Flashcards in Endocrine System Deck (39)
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1
What are they levels of t3, t4 and tsh in hyperthyroidism?
High t3 and t4
Low TSH
2
What is thyroid storm?
Thyroid storm is a life threatening emergency that occurs with uncontrolled hyperthyroidism due to graves disease. Symptoms include fever, tachycardia, agitation, anxiety, and HTN.
3
What drugs are used to treat thyroid storm?
Propylthiouracil and methimazole. These block the synthesis of T3 and T4
-Propranolol may be given to decrease excessive sympathetic stimulation
4
What is the diet for hyperthyroidism?
High calorie
High protein
Low caffeine
Low fiber
5
What should you have bedside postoperatively for a thyroidectomy?
Be prepared for laryngeal edema by having a tracheostomy set at the bedside, along with O2, and a suction machine.
Calcium gluconate should be easily accessible
6
What is the normal serum calcium level?
9.0 - 10.5 mEq/L
7
What is the best indicator of parathyroid problems?
A decreased in the clients calcium compared to the preoperative value
8
How do watch for tetany?
-Monitor serum calcium
-Check for tingling of toes and fingers and around the mouth
-Check Chvostek sign
-Check Trousseau sign
too low calcium
9
Hyperthyroidism is also called
Graves Disease and Goiter
10
Hypothyroidism is also referred to as
Hashimoto's Disease and Myxedema
11
What precipitates a myxedema coma?
acute illness
withdrawl of thyroid medication
anesthesia
use of sedatives
hypoventilation
12
What is Addisions Disease?
Primary adrenocortical deficiency/ hypo function of the adrenal cortex
13
What is the diet requirements for a patient with Addison's disease?
High Sodium
Low Potassium
High Carbohydrate
3L of fluid per day
14
What happens in an Addison's Crisis?
Vascular collapse: hypotension and tachycardia (Nursing care is to administer IV fluids at a rapid rate)
Hypoglycemia: Administer IV glucose
Administer parenteral hydrocortisone
Aldosterone replacement with simultaneous administration of salt
15
What is Cushing's Syndrome?
Excess adrenocorticoid activity
16
Physical assessment of cushing's syndrome
Mood face
truncal obesity
buffalo hump
abdominal striae
hirsutism
17
What are the electrolyte balances in Cushing's Syndrome?
Hyperglycemia
Hypernatremia
Hypokalemia
18
Teach clients to take steroids with meals
to prevent gastric irritation, they should never skip a dose.
19
What are the characterisitics of HHNKS (Hyperosmolar hyperglycemia nonketotic syndrome)
Hyperglycemia >600
Plasma hyperosmolality
Dehydration
Change in mental status
Absent ketone bodies
20
What is glycosylated HGB (HbA1c)
Indicates glucose control over previous 90-120 days. It is a valuable measurement of diabetes control and informs the diagnosis of diabetes and prediabetes
21
The body's response to illness and stress is to produce
glucose. Therefore, any illness result in hyperglycemia
22
What is basal insulin?
Long acting and intermediate acting insulin that suppresses glucose production between means and overnight
23
What is bolus insulin
limits hyperglycemia after meals. Rapid or short acting. Clear
24
Correction factor
The amount of insulin needed to correct hyperglycemia, usually give pre meal
25
What diagnostic test is used to determine thyroid activity
T3 and T4
26
What condition results from all treatments of hyperthyroidism
hypothyroidism, requiring thyroid replacement
27
State three symptoms of hyperthyroidism and three symptoms of hypothyroidism
Hyperthyroidism: weight loss, heat intolerance, diarrhea
Hypothyroidism: Fatigue, cold intolerance, weight gain
28
List five important teaching aspects for clients who are beginning corticosteroid therapy
-Continue medication until weaning plain is begun by physician
-Monitor serum potassium, glucose, and sodium frequently
-weigh daily
-and report weight gain of >5lbs/ week
-Monitor BP and pulse closely
-Teaching symptoms of Cushing's Syndrome
29
Describe the physical appearance of clients who have Cushing syndrome
Moon face
Obesity in trunk
Buffalo hump in back
Muscle atrophy
Think skin
30
