Unit 1 - Endocrine Problems

Question 1

What is Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Answer 1

Abnormal secretion of ADH by the posterior pituitary gland

Question 2

What are the manifestations of SIADH?

Answer 2

Fluid retention, serum hyper-osmolality, dilution also hyponatremia, hypochloremia, concentrated urine, increased intravascular volume, and normal renal function

Question 3

What is the most common cause of SIADH?

Answer 3

Lung cancer

Question 4

What is the goal of treatment in SIADH?

Answer 4

Restore fluid and electrolyte balance

Question 5

What are the fluid restrictions for minor cases of SIADH?

Answer 5

800-1000 ml/day

Question 6

What are the treatment for severe SIADH?

Answer 6

Fluid restrictions of 500mL/day, IV hypertonic saline, IV Lasix, and Tolvaptan to block ADH effect on renal tubule

Question 7

What must be monitored in the acute care of SIADH?

Answer 7

Decreased U/O with increased concentration, sudden increase in weight or decrease in Na

Question 8

What assessments are necessary for acute care of SIADH?

Answer 8

LOC, VS, I&O, Urine concentration, daily weight, s/s hyponatremia, heart & lung sounds

Question 9

What are nursing managements for SIADH?

Answer 9

HOB flat, protect from injury, ice chips to relieve thirst, offer gum, hard candy to suck on or moisture spray for thirst

Question 10

What is diabetes insipidus (DI)?

Answer 10

Deficiency in production or renal response to ADH

Question 11

What are the manifestations of DI?

Answer 11

Polydipsia, polyuria, fluid and electrolyte imbalances, and increased serum osmality

Question 12

What are the types of DI?

Answer 12

Neurogenic, nephrogenic, and psychologic

Question 13

What is neurogenic DI?

Answer 13

Lesion in brain interferes with synthesis, transport, or release of ADH

Question 14

What is nephrogenic DI?

Answer 14

Decreased renal response to ADH

Question 15

What is psychologic DI?

Answer 15

Structural lesion in thirst center or psychological disorder causes increased fluid intake

Question 16

What is the goal of DI treatment?

Answer 16

Treat primary cause of DI and maintain fluid and electrolyte balance

Question 17

What are the acute care DI nursing interventions?

Answer 17

Monitor I&Os, daily weights, VS, ensure adequate fluid intake, and evaluate efficacy of DDVAP

Question 18

What does the DI patient need to be taught about DDAVP?

Answer 18

Observe for weight gain, headaches, restlessness, signs of hyponatremia, and increasingly dilute urine

Question 19

What is the goal of treatment in hyperthyroidism?

Answer 19

Block adverse effects of thyroid hormones and stop their secretion

Question 20

What is the therapy for hyperthyroidism?

Answer 20

PTU or tapazole, radioactive iodine (RAI), surgery, and nutritional

Question 21

What are dietary requirements for patients with hyperthyroidism?

Answer 21

High caloric intake, 1-2g protein/kG of ideal body weight, and avoid GI stimulating foods

Question 22

What are the interventions for Acute Thyrotoxicosis?

Answer 22

Medication, supportive care, quiet room, exphothalamous care

Question 23

What are the interventions for thyroid surgery?

Answer 23

Iodine administration, PTU administration, pre-op teaching, pot-op care

Question 24

What is the goal of hypothyroidism treatment?

Answer 24

Return to euthyroid state

Question 25

What is goal of treatment in Cushing's Disease?

Answer 25

Normalize hormone secretion

Question 26

What is Cushing's Disease?

Answer 26

Pituitary release too much ACTH, which results in over production of cortisol

Question 27

What drug therapy is used in Cushing's Disease?

Answer 27

Mitotane

Question 28

What is Addison's Disease?

Answer 28

Adrenal glands hyposecrete cortisol

Question 29

How is Addison's disease treated pharmacologically?

Answer 29

Hydrocortisone

Question 30

What are the acute nursing interventions with Addison's Disease?

Answer 30

Frequent assessments, daily weights, corticosteroids, protect from infection, light/temperature/environmental extremes

Question 31

What are acute complications of DM?

Answer 31

Hypoglycemia, DKA, and HHS

Question 32

What is the medical treatment of mild to moderate hypoglycemia?

Answer 32

Give 10-15 mL of fast acting simple CHO, retest blood glucose after 15 mins, once greater than 4 mmol/L give a protein or starch

Question 33

What is the medical treatment of severe hypoglycemia?

Answer 33

Inject 1mg Glucagon SC or IM, IV administration of 25-50 mL D50W over 1-3 mins

Question 34

What causes DKA?

Answer 34

Fat is metabolized in absence of insulin causing release of ketones in blood

Question 35

What are the clinical manifestations of DKA?

Answer 35

Hyperglycemia, electrolyte imbalance, and acidosis

Question 36

What are the common causes of DKA?

Answer 36

Decreased or missed dose of insulin, illness or infection, undiagnosed or untreated diabetes

Question 37

What is the nursing management of DKA?

Answer 37

Monitor fluid status, blood glucose, renal fx, electrolyte levels, ABGs, and mental status

Question 38

What care plan issues need to be addressed for hyperthyroidism?

Answer 38

Energy management, and nutritional management

Question 39

What are the case plan priorities for hypothyroidism?

Answer 39

Weight management, nutritional management, constipation, and impaired memory