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Endocrine/Metabolism
| Question | Answer |
|---|---|
| causes: Graves’ disease (most common cause), thyrotoxicosis, thyroid storm, cancer, stress, shock, infection | hyperthyroidism |
| S/Sx: nervousness; rapid pulse; heat intolerance; tremors; skin flushed, warm, soft, and moist; exophthalmos; increased appetite; weight loss; elevated systolic BP; cardiac dysrhythmias; insomnia, increased Ca (decreased DTR), decreased phosphorus | hyperthyroidism |
| Tx: radioactive 131I therapy, meds (propylthiouracil, methimazole, thiamazole (Tapazole); sodium or potassium iodine solutions; dexamethasone; beta-blockers), surgery (subtotal thyroidectomy ) | hyperthyroidism |
| Which medication blocks synthesis of thyroid hormone? -dexamethasone -methimazole -potassium iodide -sodium iodide | methimazole/Tapazole (blocks synthesis of thyroid hormone; dexamethasone, potassium iodide, and sodium iodide suppress release of thyroid hormone) |
| thyroidectomy preoperative goals? | reduction of stress and anxiety to avoid precipitation of thyroid storm |
| 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 | Chvostek sign |
| carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with a blood pressure cuff | Trousseau sign |
| T or F? A patient in acute hypercalcemic crisis requires close monitoring for life-threatening complications and prompt treatment to reduce serum calcium levels. | True |
| causes: adrenal glands are damaged and cannot produce sufficient amounts of cortical hormones; adrenal suppression | Adrenocortical Insufficiency (Addison Disease) |
| S/Sx: muscle weakness, anorexia, GI symptoms, fatigue, dark/bronze pigmentation of skin and mucosa, hypotension, low blood glucose, low serum sodium, high serum potassium, apathy, emotional lability, confusion | Adrenocortical Insufficiency (Addison Disease) |
| acute adrenocortical insufficiency; characterized by hypotension, cyanosis, fever, nausea/vomiting, and signs of shock; brought on by stress | Addisonian crisis |
| Tx: -monitor for S/Sx of fluid volume deficit -foods high in sodium -hormone replacement as prescribed -dexamethasone -avoid stress and activity until stable -quiet, nonstressful environment -reduce anxiety | Addisons |
| excessive adrenocortical activity or corticosteroid medications | Cushing Syndrome |
| S/Sx: hyperglycemia; obesity w/buffalo hump; heavy trunk, thin extremities; fragile/thin skin; bruising; striae; lassitude; osteoporosis; muscle wasting; HTN; moon-face; acne; virilization (women); loss of libido; mood changes; increased Na; decreased K | Cushing Syndrome |
| three tests used to diagnose this are serum cortisol, urinary cortisol, and low-dose dexamethasone (Decadron) suppression tests | Cushing Syndrome |
| medication class? used extensively for adrenal insufficiency and are also widely used in suppressing inflammation and autoimmune reactions, controlling allergic reactions, and reducing the rejection process in transplantation | corticosteroids |
| corticosteroids med examples? | the "one" meds (beclomethasone, betamethasone/Celestone, cortisone, dexamethasone, dexamethasone, hydrocortisone/Solu-Cortef, methylprednisolone/Solu-Medrol, prednisone, prednisolone, triamcinolone/ Kenalog |
| corticosteroids patient education? | -timing of doses -need to take as prescribed, tapering required to d/c or reduce therapy -potential side effects and measures to reduce side effects |
| T or F? Oversecretion of adrenocorticotropic hormone (ACTH) or the growth hormone results in Graves’ disease. | False (Oversecretion of ACTH or growth hormone results in Cushing disease. Graves’ disease results from an excessive output of thyroid hormones caused by abnormal stimulation of the thyroid gland by circulating immunoglobulins.) |
| causes: Hashimotos, stress, underactive thyroid, thyroidectomy | hypothyroidism |
| labs for hypothyroidism? | TSH, T3, T4 |
| S/Sx: weight gain, fatigue, cold intolerance, hair loss, decreased Ca, increased DTR, increased phosphorus, + Trousseaus and Chvosteks, parasthesias | hypothyroidism |
| meds given to Tx hypothyroidism? | levothyroxine (Synthroid), PO calcium and Vit D |
| Txs for Cushing Syndrome | -adrenalectomy (temporary replacement therapy w/hydrocortisone may be necessary for several months, until the adrenal glands begin to respond normally to the body’s needs) -reduce or taper corticosteroids |
| The most common cause of hypothyroidism | autoimmune thyroiditis (Hashimoto disease) |
| The most common type of hyperthyroidism is _____ | Graves' disease |
| The two most common meds used to Tx hyperthyroidism are ____ and ____. | methimazole (Tapazole), propylthiouracil (PTU) |
| Tetany is evidenced when either of these signs are positive: ____ or ____. | Trousseau, Chvostek |
| When thyroid hormone is given for prolonged hypothyroidism, what should the nurse monitor for? -angina -depression -mental confusion -hypoglycemia | angina |
| What Sx does the nurse recognize would be associated w/diagnosis of hyperthyroidism? (select all) -HR <90 -elevated systolic BP -muscular fatigability -weight loss -intolerance to cold | -elevated systolic BP -muscular fatigability -weight loss |
| Nurse is caring for a pt w/hyperthyroidism who suddenly develops Sx r/t thyroid storm. What Sx does the nurse recognize that is indicative of this emergency? -HR 62 -BP 90/58 -SpO2 96% -Temp 102F | Temp 102F |
| What med therapy does the nurse anticipate administering when the pt is experiencing thyroid storm? (select all) -acetaminophen -iodine -propylthiouracil -synthetic levothyroxine -dexamethasone | -acetaminophen -iodine -propylthiouracil |
| The nurse assesses a pt who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this? -thyrotropin -iodine -thyroxine -calcitonin | iodine |
| Breakfast items the nurse would recommend for a pt w/hyperthyroidism? -cereal w/milk and bananas -fried eggs and bacon -orange juice and toast -pork sausage and cranberry juice | pork sausage and cranberry juice |
| The nurse auscultates a bruit over the thyroid glands. What does the nurse understand is the significance of this finding? -pt may have hypothyroidism -pt may have thyroiditis -pt may have hyperthyroidism -pt may have Cushing disease | pt may have hyperthyroidism |
| Pt w/history of hypothyroidism admitted to ICU unconscious w/temp 95.2. Family member informs nurse pt has not taken thyroid med in over 2 months. Findings indicate? -thyroid storm -myxedema coma -diabetes insipidus -SIADH | myxedema coma |
| Nurse is caring for pt w/long-standing hypothyroidism who has been taking levothyroxine sporadically. Priority that nurse monitors for in this pt? -Sx acute coronary syndrome -dietary intake of foods w/saturated fats -Sx pneumonia -heat intolerance | Sx acute coronary syndrome |
| Which glands regulate calcium and phosphorous metabolism? -Parathyroid -Thyroid -Adrenal -Pituitary | Parathyroid (parathormone--calcium and phosphorous metabolism; thyroid gland--cellular metabolic activity; adrenal medulla--catecholamines; adrenal cortex--steroid hormones; pituitary gland--hormones that control the secretion of other hormones) |
| The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? -Potassium of 6.0 mEq/L -Sodium of 140 mEq/L -Glucose of 100 mg/dL -A blood pressure reading of 135/90 mm Hg | Potassium of 6.0 mEq/L (Addison's disease is characterized by hypotension, low blood glucose, low serum sodium, and high serum potassium levels. The normal serum potassium level is 3.5 to 5 mEq/L.) |
Created by:
nurse savage
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