Exam 5 Flashcards
(128 cards)
1
Q
s/s including sweating, tachycardia, palpitations, heat intolerance are seen in which condition
A
hyperthyroidism
2
Q
s/s including dry mucus membranes, tachycardia, hypotension are seen in which condition
A
HHS (bc you’re dry & dehydrated!!!)
3
Q
IV fluids, insulin drip, monitor for decreased LOC, diaphoresis are interventions for what condition
A
HHS (or DKA but HHS needs more fluids)
4
Q
s/s include hypotension, hypothermia, lethargy, bradycardia are seen in which condition
A
myxedema coma
(severe hypothyroidism)
5
Q
very increased serum calcium levels
A
hyperparathyroidism
6
Q
glucose greater than 600
A
HHS (hyperosmolar hyperglycemic state)
7
Q
decreased sodium level
A
SIADH
(bc you have so much water in you since you’re retaining it so it’s diluting your sodium)
8
Q
decreased or normal TSH is seen in which condition
A
hyperthyroidism
9
Q
calcitonin is given to treat this endocrine disease
A
hyperparathyroidism
(bc we have too much calcium & need to TONE IT DOWN)
10
Q
calcium gluconate is given to help this endocrine condition
A
hypoparathyroidism
(bc we need more calcium!)
11
Q
radioactive iodine & thyroidectomy are treatments for which condition
A
thyroid cancer
12
Q
hydrate, walk each day, and minimize intake of calcium are interventions of what
A
hyperparathyroidism
**drink to pee out the calcium, walk bc brittle bones
13
Q
decreased aldosterone and cortisol are seen in which condition
A
Addison’s
14
Q
thyroid scan are used to test for which conditions
A
hyperthyroidism & cancer
(not usually hypothyroidism bc we are looking for enlarged thyroid or goiters)
15
Q
diuretics treat this endocrine condition
A
SIADH (soaked inside bc retaining water so given lasix to pee it all off)
16
Q
increased ACTH is seen in which condition
A
Cushing’s
bc it’s too much cortisol so ACTH is elevated bc adrenal hormone bc producing cortisol so ACTH is elevated due to tumor or some issue
17
Q
methimazole and PTU treat this endocrine condition
A
Hyperthyroidism
**PTU is drug of choice for preg women
**methiazole causes yellowing of skin
18
Q
increased PTH is seen in what condition
A
hyperparathyroidism
19
Q
monitor for tingly and muscle spasms are post op nursing interventions for what
A
thyroidectomy
20
Q
X ray for bone deformities is iteration for what condition
A
hyperparathyroid bc increased calcium (bone doesn’t have enough bc its going into the blood)
21
Q
increased ADH is seen in which condition
A
SIADH
**increased ADH look at the word!!!! siADH
22
Q
desmopressin or DDAVP treat this condition
A
DI
23
Q
increased cortisol level
A
Cushing’s
24
Q
cortisol levels and dexamethasone suppression tests (for adrenal!) are used for which condition
A
Cushing’s
25
daily weight, monitor for s/s of infection are for what condition
Cushing's bc too much cortisol so risk for infection
26
dehydration, fatigue, increased UoP are seen in what
DI
27
increased TSH level
hypothyroidism
28
tetany, numbness, and tingly are seen in which condition
hypoparathyroidism
29
fluid deprivation test is used for which condition
DI
30
nursing interventions such as cutting toe nails, keeping feet dry
DM
31
intermediate acting insulin onset, peak, duration time
1 - 1.5 onset, peak 4 - 12, duration 24 hrs
32
which condition is when the kidneys are unable to concentrate urine adequately, leading to dilute urine production despite fluid deprivation?
ADH is not secreted or there is a resistance of the kidney to ADH
DI
33
Fluid deprivation test is a period of fluid restriction where providers can distinguish this condition caused by inadequate ADH production or kidneys resistant to ADH
DI
34
central DI vs nephrogenic DI
central DI - lacks production of ADH from posterior pituitary
nephrogenic DI - kidneys don't respond properly to ADH
35
what hormone imbalance characterizes syndrome of inappropriate antidiuretic hormone secretion (SIADH)
elevated levels of ADH (antidiuretic hormone which is secreted from the posterior pituitary gland)
36
pt education for pt with DM
cut toenails, keep feet dry, check feet daily, monitor for sores
37
tetany, numbness, tingling sensations are s/s of what
hypoparathyroidism
38
what is main cause of low blood calcium levels in hypoparathyroidism
deficiency of PTH which leads to decreased calcium release form bones & impaired calcium absorption --> hypocalcemia
39
which diagnostic lab finding is associated with hypothyroidism
increased TSH
40
what med is commonly used to treat DI
DDAVP (Desmopressin, vasopressin)
41
how does cortisol affect immune function in conditions like Cushing's syndrome
cortisol suppresses immune function by impeding the activity of essential immune cells such as lymphocytes (including T cells and B cells) as well as macrophages
42
this is a blood analysis for cortisol levels after administration of synthetic glucocorticoid
during this, a pt is given a dose of it which should normally suppress cortisol production by adrenal glands but w/ cushings, the adrenal glands continue to produce cortisol despite giving this med
dexamethasone suppression test
43
elevated cortisol level is indicative of what condition
Cushing's syndrome
44
what meds are commonly used to treat hyperthyroidism
methimazole and PTU (propylthiouracil)
45
what diagnostic test is used to confirm hyperthyroidism
thyroid scan
45
how does walking contribute to bone health
improves bone density, stabilizes / strengthens bones, promotes calcium production
46
sweating, tachycardia, palpitations, heat intolerance
s/s of hyperthyroidism
46
increased ACTH (adrenocorticotropic hormone) is a hormonal imbalance for what condition
Cushing's
47
what med is typically administered for SIADH
diuretics
48
this is characterized by excessive releases of antidiuretic hormone (ADH) which causes water retention and hyponatremia
SIADH (syndrome of Inappropriate Antidiuretic Hormone Secretion)
49
primary treatment approach for syndrome of inappropriate antidiuretic hormone secretion (SIADH)
manage fluid balance / correcting hyponatremia bc pt is diluted due to being soaked inside
**diuretics !!! correct fluid overload by eliminating excess water from body
50
why is there elevated blood calcium levels in hyperparathyroidism
excess parathyroid hormone (PTH) promotes calcium release from bones into the blood
50
nursing interventions for DKA or HHS
imitate IV fluids
administer insulin drip
monitor for diaphoresis
monitor for decreased LOC
51
what can hyperparathyroidism cause and what med is used for treatment
hypercalcemia (high calcium), treat with calcitonin
51
what is important to monitor for pt undergoing thyroidectomy due to risk of damage or removal of parathyroid glands
monitor for tingling aka paresthesia / muscle spasms
(low calcium leading to hypoparathyroidism!)
52
decreased level of TSH indicates what type of thyroid function
hyperthyroidism
53
the function of this hormone is to control the excretion of water by the kidneys
vasopressin (ADH)
54
s/s of this include polydipsia (thirsty), polyuria, urine specific gravity of 1.001 - 1.005, limiting the intake of fluid does not control the disease
DI
55
pt who has bilateral adrenalectomy will require lifelong replacement of
cortisol
56
what hormone goes with the pancreas
insulin
57
what hormone goes with the adrenal glad
epinephrine
58
what hormone goes with the pituitary gland
TSH & ADH
59
normal A1C
less than 6.5 (4 - 6%)
above 6.5 = diabetes
59
what type of feedback is the endocrine / hormone system
negative feedback
60
normal calcium serum level
8.5 - 10.5
61
these are s/s of what
moon face
buffalo hump
purple striae
hirsutism
truncal obesity
Cushings
62
these are s/s of what
fatigue
weight loss/anorexia
n/v
hypoglycemia
salt cravings
muscle weakness
hyperpigmentation of the skin
Addisons
63
low urine specific gravity, high sodium
DI
64
low sodium, high urine specific gravity
SIADH
65
increased potassium, decreased glucose
Addison's
66
decreased potassium, increased ACTH and cortisol
Cushings
67
increased TSH, decreased T3 & T4
hypothyroidism
68
increased A1C, blood sugar
DM
68
decreased TSH, increased T3 & T4
hyperthyroidism
69
low calcium is what condition
hypoparathyroidism
70
increased calcium is what condition
hyperparathyroidism
71
normal potassium level
3.5 - 5.0
72
normal glucose level
70 - 110 mmg/dL
73
normal sodium level
135 - 145
74
normal urine specific gravity
1.010 - 1.030
75
which hormone is secreted by the posterior pituitary
vasopressin
corticosteroids are secreted be adrenal cortex
75
positive trousseau sign and / or positive Chvostek sign means what
Trousseau - tetany which is when you b/p cuff for 3 mins
Chvostek - tapping face makes your face twitch / spasm
**low calcium
76
disorder that results fro excessive secretion of somatotropin (growth hormone)
acromegaly (enlargement of Body parts)
77
which symptom of thyroid disease is seen in older adults
weight loss and A Fib
78
glycosylated hemoglobin reflects blood glucose concentrations over how long
3 months
79
by product of fat breakdown in the absence of insulin and accumulates in the blood / urine
ketones
79
80
order of insulin administration
CLOUDY CLEAR CLEAR CLOUDY
inject air into cloud
inject air into clear
draw up clear
draw up cloudy
NPH is cloudy, regular is clear
81
initial treatment that should be implemented first for a pt with DKA
infuse 0.9% NS 1L/hr for 2 hours
correct dehydration prior to correcting hyperglycemia
81
peak for glargine insulin
NO PEAK bc long acting insulin
82
what will help confirm if a pt has DKA
assess client's breath odor for fruity breath
83
what clinical manifestation of type 2 diabetes occurs if glucose levels are very high
blurred vision
84
weight loss meds
orlistat
lorcaserin
liraglutide
phentermine
phentermine / topiramate ER
naltrexone / bupropion
Orlistat - Reduction in fat absorption, leading to weight loss
Lorcaserin - Appetite suppression, resulting in reduced food intake
Liraglutide - Delayed gastric emptying and reduced appetite
Phentermine - Appetite suppression, leading to reduced food intake
Phentermine/topiramate-ER - Suppression of appetite and reduction in food intake
Naltrexone/bupropion - Diminished appetite and cravings, leading to reduced food consumption
85
this is acute adrenocortical insufficiency characterized by severe hypotension, cyanosis, fever, n/v, shock, h/a, abd pain, diarrhea, confusion, restlessness AKA SIGNS OF SHOCK
Addison's crisis
86
risk factors for Addison's disease
- therapeutic use of corticosteroids (most common)
- Autoimmune disorders
- Infections like tuberculosis or histoplasmosis
- Surgical removal of adrenal glands
- Medications such as rifampin, barbiturates, ketoconazole, and tyrosine kinase inhibitors
- Metastatic cancers such as lung, breast, colon, and melanoma
87
how to diagnose Addison's disease
lab tests early morning serum cortisol & plasma ACTH levels
**increased plasma ACTH levels and low serum cortisol levels
**might also have hypoglycemia, hyponatremia, hyperkalemia, leukocytosis
88
treatment for Addisons disease
IV hydrocortisone w/ NS or dextrose solution
antbx if infection
lifelong replacement of cortiocosteroids may be necessary
89
risk factors for Cushing's
- Prolonged use of corticosteroid medications (most common)
- Pituitary adenomas (producing excess ACTH)
- Adrenal adenomas or carcinomas
- Ectopic production of ACTH by tumors, commonly bronchogenic carcinom
90
treatment for Cushing's syndrome
depends on the cause; surgery (transsphenoidal hypophysectomy or adrenalectomy) is often required.
- Radiation therapy may be utilized for pituitary tumors.
- Adrenal enzyme inhibitors (e.g., metyrapone, ketoconazole) may be used to reduce hypercortisolism.
- Gradual tapering of corticosteroid medications if the syndrome is caused by exogenous sources.
90
Primary adrenal insufficiency due to dysfunction of the adrenal glands, often autoimmune, tuberculosis, or histoplasmosis-related destruction of adrenal tissue.
Addisons
91
Resulting from prolonged exposure to high levels of cortisol, either due to excess production by the adrenal glands, pituitary adenomas producing excess ACTH, or exogenous corticosteroid use.
Cushings
92
how to diagnose Cushing's
serum cortisol, urinary cortisol, low dose dexamethasone suppression test to confirm
93
this leads to defieicny in antidiuretic hormone (ADH or vasopressin) which arises from damage to the hypothalamus or the posterior pituitary gland
DI
94
risk factors for DI
Central DI: Head trauma, surgery, infection, inflammation, brain tumors, cerebral vascular disease
- Nephrogenic DI: Kidney injury, medications (e.g., lithium), electrolyte imbalances (e.g., hypokalemia, hypercalcemia)
- Dipsogenic DI: Defect in hypothalamus, head injury, surgery, infection, inflammation, pituitary gland tumors
95
how to diagnose DI
- Fluid deprivation test
- Plasma and urine osmolality studies
- Measurement of plasma ADH levels
- Trial of desmopressin therapy
- Evaluation of plasma and urine osmolality
- Identification of inability to concentrate urine
96
treatment for DI
- Monitoring for signs of dehydration
- Providing patient education
- Replacement of ADH
- Ensuring adequate fluid replacement
- Addressing underlying causes
96
- Excretion of large volumes of diluted urine
- Low specific gravity of 1.001 to 1.005
- Extreme thirst (polydipsia)
- Consumption of large amounts of fluids
- Craving cold water
- Gradual or sudden onset in adults
s/s of what
DI
97
how to give desmopressin for DI
intranasally which causes vasoconstriction
should see a decrease in UoP
98
Disruption in the normal feedback mechanism that controls the release and inhibition of antidiuretic hormone (ADH). This disruption leads to the excessive release of ADH, which results in the inability of the kidneys to excrete dilute urine, causing fluid retention and dilutional hyponatremia (low sodium levels in the blood).
SIADH
99
risk factors for SIADH
Bronchogenic carcinoma, severe pneumonia, pneumothorax, CNS disorders (e.g., head injury, infection), and certain medications (e.g., vincristine, - phenothiazines, tricyclic antidepressants, thiazide diuretics, nicotine) increase susceptibility to SIADH.
100
how to diagnose SIADH
- Diagnosis involves assessing serum sodium levels and urine osmolality.
- Imaging may be needed to identify underlying causes, such as lung tumors or CNS lesions.
101
Patients exhibit signs of hyponatremia, including neurologic symptoms (e.g., confusion, weakness, seizures) and fluid retention-related symptoms (e.g., edema, weight gain).
s/s of what
SIADH
102
treatment of SIADH
-address the underlying cause, fluid restriction, and, in severe cases, administration of hypertonic saline or diuretics like furosemide.
- Close monitoring of fluid balance, neurologic status, and pt education about treatment & self-care
103
Graves disease causes what
hyperthyroidism
exophthalmos (protrusion of eyeball)
104
If sodium is high then scpecific gravity is ...
LOW!
and vice versa (inverse!)
105
pt is post op thyroidectomy.. what is indicative of thyroid crisis
dyspnea
abd pain/GI symptoms
mental confusion
tachycardia
106
constipation, menorrhagia (heavy period) or amenorrhea (no period), dry skin, hoarseness are s/s of what
hypothyroidism
107
if a pt undergoes hypophysectomy (for cushings), what should nurse monitor pt for
nasal drainage - test foc glucose for CSF leak!
108
low Na, high K, high Ca, high BUN, hypoglycemia
Addison's
109
clients who have acute adrenal insufficiency are what
hyperkalemic and hyponatremic
110
warm skin, dry skin, fruity breath
hyperglycemic
111
cool skin, clammy skin, blurred vision
hypoglycemic
112
fruity odor breath, nausea
positive ketones
HHS or DKA
DKA
113
seizure active and reversible paralysis
negative ketones , pH greater than 7.4
HHS or DKA
HHS
114
initial treatment for DKA
rapid IV infusion of 0.9% sodium chloride over the first hr to replace fluid loss
115
how to prevent DKA
notify provider if blood glucose is over 250
116
s/s include
Increased urine output (polyuria)
Weak peripheral pulses bc no vol
Hypotension bc no vol
Increased HR bc compensating
Polydipsia – thirsty
Dilute urine with low specific gravity
ataxia
DI
117
treatment for DI
ADH replacement such as DDAVP or vasopressin
