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HESI NCLEX-RN EXAMINATION > Endocrine System > Flashcards

Endocrine System Flashcards

1
Q

What are they levels of t3, t4 and tsh in hyperthyroidism?

A

High t3 and t4

Low TSH

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2
Q

What is thyroid storm?

A

Thyroid storm is a life threatening emergency that occurs with uncontrolled hyperthyroidism due to graves disease. Symptoms include fever, tachycardia, agitation, anxiety, and HTN.

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3
Q

What drugs are used to treat thyroid storm?

A

Propylthiouracil and methimazole. These block the synthesis of T3 and T4
-Propranolol may be given to decrease excessive sympathetic stimulation

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4
Q

What is the diet for hyperthyroidism?

A

High calorie
High protein
Low caffeine
Low fiber

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5
Q

What should you have bedside postoperatively for a thyroidectomy?

A

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

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6
Q

What is the normal serum calcium level?

A

9.0 - 10.5 mEq/L

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7
Q

What is the best indicator of parathyroid problems?

A

A decreased in the clients calcium compared to the preoperative value

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8
Q

How do watch for tetany?

A

-Monitor serum calcium
-Check for tingling of toes and fingers and around the mouth
-Check Chvostek sign
-Check Trousseau sign
too low calcium

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9
Q

Hyperthyroidism is also called

A

Graves Disease and Goiter

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10
Q

Hypothyroidism is also referred to as

A

Hashimoto’s Disease and Myxedema

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11
Q

What precipitates a myxedema coma?

A 
acute illness
withdrawl of thyroid medication
anesthesia
use of sedatives
hypoventilation
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12
Q

What is Addisions Disease?

A

Primary adrenocortical deficiency/ hypo function of the adrenal cortex

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13
Q

What is the diet requirements for a patient with Addison’s disease?

A

High Sodium
Low Potassium
High Carbohydrate
3L of fluid per day

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14
Q

What happens in an Addison’s Crisis?

A

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

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15
Q

What is Cushing’s Syndrome?

A

Excess adrenocorticoid activity

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16
Q

Physical assessment of cushing’s syndrome

A 
Mood face
truncal obesity
buffalo hump
abdominal striae
hirsutism
17
Q

What are the electrolyte balances in Cushing’s Syndrome?

A

Hyperglycemia
Hypernatremia
Hypokalemia

18
Q

Teach clients to take steroids with meals

A

to prevent gastric irritation, they should never skip a dose.

19
Q

What are the characterisitics of HHNKS (Hyperosmolar hyperglycemia nonketotic syndrome)

A 
Hyperglycemia >600
Plasma hyperosmolality
Dehydration
Change in mental status
Absent ketone bodies
20
Q

What is glycosylated HGB (HbA1c)

A

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
Q

The body’s response to illness and stress is to produce

A

glucose. Therefore, any illness result in hyperglycemia

22
Q

What is basal insulin?

A

Long acting and intermediate acting insulin that suppresses glucose production between means and overnight

23
Q

What is bolus insulin

A

limits hyperglycemia after meals. Rapid or short acting. Clear

24
Q

Correction factor

A

The amount of insulin needed to correct hyperglycemia, usually give pre meal

25
Q

What diagnostic test is used to determine thyroid activity

A

T3 and T4

26
Q

What condition results from all treatments of hyperthyroidism

A

hypothyroidism, requiring thyroid replacement

27
Q

State three symptoms of hyperthyroidism and three symptoms of hypothyroidism

A

Hyperthyroidism: weight loss, heat intolerance, diarrhea
Hypothyroidism: Fatigue, cold intolerance, weight gain

28
Q

List five important teaching aspects for clients who are beginning corticosteroid therapy

A
  • 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
Q

Describe the physical appearance of clients who have Cushing syndrome

A 
Moon face
Obesity in trunk
Buffalo hump in back 
Muscle atrophy
Think skin
30
Q

Which type of diabetes always requires insulin replacement

A

Type 1

31
Q

Which type of diabetes sometimes requires no medication

A

Type 2

32
Q

List five symptom’s of hyperglycemia

A 
Polydipsia
Polyuria
Polyphagia
Weakness
Weight loss
33
Q

List five symptoms of hypoglycemia

A 
Hunger
Lethargy
Confusion
Tremors or shakes
SWeating
34
Q

Name the necessary elements to include in teaching client newly diagnosed with diabetes

A 
The underlying patho
Management and treatment
Meal planning
exercise program
insulin administration
sick day management
symptoms of both hypo and hyper
foot care
35
Q

In fewer than 10 steps, describe the method of drawing up a mixed dose of insulin
Clear to Cloudy

A
  • Identify the prescribed dose and type of insulin
  • Store unopened insulin in the refrigerator
  • Opened insulin may be kept at room temperature
  • Draw up regular insulin first
  • Rotate injection sites
  • May reuse syringe by recapping
36
Q

Identify the peak action time of the following types of insulin:
Rapid acting
Intermediate acting
Long acting

A

Rapid acting: 2-4 hours
Intermediate: 6-12
Long; 14-20

37
Q

When preparing a client with diabetes for discharge, the nurse teaches the client the relationship between stress, exercise, bedtime snacking, and glucose balance. State the relationship of each

A
  • Stress and stress hormones usually increase glucose production and increase insulin need
  • Exercise may increase the change of hypoglycemia therefore client should always carry a fast acting source of carbohydrates
38
Q

When making night rounds, the nurse notes that a client prescribed insulin is complaining of a headache, slight nausea, and minimal trembling. This clients hand is cool and moist. What is the client most likely experiencing

A

hypoglycemia

39
Q

Identify five foot care intervention that should be taught to a client with diabetes.

A

-Check feet daily
-report any break or sores
-wear well fitting shoes
-never go barefoot
-never personally remove corns or calluses
-wash feet daily with mild soap
-

HESI NCLEX-RN EXAMINATION (6 decks)

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