endocrine test

Question 1

overweight bmi

Answer 1

25 to 29.9

Question 2

obese bmi

Answer 2

exceeding 30

Question 3

severe/extreme bmi

Answer 3

exceeding 40

Question 4

metabolic syndrome criteria

Answer 4

Waist circumference >35 in women and >40 in men
High LDL level — 150 mg/dL
Less than 40 mg/dL in men or less than 50 mg/dL in women HDL
Increased blood pressure — 130/85 or higher
high fasting blood glucose

Question 5

Orlistat education

Answer 5

educate the patient that they need to take a multivitamin and eat a nutrient rich diet

Question 6

Liraglutide education

Answer 6

important to educate the patient on how to give sub Q injections. Demonstration with teach back

Question 7

Naltrexone and Bupropion combination purpose and contraindications

Answer 7

Can help with obesity when combined. Contraindications: HTN, epilepsy, SI, hx eating disorders, alcohol or substance abuse

Question 8

Intragastric balloon therapy s/s to look for

Answer 8

Increased abd girth, abd pain, constipation > Indicates balloon rupture

Question 9

effects of obesity

Answer 9

Mechanics of ventilation and circulation
Pharmacokinetics and pharmacodynamics
Skin integrity
Body mechanics and mobility

Question 10

Roux-en-Y Gastric Bypass Notes

Answer 10

Involves restrictive and malabsorption components. EDUCATE: Food intake needs to be limited. Absorption of calories and nutrients will be limited.

Question 11

Gastric Banding Education

Answer 11

EDUCATE patient not to eat like normal. Very very small amounts of water

Question 12

Biliopancreatic Diversion with Duodenal Switch notes

Answer 12

Nutrient dense foods in small, frequent meals. Keep at LOW fowler during meal time and for 20-30 minutes after meal time to delay stomach emptying and can decrease risk of dumping syndrome.

Beverages should be consumed 30 minutes before or 60 minutes after meals

Question 13

gastric surgery and female patients of childbearing age

Answer 13

After bariatric surgery female clients of childbearing age should use contraceptives for at least 18 months after surgery to prevent pregnancy.

Question 14

potential complications of bariatric surgery

Answer 14

anastomotic leak – a leaking of gastric content into peritoneal space that can lead to sepsis. Risk includes older age males, greater body mass (stage 3 obesity), nonspecific s/s including fever, abdominal pain, tachycardia, leukocytosis

Dumping syndrome s/s: nausea, weakness, diaphoresis, palpitations, syncope, diarrhea, hypoglycemia (priority assessment after immediate symptoms)

Question 15

dumping syndrome s/s

Answer 15

nausea, weakness, diaphoresis, palpitations, syncope, diarrhea, hypoglycemia (priority assessment after immediate symptoms)

Question 16

anastomotic leak s/s

Answer 16

fever, abdominal pain, tachycardia, leukocytosis

Question 17

gestational diabetes cause

Answer 17

Gestational diabetes happens during pregnancy due to secretions of placental hormones that causes insulin resistance

Question 18

exocrine glands go into the

Answer 18

glands and ducts (includes salivary glands)

Question 19

endocrine glands go into the

Answer 19

bloodstream

Question 20

Over secretion of acth or gh leads to

Answer 20

Cushing’s syndrome, gigantism, acromegaly

Question 21

Under secretion of acth or gh leads to

Answer 21

dwarfism, panhypopituitarism

Question 22

Before during and after hypophysectomy

Answer 22

blood glucose monitoring and monitor the stools for blood

Question 23

notes on diabetes insipidus

Answer 23

ENOURMOUS amount of very clear urine. With a specific gravity of 1.00-1.05

Question 24

Calcitonin helpful hint

Answer 24

tone the calcium down

Question 25

Parathormone regulates

Answer 25

calcium and phosphorus balance

Question 26

aldosteronism (conn's syndrome)

Answer 26

when the adrenal glands make too much aldosterone. Monitor BP and K+. Potassium will be low **hypertension**, headache, hyperhidrosis (excessive sweating), hyper-, hyperglycemia**

Question 27

what is essential for thyroid hormone production

Answer 27

iodine. TSH stimulates the release of T3 and T4

Question 28

classic manifestation of hypothyroidism

Answer 28

Constipation Educate to increase fiber, water, movement

Question 29

Hashimoto disease symptoms

Answer 29

facial edema, cold intolerance, bradycardia, constipation

Question 30

Thyroid storm aka thyrotoxic crisis

Answer 30

**promote relaxation** – insomnia, heat intolerance, tachycardia, nervousness, tremors, warm soft and moist skin, increased appetite, cardiac dysrhythmias, weight loss can occur with an acute overdose of levothyroxine (insomnia, heat intolerance, tachycardia)

Question 31

most common drug to reduce heart rate

Answer 31

beta blockers

Question 32

Tetany

Answer 32

general muscle hypertonia, with tremor and spasmodic or uncoordinated contractions occurring with or without efforts to make voluntary movements

Question 33

Chvostek sign

Answer 33

a sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth, nose, and eye – hypocalcemia -

Question 34

Trousseau sign

Answer 34

carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with a blood pressure cuff

Question 35

If a patient gets a thyroidectomy and reports sores on feet and around the lips

Answer 35

it means the calcium is probably low because loss of calcitonin. Check for hypocalcemia. -- always check electrolytes --

Question 36

Addison’s disease

Answer 36

characterized by weight loss, muscle weakness, fatigue, low blood pressure, loss of body hair, vitiligo, hyperpigmentation in both exposed and non exposed parts of the body. hypotension is a big component in Addison’s disease. Get a daily weight

Question 37

Cushing’s Syndrome education

Answer 37

Educate: when a pt is on corticosteroid watch for osteoporosis, hyperglycemia, can mask signs of infection

Question 38

Thyroidectomy

Answer 38

can lead to hypocalcemia Priority is ABCs – can lead to airway problems

Question 39

Diagnostic Findings of Diabetes

Answer 39

Very viscous, honey like blood Keep A1c less than 6.5%

Question 40

Diabetes management has five components:

Answer 40

Nutritional therapy Exercise Monitoring Pharmacologic therapy Educationi

Question 41

insulin and periods of stress

Answer 41

during periods of high levels of stress such as surgery and trauma BG tends to increase.

Question 42

Before adrenalectomy

Answer 42

pre-treat with solumedrol (corticosteroids) and continue treatment after surgery

Question 43

Diabetic pt is sick

Answer 43

in order to prevent DKA instruct the patient to drink fluids every hour eat frequent small meals, blood glucose and urine ketones must be assessed every 4 hours when sick, take the usual doses of insulin

Question 44

DKA manifestations

Answer 44

hyperglycemia, acidosis, dehydration, hypotension

Question 45

DKA hydration guidelines and treatment

Answer 45

**N/S 15 mL/kg/hour** Rehydration with IV fluid IV continuous infusion of regular insulin Reverse acidosis and restore electrolyte balance

Question 46

DKA things to monitor

Answer 46

Monitor blood glucose, renal function and urinary output, ECG, electrolyte levels, VS, lung assessments for signs of fluid overload

Question 47

Management of HHS

Answer 47

Rehydration Insulin administration Monitor fluid volume and electrolyte status

Question 48

long term complications of diabetes

Answer 48

**Keep bg under control is the best protection against long term effects.** Can lead to neuropathy, microvascular problems and CAD, cerebrovascular disease

Question 49

acute overdose of levothyroxine s/s

Answer 49

insomnia, heat intolerance, tachycardia, sweating, hyperthermia

Question 50

treatment for thyroid storm

Answer 50

reduce heart rate, reduce temperature relaxation techniques, beta blockers, ice packs, cold washcloths, remove blankets.