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NCA spring > EXAM 3 - endocrine > Flashcards

EXAM 3 - endocrine Flashcards

(102 cards)

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1
Q

The nurse provides care for a conscious client with severe ketoacidosis. The nurse anticipates which treatment modality?

A

insulin

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2
Q

The nurse provides care for a client with Addison disease. The nurse assesses for which of the following conditions most importantly?

A

dysrhythmias

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3
Q

A client is evaluated in the outpatient clinic for hypothyroidism. The nurse expects the client to exhibit which symptom?

A

fatigue

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4
Q

A client is recovering from a subtotal thyroidectomy. The nurse identifies which symptom indicating damage to the parathyroid gland?

A

HYPOCALCEMIA:
numbness in fingers
face twitch (pos chovstek)
arm twitch (pos trosseaus)
stridor

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5
Q

The nurse counsels a client about preparation for a subtotal thyroidectomy. The client was prescribed an iodine solution to take prior to the surgery, and asks the nurse why this is necessary?

A

prevents post op hemorrhage

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6
Q

The nurse understands that glucocorticoids provide a source of energy during a stressful situation. Which statement best describes the action of glucocorticoids?

A

converts fat to glucose

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7
Q

A client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) reports nausea, vomiting, headache, and confusion. Which nursing intervention is an essential part of care

A

seizure precautions

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8
Q

A client has laboratory tests regarding thyroid function. Which test results indicate to the nurse the client an underactive thyroid gland?
3

A

high TSH
low BMR
high cholesterol

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9
Q

hormones produced by anterior pituitary

A

TSH and GH

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10
Q

thyroid produces what hormone

A

t3 / t4

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11
Q

posterior pituitary produces what hormone

A

ADH

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12
Q

is Na and K high or low in SIADH

A

low Na and high K

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13
Q

is Na and K high or low in DI

A

high NA and low K

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14
Q

is Na and K high or low in cushings

A

high Na, low K+

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15
Q

is Na and K high or low in addisons

A

low Na, high K

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16
Q

is Na and K high or low in DKA

A

low K , low Na

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17
Q

is Na and K high or low in HHS**

A

low K

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18
Q

tx for hyponatremia

A

push NaCl slowly

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19
Q

tx for hypernatremia

A

hypotonic saline

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20
Q

what is SIADH

A

increased ADH

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21
Q

9 ss of SIADH

A

hyponatremia
urinary retention
serum HYPOosmolality
fluid retention
tachycardia
anorexia
n/v
lethargy
polydypsia

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22
Q

positioning in bed for SIADH

A

flat HOB

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23
Q

4 interventions for chronic SIADH

A

fluid restriction
restrict K and increase Na
monitor F and E
ice chips for thirst

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24
Q

MOA of conivaptan

A

vasopressin - causes urination by increasing ADH

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25
what to monitor for with vasopressin
liver function tests
26
what can diuretics cause
hypokalemia
27
what is DI
too little ADH
28
7 SS OF DI
high osmolality high urine output (polyuria >2L) low urine SG HYPER natremia fatigue weakeness polydypsia
29
nutrition for DI
lower Na in diet
30
desmopressin function
ADH supplement
31
indomethacin MOA
increases renal response to ADH
32
hyopituitary lab values 2
low TSH low ACTH
33
tx meds for hypopituitary
LIFELONG hormone replacemnt
34
lab value for acromegaly
INC GH
35
octreotide use
lowers GH in acromegaly
36
hypophysectomy is
removal of pituitary
37
position in bed for hypophysectomy
30 deg
38
what are pts at risk for post hypophysectomy
SIADH and DI
39
what is most important action post hypophysectomy
assess for CSF
40
teaching post hypophysectomy
no straining, bending, lifting, coughing
41
lab values for hypothyroid and hyperthryoid
hypo: high TSH and low T3/4 hyper: low TSH and high T3/T4
42
7 ss of hypothyroid
decrease sweat cold intolerance weight gain constipation LOW HR (bradycardia) puffy face high cholesterol
43
4 ss of hyperthyroid
diaphoresis weight loss diarrhea HIGH HR (tachycardia)
44
3 shared ss of hypo and hyperthyroid
fatigue hair loss insomnia
45
MOA of levothyroxine
inrease T4
46
2 nursing actions for levothyroxine
monitor for DYRHYTHMIAS and chest pain
47
4 teaching for levothyrox
lifelong taking empty stomach increase fiber dont switch brands
48
what are pts who have exothalamos at risk for
corneal lesions so tape over eyes
49
popythyuracil MOA
decrease thryoid hormone synthesis
50
methimazole MOA
decrease thryoid hormone synthesis
51
main teaching for antithyroid meds
dont abruptly stop
52
MOA of metoprolol in hyperthryoid
relieves symptoms of hyper, but not synthesis
53
when are beta blockers used in hyperthryoid
during thyroid storm
54
iodine MOA
dec T3/4 synthesis
55
if pt has bucchal swelling, salivating, n/v what is happening and what to do
too much iodine, discontinue it
56
teaching for someone doing RAI
use separate laundry, food, etc
57
6 nutrition inc or dec for hyperthryoid
dec fiber dec caffeine dec iodine (like fish) inc cal inc carb inc protein
58
what does thyroiectomy accomplish
dec T3/T4
59
most important complication of thyroidectomy
LOW CA because parathyroid may have been remvoed
60
4 main nursing actions for thyroidectomy
trach tray O2 suction maintain airway
61
4 teaching for thyroidectomy post op
lifelong meds regular exercise AVOID EXTREMES IN TEMP etc WATCH FOR SS OF HYPOTHYROID
62
9 ss of cushings
HIGH BP (HTN) edema purple striae increased infection risk buffalo hump trunchal obesity thin arms and legs moon face HYPERNATREMIA
63
what VS for addisonian crisis
LOW BP and HIGH HR
64
2 labs for addisons
low cortisol and low aldosterone
65
5 ss of addisons
bronze skin N/v exhaustion cramps salt cravings
66
how to dx cushings
dexamethasone test - if cortisol is increased then its pos for cushings
67
how to dx addisons 2
ACTH stimulation - if cortisol doesnt rise, then pos for addisons CRH stim - if no cortisol then pos for addisons
68
most important teaching for cushings
body image
69
most important teaching for cushings and addisons
avoid extreme temps
70
IF SOMEONE IS HYPOKALEMIA WHAT IS PRIORITY OVER EVERYTHING ALWAYS
cardiac monitoring
71
what is most important to monitor after adrenalectomy
F and E
72
corticosteroid MOA
convert fat to glucose
73
8 SE of corticosteroids
inc glucose low BP lowK high Na low CA delayed healing infection prone dec protein
74
important corticosteroid teaching when someone is stressed
inc dose when stressed
75
8 SS of hyperglycemia and what are 2 disorders with hyperglycemia
glyocuria diarrhea cramps polyuria weakness fatigue blurry vision mood swings n/v DKA and HHS
76
what is number one cause of low K
DKA
77
16 ss of DKA
kusmall resp ketosis acidosis dehydration dry membranes tachycardia increase urine lethargy weakness sweet breath low bicarb high CO2 ketones in urine hot dry skin inc thirst acidic PH of blood
78
difference between HHS and DKA
HHS has no ketones in urine, no acidosis, no sweet breath, no KUSMALL
79
tx for DKA
INSULIN
80
9 ss of hypoglycemia
shakiness pallor hunger confusion change in mental visual disturb diaphoresis palpitations nervousness
81
3 causes of hypoglycemia
alc without food increased exercise beta blockers
82
if BG is below 70 what to do
give carb and juice and recheck in 15
83
what to do if BG is low but above 70
investigate further
84
if pt is unresponsive with low BG what to do
give dextrose and glucagon
85
how to dx diabetes
H1ac (2-3 mo fasting) or 8 hour fast and <99 is normal and 100-125 is prediabetes
86
what is angiography
complication of diabetes - damage to blood vessels
87
teaching for retinopathy
routine eye exams
88
sensory vs autonomic neuropathy
sensory is loss of LE sensation and autonomic is systemic symptoms like gastroparesis
89
capsacin use
sensory neuropathy
90
amitriptyline use
inc pain signals to brain
91
diabetic demopathy
red brown oval patches
92
acanthsis nigricans
velvety skin
93
necrobiosis diabeticorum
red yellow lesions
94
what does glyburide do
stimulates insulin production
95
if Q comes up with boxes and assessment datanew nclex what to choose
give fluids + sugar
96
OPD of short acting insulin
30 2-5
97
OPD of intermediate acting insulin
1-2 4-12
98
4 nutriton teaching for diabetes
low fat low carb high fiber limit alcohol
99
exercise teaching for diabetics
dont exercise if BG > 300 exercise 1 hr after meal monitor before during after exercise
100
teaching for someone with insulin pump
need backup insulin
101
teaching after pancreas transplant
need lifelong immunosupression
102
if pt calls and has n/v diarrhea is suck what to do
monitor BG every 2-4 hours

NCA spring (9 decks)

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