The patient needs to avoid prolonged contact with others especially children and pregnant women. The majority of Ra++ (radioactive) iodine leaves the body in 48 hours. It is excreted in sweat, stool, vaginal secretions, saliva, and tears.
If there is an infant the home arrange for other care.
Use private toilet, flush twice after use.
Bathe daily and wash hands frequently.
Drink normal amounts of fluid. No changes.
Use disposable eating utensils or wash separately from others.
Sleep alone.
Avoid prolonged into the contact for three days. Brief contact (hugging/handshaking) is permitted.
This is patient education regarding what treatment for a thyroid disorder?
Radioiodine treatment of Hyperthyroidism
60
```
Assessment:
-Subjective (past health history, infections, trauma, iodine deficiency, traveling to areas where iodine deficient > can lead to glandular hypertrophy, autoimmune diseases, medications, family history, sweating Dyspnea, palpitations, muscle weakness, herbal remedies that affect thyroid hormone, diarrhea, polyuria, sweating, fatigue, head to toe physical exam
-Objective
-Physical exam
-Lab results:
Increased T3 and T4
Decreased TSH
Chest x-ray: Enlarged heart
EKG: Tachycardia
EKG: Atrial fibrillation
Resp: Tachypnea
Gi: Hyperactive bowel sounds
Neuro: hyperreflexes, double vision, Tremors of the hands menstrual irregularities
```
Come back to slide #28
61
Activity intolerance
Imbalanced nutrition less than body requirements.
Knowledge deficit related to pathophysiology.
Knowledge deficit related to medication regimen.
These nursing diagnoses related to what thyroid disorder?
Hyperthyroidism
| Graves Disease
62
Patient will experience relief of symptoms.
Patient will have no serious complications related to disease or treatment.
Patient will maintain nutritional balance.
Patient will actively participate in therapeutic plan. These are the goals for a patient with what thyroid disorder?
Hyperthyroidism
| Graves' disease
63
Administer medications that block thyroid production and the sympathetic nervous system.
Ex. Beta blockers
Implement supportive therapy.
Ex. Cardiac monitoring, Administration of Oxygen, and IV fluids to replace lost fluids and electrolytes. Provide a calm environment.
Ex. Patient can be irritable, agitated, and not sleeping well. Place patient in a cool room. Light bed sheets that you change frequently if they are diaphoretic. Give the patient a fan. Place the patient away from high traffic area and really ill patients if possible.
Increase activity that encourages large gross muscle groups because they will have fine motor tremors. Establish a trusting relationship.
Prevent corneal injury.
Ex. Administer artificial tears.
Implement SALT RESTRICTION to reduce peri-Orbital edema and ELEVATE the HEAD of the bed to reduce EDEMA.
Apply dark sunglasses to reduce glare.
These are the nursing interventions related to what thyroid disorder?
Severe hyperthyroidism
| Acute Thyrotoxicosis
64
Treatment: Subtotal thyroidectomy.
Leave a little bit of thyroid to maintain the normal level.
Implement Pre-op teaching.
Administration of medications.
Incision in the neck so the nurse will need to provide support to the head and neck and assist with turning in bed to prevent putting pressure on the sutures. Teach to support head manually after surgery.
These are the nursing interventions related to what thyroid disorder?
Hyperthyroidism
| Graves' disease
65
Airway obstruction interventions:
Treatment: Subtotal thyroidectomy.
Careful monitoring of respiratory status.
Neck can have swelling related to surgery which can obstruct the airway.
Rare but life-threatening complication
Keep a trach tray by the bedside just in case.
These are the nursing interventions related to what thyroid disorder?
Hyperthyroidism
| Graves' disease
66
Discharge home:
Teach to monitor for hypothyroid.
Calorie intake decrease.
Iodine intake
Ex. seafood 1 to 2 times per week or iodized salt use.
These are discharge instructions for the treatment related to what thyroid disorder?
Post Sub Total Thyroidectomy
| which is a treatment for Hyperthyroidism
66
Evaluation:
The patient will have relief of symptoms.
The patient will have no serious complications.
The patient will participate with therapeutic regimen.
These are nursing evaluation goals for the treatment related to what thyroid disorder?
Post Sub Total Thyroidectomy
| which is a treatment for Hyperthyroidism
67
```
Hypothermia
Bradypnea - slow breathing
Hypotension
Hypoglycemia
Unresponsiveness
Increased risk for infection
Infertility - miscarriage
These are the signs and symptoms of what thyroid disorder?
```
Rare form of Severe Hypothyroidism
| - Myxedema Coma
67
_________ is the most common cause of inadequate secretion of parathyroid hormone caused after thyroidectomy. This disorder results in hyperphosphatemia and hypocalcemia.
Hypoparathyroidism
| Addison's disease
68
Positive Trousseau's or Chvostek's sign suggests latent tetany.
Diagnosis is difficult as signs and symptoms are vague.
Decreased serum calcium level.
Increased phosphate level.
Bones show increased density.
These are the signs and symptoms of what parathyroid disorder?
Hypoparathyroidism
Addison's disease
Study Tip: There is an increased bone density because the parathyroid gland pulls calcium out of the bone in response to the low blood calcium levels but the feedback mechanism is broken so that is not occurring.
70
The goal is to treat acute complications
Ex. Tetany
Increase serum calcium level 9-10 mg/dL
Prevent long-term complications.
These are the nursing interventions related to the treatment of what parathyroid disorder?
Hypoparathyroidism
| Addison's disease
71
Administer calcium gluconate.
Monitor EKG
-During Calcium administration can have hypotension, serious dysrhytmias, and cardiac arrest.
These are the nursing interventions related to what parathyroid disorder?
Hypoparathyroidism
Addison's disease
Don't give PTH because it has to be given IV and it is expensive. This is to be given for life so it can become costly.
72
________ is caused by overproduction of parathyroid hormone. The main function of parathyroid hormone (PTH) is calcium and phosphorus balance. If this has a primary cause it originates in the gland. If this has a secondary cause it is due to other conditions such as ________. When the gland fails it is usually only one but people have four so if the surgeon removes one the other three will compensate.
Hyperparathyroidism
Cushing's Disease
renal failure
73
Serum total calcium level.
Serum ionized calcium level.
Serum PTH level.
These labs indicate that the patient has what parathyroid disorder?
Hyperparathyroidism
| Cushing's Disease
73
Bone Decalcification
-Severe Osteoporosis if untreated
Renal calculi caused by calcium composition.
Urinary tract infection.
Gastric ulcers because hypercalcemia increases gastric secretion.
Cholelithiasis. Too much Ca+ causes stones
Pancreatitis.
These are the signs and symptoms of what parathyroid disorder?
Hyperparathyroidism
| Cushing's Disease
74
Collaborative Intervention: Surgery this is the ONLY definitive treatment for a patient with a primary diagnosis.
These are the nursing interventions related to treatment of what parathyroid disorder?
Hyperparathyroidism
| Cushing's Disease
75
Non-surgical treatments do not affect clinical outcomes of a primary diagnosis.
Medications are given to facilitate calcium excretion.
Patient is given 2 to 3 L of fluid per day to enhance calcium excretion.
High fiber diet is implemented to enhance bowel function.
Watch the patient for hypocalcemia in case we overcorrect with treatment.
These are the nursing interventions related to the treatment of what parathyroid disorder?
Hyperparathyroidism
| Cushing's Disease
76
Without the parathyroid hormone there is decreased _________ and decreased ___________.
Intestinal absorption of calcium
| Calcium reabsorption by the bone.
77
If signs and symptoms occur immediately after thyroidectomy.
-Give ________
If seizures and neuromuscular activity continue
-Give _______
These are the nursing interventions related to the treatment of what parathyroid disorder?
IV Calcium Gluconate
Sedatives
Hypoparathyroidism
Addison's disease
78
Patient Education
- Medications: Calcium Replacement Therapy
Vitamin D (necessary for calcium absorption)
PTH not given why?
These are the patient teaching's related to what parathyroid disorder?
Hypoparathyroidism
Addison's disease
Don't give PTH because it has to be given IV and it is expensive. This is to be given for life so it can become costly.
79
__________ is responsible for secreting these three classes of hormones:
Glucicorticoids/sugar which is Cortisol. Mineralocorticoids/salt which is Aldosterone
Androgen which is sex hormones.
Adrenal gland
80
________ stimulate gluconeogenesis > glucose production
- Activates anti-stress and anti-inflammatory pathways.
- During this process ______ prevents inflammation. This decreases the immune and inflammatory response.
Glucocorticoids
| Cortisol
81
_________ is also known as Addison's disease. This disease may have a primary or secondary cause.
Adrenal Insufficiency
82
```
Muscle weakness
Fatigue
Weight loss
Decreased appetite
Hyperpigmentation skin -Darker skin
Hypotension
Fainting
Salt craving- Aldosterone deficient
Hypoglycemia
Nausea
Vomiting
Diarrhea
Muscle and joint pain
Irritability
Depression
These are the signs and symptoms of what adrenal gland disorder?
```
Hypofunction of adrenal gland
| Addison's Disease
83
Serum cortisol levels must be drawn between
6am - 8am in the morning. This is when the nurse will give aldosterone because this is when the body produces the most cortisol naturally so it is given to mimic the bodies natural production.
Electrolyte levels.
ACTH stimulation test. This test measures the level of cortisol in your blood before and after being given ACTH. ACTH signals adrenal glands to secrete cortisol. If the gland is damaged there will be no difference in the levels before and after. There is no response.
These are the labs required to diagnose what adrenal gland disorder?
Hypofunction of adrenal gland
Adrenal Insufficiency
Addison's disease
83
What are four causes of Endogenous > Cushing's Disease?
- Pituitary gland tumor
- Other tumors.
- Adrenal gland disease
- Familial Cushing's disease (Rare)
84
The ONLY treatment for adrenal insufficiency is ________.
hormone replacement
84
```
Buffalo hump - altered fat deposits.
Rounded face - moon face
Pink or purple stretch marks > Striae
Hypertension
Diabetes
Poor wound healing
Weight gain
Thinning fragile skin that bruises and tears easily
(Internal and External)
Translucent skin
These are the signs and symptoms of what adrenal gland disorder?
```
Cushing's Syndrome
| Hyperfunction of adrenal gland
84
Physical exam
Urine and blood tests - Cortisol levels
Saliva test - cortisol level is tested at night.
These are the labs required to diagnose what adrenal gland disorder?
Cushing's Syndrome
| Hyper function of adrenal gland
85
```
In addition to previous symptoms this includes:
Sudden onset
Pain in lower back, abdomen, and legs.
Severe Vomiting
Severe Diarrhea
Dehydration
Hypotension
Loss of consciousness
Hyperkalemia
Low bloodpressure
Hypoglycemia
These are the signs and symptoms of what adrenal gland disorder?
```
Addisoninan Crisis
Adrenal insufficiency
Hypofunction of adrenal gland
85
Administer corticosteroids
These medications must be taken a.m.
Do not stop taking this medication ABRUPTLY. Monitor the patient for a G.I. bleed because it can cause a crisis.
These are the nursing interventions related to treatment of what parathyroid disorder?
Addison's disease
Adrenal insufficiency
Hypofunction of adrenal gland
85
The goal of treatment is to lower cortisol levels. Reducing corticosteroid use. NEVER stop abruptly.
Surgical removal of causative tumor.
Radiation.
These are the nursing interventions related to the treatment of what adrenal gland disorder?
Cushing's Disease
| Hyper function of adrenal gland
89
Changes in fat distribution ask patient if there have been any physical changes?
- Truncal obesity with thin arms and legs also seen in respiratory patients ex. Patients on steroids
Moon face
Hyperglycemia
This is the nursing assessment related to the diagnosis of what adrenal gland disorder?
Cushing's Disease
| Hyper function of adrenal gland
90
_________ stimulates and controls development of male sex characteristics.
Androgens
91
Adrenalectomy.
-Closely monitor vital signs.
Monitor for signs and symptoms of infection.
Evaluate for desired effects of treatment.
These are the nursing interventions related to the treatment of what adrenal gland disorder?
Cushing's Disease
| Hyper function of adrenal gland
92
The Principal mineralocorticoidsecreted from the adrenal gland is _________.
Aldosterone
93
Adrenal Insufficiency is caused by insufficient production of?
cortisol(mostly)
| aldosterone
94
The _________ cause of Addison's Disease is rare due to distruction of adrenal gland.
Ex. Causes include: Tuberculosis (throughout the body), fungal infections, hemorrhage, idiopathic, and autoimmune dysfunction.
primary
95
Assessment:
Cardiac - fluid volume and electrolyte changes > fluid volume excess> HF
Musculoskeletal > protein depletion and mineral loss causes muscle wasting and weakness> Bone thinning and depletion > Increased risk for pathological fractures.
These are the nursing interventions related to diagnosis of what parathyroid disorder?
Cushing's Disease
| Hyper function of adrenal gland
96
The ________ cause of Addison's Disease is due to pituitary gland disorders.
Ex. Causes include Pituitary disease or suppression.
secondary
98
__________ - This medication suppresses the release of thyroid hormone. This is used to treat what thyroid disorder?
Dexamethasone
Hyperthyroidism
98
Prevent fluid volume excess - Monitor Daily Weight.
Prevent infection -Handwashing. Avoid infectious visitors.
Prevent skin breakdown - Air overlays on the bed , frequent repositioning, foam pads on the bed, assess oxygen nasal cannula pressure areas, and assess bony prominences.
Administer medications that interferes with ACTH as ordered.
Possible fluid and sodium restriction.
Monitor blood glucose.
These are the nursing interventions related to what adrenal gland disorder?
Cushing's Disease
| Hyper function of adrenal gland
99
_________ occurs if loss if the adrenal hormones occurs suddenly. What is the cause of this adrenal gland disorder?
Adrenal crisis
Addisonian Crisis
Ex. Accident, injury, surgery severe infection thus can be fatal.
100
All patients that have adrenal insufficiency or are steroid dependent are at risk for this acute adrenal crisis called ________ which is life threatening.
Addisoninan Crisis
Adrenal insufficiency
Hypofunction of adrenal gland
101
__________ affects women eight times more than men.
Graves' disease
| Hyperthyroidism
102
Serum thyroid stimulating hormone / TSH level
Serum Free T4
Serum T3 and T4
These lab tests diagnose what endocrine disorder?
1. TSH is produced when the body needs more thyroid hormone. These are screening tests done every 5 years on adults over 35.
2. Only checked if the TSH lab is abnormal this is ordered to determine if the problem is primary or secondary.
Thyroid hormone disorders
103
```
Metabolism - alterations hyper/hypo
Brain development R/T gestational thyroid imbalance during pregnancy
Breathing
Heart and Nervous system function
Body temperature
What hormone affects these body systems?
```
Thyroid Hormone
104
Assessment:
Skin > thinning Ex. internal and external
Immunosuppression > decreased lymphocytes > macrophages are inhibited > increased risk for infection > inflammatory chemicals are inhibited > decreasing the inflammatory/immune response.
These are the nursing interventions related to the diagnosis of what parathyroid disorder?
Cushing's Disease
| Hyper function of adrenal gland
