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Endocrine Disords
Endocrine Disorders
Question | Answer |
---|---|
What are the 7 functions of the endocrine system? | Reproduction; Stress response; Electrolyte balance; Energy metabolism; Growth; Maturation; Aging |
What is the difference between exocrine and endocrine glands? | Exocrine secrete into ducts and endocrine secrete directly into blood. |
What are the different feedback systems? | Negative; Positive; Complex; NS control; Rhythms |
What is one of the important areas to assess when performing a physical assessment of the Endocrine system? | Mental/emotional status. |
What are the disorders for the anterior pituitary and the Posterior Pituitary? | AP= Acromegaly; PP= SIADH |
What are the Thyroid disorders? | Hyper and Hypothyroidism |
What are the parathyroid disorders? | Hyper and Hypoparathyroidism |
What are the Adrenal disorders? | Cushing's syndrome, and Addison's disease |
What is Acromegaly? | Overproduction of GH leading to overgrowth of bones and soft tissue. (usually caused by benign pituitary tumor) |
What are some assessment findings for Acromegaly? | Hyperglycemia, polydipsia, polyuria, enlarged laryngeal tissues, visual disturbances, lethargy, muscle weakness. |
What are some possible RN diagnosis for Acromegaly? | Disturbed body image, impaired physical mobility, ineffective airway clearance. |
What is the Care for Acromegaly? | Surgery/Radiation therapy and hormone replacement for life; Drug therapy to reduce GH to normal levels. |
What are some nursing managements for Acromegaly? | Provide emotional support; Monitor blood sugar levels; Admin Meds; Safety; Monitor side effects of radiation. |
What is SIADH? | Abnormal production or sustained secretion of ADH |
What does SIADH cause? | Fluid retention, serum hypoosmolality, dilutional hyponatremia, hypochloremia, concentrated urine. |
What are some assessment findings for SIADH? | Low urine; increase body weight; muscle cramping, pain/weakness; Na decrease, vomiting, abdominal cramps, muscle twitching, seizures; lethargy, headache, confusion, coma. |
What is the collaborative care for SIADH? | Fluid restrictions; Loop diuretics; IV hypertonic saline solution |
What is the Nursing management for SIADH? | Monitor daily weights and LOC; I & O's and Na serum levels; Provide safety; Education |
What is Graves disease? | (hyperthyroidism) Autoimmune disease with unknown etiology; development of TSH receptor antibodies; Thyroid enlargement & excess thyroid hormone secretion. May destroy thyroid tissue = hypothyroidism. |
What is a Thyrotoxic crisis? | Heightened hyperthyroid signs (Severe tachycardia; HF; Shock; hyperthermia; restlessness; seizures). |
What are the treatments for Thyrotoxic crisis? | Reduce thyroid hormone levels; manage fever, fluid and stressors. |
What are the assessment findings for hyperthyroidism? | Goiter; Tachy; weightloss; Nervousness; irritable; Bruits upon auscultation of thyroid gland; confusion; changes in skin. |
What are some possible RN Dx for hyperthyroidism? | Activity intolerance; Imbalanced nutrition; Disturbed body image. |
What is the collaborative care for hyperthyroidism? | Radioactive iodine therapy; drug therapy; subtotal thyroidectomy. |
What is the RN management for Hyperthyroidism? | Monitor VS, weight, fluid balance; Promote comfort; provide emotional support; admin antithyroid meds; protect eyes. |
What is Hypothyroidism? | Insufficient thyroid hormone from destruction of thyroid tissue, defective hormone synthesis, decreased TSH, thyroiditis, iodine deficiency, or Graves's disease. |
What are some assessment findings of Hypothyroidism? | Weight gain; fatigue; impaired memory; slow speech; low exercise tolerance; SOB on exertion; Constipation; Cold intolerance; Hair loss; Myxedema. |
What are some RN Dx's for Hypothyroidism? | Activity intolerance r/t SOB on exertion; Constipation; Impaired memory; disturbed body image. |
What is the Collaborative care for Hypothyroidism? | Low-Calori diet; Drug therapy (Synthroid) |
What is the RN management for Hypothyroidism? | Encourage appropriate pace of activities; promote comfort, rest, and sleep; Prevent constipation; help to maintain skin integrity; provide emotional support; admin. drug replacement therapy. |
What is Hyperparathyroidism? | Increased secretion of PTH, leading to increased serum Ca levels. Has primary, secondary, tertiary. |
What are some findings of Hyperparathyroidism? | Muscle Weakness; Loss of appetite; Constipation; Fatigue; Shortened attention span; Osteoporosis; Renal failure, pancreatitis, cardiac changes. |
What is the collaborative care for Hyperparathyroidism? | Surgical therapy; Continued monitoring of lab values (bone densities); diet with high fluid intake and moderate calcium intake; drug therapy (bisphosphonates, oral phosphate; calcimimetic agents. |
What is the RN management of Hyperparathyroidism? | Encourage fluid intake to decrease renal calculi; I&O's; Safety; Monitor Electrolyte lab values; Encourage exercise program to strengthen bones. |
What is Hypoparathyroidism? | Inadequate PTH; characterized by hypocalcemia; may be due to neck surgery or decreased calcium absorption. |
What are the assessment findings of Hypoparathyroidism? | Tetany; Paresthesias of lips, hands and feet; Tremor, seizures; confusion; weakness; tachycardia; Laryngospasms. |
What are the RN Dx's for Hypoparathyroidism? | Acute pain r/t muscle spasms; Risk for ineffective airway clearance r/t spasms of laryngeal muscles; anxiety r/t threat to change in health status. |
What is the collaborative care for Hypoparathyroidism? | May require IV calcium chloride or calcium gluconate *(with EKG monitoring); Rebreathing to reduce neuromuscular symptoms; Oral calcium and/or vitamin D. |
What is the RN management for Hypoparathyroidism? | Administer Ca medications w/monitoring; Observe for tetany; Encourage diet that is high in calcium and low in phosphorus (green leafy vegetables, soybeans, tofu. |
What is Cushings Syndrome? | caused by Excess corticosteroids often from prologed administration of high dose corticosteroids; ACTH-secreting pituitary tumor; Adrenal tumors and ectopic ACTH-producing tumors. |
What are the assessment findings of Cushings? | Weight gain; muscle wasting; delayed wound healing; Purplish strie; Irritability, anxiety; HT |
What are the possible RN Dx for Cushing's? | Activity intolerance r/t fatigue/weakness; Disturbed body image; Risk for infection r/t suppression of immune system; Impaired skin integrity r/t delayed wound healing. |
What is the collaborative care for Cushing's? | Treatment to address underlying cause (surgical removal of tumor, revision of corticosteroid therapy); Drug therapy to inhibit adrenal function. |
What is the RN managements of Cushing's? | Emotional support; Prevent infection; Safety (falls/fractures); Provide post-adrenalectomy care. |
When taking care of a patient with Cushing's disease what two interventions might be the most important? | Monitoring FSBS; Protecting Pt. from exposure to infection. |
What is Addison's Disease? | Adrenocortical hypofunction due to insufficient secretion from adrenal cortex. An autoimmune response which destroys adrenal tissue. |
What are the assessment findings of Addison's disease? | Signs may be delayed until 90% of tissue is damaged; Skin hyperpigmentation; Fatigue; Depression; Anorexia; Fluid/Electrolyte imbalance. N/V, diarrhea. |
What are some possible RN Dx's for Addison's? | Activity intolerance; Disturbed body image; Deficient fluid volume; Risk for injury. |
What is the collaborative care for Addison's? | Replacement therapy (Hydrocortisone). |
What is the RN Management for Addison's? | Emotional support; Monitor Labs, VS, EKG, Fluid volume; Safety; Provide hormonal replacement; Education. |