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ENDOCRINE/PREOP Flashcards

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1
Q

What dietary deficiencies should be assessed in patients with endocrine problems?

A
  • Protein
  • Iodide-containing foods
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2
Q

What changes should be noted in a patient’s physical appearance during assessment?

A
  • Hair texture and distribution
  • Facial contours and eye protrusion
  • Voice quality
  • Body proportions
  • Secondary sexual characteristics
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3
Q

What is a key neurological symptom associated with hypopituitarism?

A

Change in vision

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4
Q

What is acromegaly?

A

Growth hormone hypersecretion after puberty

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5
Q

What are common symptoms of diabetes insipidus (DI)?

A
  • Polydipsia
  • Polyuria
  • Dehydration
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6
Q

True or False: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is characterized by vasopressin secretion even when plasma osmolarity is low.

A

True

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7
Q

What is the primary intervention for diabetes insipidus?

A

Lifelong vasopressin therapy

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8
Q

What does a high aldosterone level promote?

A

Sodium and water reabsorption and potassium excretion

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9
Q

What is a common assessment finding in SIADH?

A
  • Headache
  • Weakness
  • swollen
  • Muscle cramps
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10
Q

Fill in the blank: The major mineralocorticoid produced by the adrenal cortex is _______.

A

Aldosterone

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11
Q

What should be monitored post-transsphenoidal pituitary surgery?

A
  • Neurologic response
  • Postnasal drip
  • Hormone replacement
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12
Q

What might truncal obesity and buffalo hump indicate?

A

Adrenocortical excess

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13
Q

What is the result of ADH deficiency in diabetes insipidus?

A

Excretion of large amounts of diluted urine

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14
Q

What are some interventions for SIADH?

A
  • Fluid restriction
  • Monitoring intake and output
  • Drug therapy with vasopressin antagonists
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15
Q

What physical changes are assessed in patients with potential endocrine disorders?

A
  • Height
  • Weight
  • Fat distribution
  • Muscle mass
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16
Q

What are signs of dehydration in a patient with diabetes insipidus?

A
  • Extreme thirst
  • Weight loss
  • Muscle weakness
  • Dry mucous membranes
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17
Q

What neurological changes could indicate hyperpituitarism?

A
  • Visual changes
  • Headache
  • Increased intracranial pressure
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18
Q

What is the primary function of aldosterone?

A

Controls extracellular fluid volume by promoting sodium and water reabsorption and potassium excretion

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19
Q

What is Addison’s disease?

A

A condition characterized by diminished production of mineralocorticoids and glucocorticoids, resulting in decreased aldosterone and cortisol

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20
Q

What are common causes of primary adrenal insufficiency?

A
  • Idiopathic autoimmune (majority of cases) * Tuberculosis * Metastatic cancer * AIDS * Hemorrhage * Gram-negative sepsis * Adrenalectomy * Abdominal radiation * Drugs or toxins
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21
Q

What triggers Addison’s crisis?

A

Rapid onset life-threatening event; need for cortisol and aldosterone exceeds available supply, often in response to stress

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22
Q

What are common symptoms of adrenal gland insufficiency?

A
  • Anorexia * Nausea/Vomiting * Abdominal pain * Bowel changes * Weight loss * Salt craving * Hyperpigmentation * Muscle weakness
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23
Q

What interventions are important for adrenal gland insufficiency?

A
  • Promote fluid balance * Prevent hypoglycemia * Monitor labs * Administer hydrocortisone and fludrocortisone
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24
Q

What is Cushing’s syndrome?

A

A condition caused by hypersecretion of adrenal cortex hormones leading to excessive cortisol or androgen production

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25
What are common manifestations of Cushing’s syndrome?
* Central obesity * Fragile skin * Diabetes * Osteoporosis * Muscle wasting * Hypertension * Moon face * Increased susceptibility to infection
26
What is hyperthyroidism?
Excessive secretion of thyroid hormones from the thyroid gland
27
What are common causes of hyperthyroidism?
* Graves’ disease * Toxic nodular goiter * Exogenous hyperthyroidism
28
What are symptoms of hyperthyroidism?
* Nervousness * Heat intolerance * Weight loss * Palpitations * Bulging eyes (exophthalmos) * Increased appetite
29
What is thyroid storm?
A life-threatening condition of extreme hyperthyroidism requiring immediate medical attention
30
What is hypothyroidism?
A condition characterized by insufficient production of thyroid hormones
31
What are common manifestations of severe hypothyroidism?
* Extreme fatigue * Hair loss * Weight gain * Cold intolerance * Myxedema coma
32
What is myxedema coma?
A rare and life-threatening condition caused by severe hypothyroidism, often triggered by stress or sedatives
33
What is the most common treatment for Graves' disease?
Radioactive iodine therapy
34
What dietary requirements are necessary for thyroid hormone production?
Adequate intake of protein and iodine
35
What are the early signs and symptoms of Myxedema Coma?
Depression, diminished cognitive status, lethargy, somnolence, and respiratory drive depression. ## Footnote These symptoms can lead to coma, and the condition is considered an emergency.
36
What precautions should be taken when treating Myxedema Coma?
Administer oxygen and fluids cautiously, avoid heating pads. ## Footnote Heating pads increase oxygen requirements and may lead to vascular collapse.
37
What is a goiter?
An enlarged thyroid gland, often associated with thyroid tumors.
38
What characterizes an Iodine Deficient Goiter?
High TSH levels with thyroid enlargement to compensate for low thyroid hormone levels. ## Footnote Usually presents with no symptoms other than swelling.
39
What is a Nodular Goiter?
A thyroid enlargement with nodules, can be associated with thyroid cancer.
40
What are the post-operative concerns after a Thyroidectomy?
Edema of the glottis, airway management, potential injury to parathyroid glands leading to calcium deficiency, and risk of laryngospasm. ## Footnote Keep a trach set at bedside and advise the patient to minimize talking.
41
What is Hyperparathyroidism?
An increase in parathyroid hormone (PTH) levels leading to hypercalcemia and hypophosphatemia.
42
What are common assessment findings in Hyperparathyroidism?
Weight loss, bone fractures, osteoporosis, arthritis, psychological distress.
43
What is the management for Hyperparathyroidism?
Nonsurgical and surgical management, including diuretics and hydration with normal saline.
44
What defines Hypoparathyroidism?
Decreased function of the parathyroid gland, often due to removal of parathyroid tissue.
45
What symptoms might a patient with hypothyroidism exhibit?
Fatigue, muscle aches, bradycardia, non-pitting edema, and low blood pressure.
46
Which patient statement indicates a need for further teaching about hypothyroidism?
When I am feeling better in a few months, I will no longer need to take the Synthroid pills.
47
Which finding requires immediate attention in a patient with Grave’s disease?
Irregular heart rate and rhythm.
48
What is the priority nursing intervention for an older female patient with hyperparathyroidism?
Implement fall precautions.
49
What should be included in the postoperative plan of care after a total thyroidectomy?
Avoiding extending the patient’s neck.
50
When does the preoperative phase begin and end?
Begins when patient is scheduled for surgery; ends at time of transfer to surgical suite
51
What are methods to minimize anxiety in preoperative patients?
* Encourage communication * Promote rest * Use distraction * Teach the caregiver
52
What is essential for informed consent in the preoperative phase?
Ensure informed consent is obtained
53
What should be documented before surgery?
* Allergies * Height * Weight * Laboratory and diagnostic test results
54
What are expected outcomes of the preoperative phase?
* States understanding of informed consent * Demonstrates preoperative exercises * Verbalizes reduced anxiety
55
What should be assessed in the respiratory system postoperatively?
Patent airway and adequate gas exchange
56
What vital signs should be monitored in the cardiovascular system postoperative?
Report BP changes that are 25% higher or lower than baseline
57
What should be assessed in the neurologic system postoperatively?
Cerebral function and level of consciousness
58
What should be assessed in the gastrointestinal system postoperatively?
* Postoperative nausea/vomiting (PONV) * Intestinal peristalsis * Constipation
59
What should be assessed in psychosocial evaluation postoperatively?
Signs of anxiety
60
What should self-management education include postoperatively?
* Pain management * Drug therapy * Safety * Prevention of infection * Nutrition therapy
61
What are expected outcomes for postoperative patients?
* Adequate lung expansion * Appropriate wound healing * Acceptable pain management * Return of peristalsis
62
What nursing actions are appropriate for a client with GI bleeding showing signs of hypovolemia?
* Increase IV infusion rate * Monitor vital signs frequently * Administer supplemental oxygen * Notify the Rapid Response Team
63
What causes hypovolemic shock?
Too little blood volume, resulting in decreased Mean Arterial Pressure (MAP).
64
List three laboratory assessment signs of hypovolemic shock.
* Decreased pH * Increased lactic acid * Increased or decreased hemoglobin
65
What are the nonsurgical management strategies for hypovolemic shock?
* Oxygen therapy * IV therapy * Drug therapy * Monitoring
66
What are early indicators of shock that should be taught to patients and family members?
* Increased thirst * Decreased urine output * Light-headedness
67
What is the priority nursing intervention when a client with suspected sepsis has vital signs of BP 92/44, HR 134, and SpO2 90%?
Initiate intravenous fluid resuscitation.
68
What is the earliest clinical sign of hypovolemic shock?
Increased heart rate.
69
What should be done before administering antibiotics in cases of suspected sepsis?
Obtain blood cultures.

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