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chpt 50 study guide

Endocrine Problems

QuestionAnswer
A pt w/acromegly has an increased GH level. The nurse also expects a serum somatomedin C of more than 300 ng/ml
During assessment w/a pt who has acromegly, the nurse would expect the pt to complain of what? changes in appearance
A pt w/acromegaly is tx w/a transsphenoidal hypophysectomy. Postoperatively, the nurse does what? ensures that any clear nasal drainage is tested for glucose
Octreotide (sandostatin) is a _________ in primary tx of acromegaly to _______ of GH. somatoform analog, reduce levels
A pt w/DM who undergoes a hypophysectomy will require a ______ dose of insulin thanpreoperatively smaller
pituitary tumors causing hyper/hypo-pituitarism may cause visual changes true
Early hypofx of the pituitary glandusually results in nonspecific s/s primarily b/c there is no obvious manifestations of GH deficiencies in adults true
name 5 hormones that are replaced when panhypopituitarism results from radiation tx or total hypophysectomy as tx for pituitary tumors cortisol, thyroid, vasopressin (ADH analog), GH, sex H; testoserone, follicle stimulating hormone & leutinizing H if fertility is desired. If not, estrogen & progesterone
during care for a pt w/SIADH, the nurse should... monitor neurologic status Q2H
A pt w/SIDH is tx w/water restriction & administration of IV fluids. Tx has been effective when the pt experiences... inc urine output, inc serum Na+, & dec urine specific gravity
In a pt w/central diabetes insipidus, administration of ADH during a water deprivation test will result in... inc urine osmolality
A pt w/diabetes insipidus is tx w/nasal desmopressin. The nurse realizes the pt is not experiencing therapeutic effects when he experiences... A urine specific gravity of 1.002
when caring for a pt w/nephrogenic diabetes insipidus, the nurse would expect tx to include... thiazide diuretics
viral-induced hyperthyroidism is r/t... subacute granulomatous thyroiditis
Autoimmune fibrosis and lymphocytic replacement of the thyroid gland is r/t... hashimotos thyroiditis
an enlarges thyroid glan is a ... goiter
lymphocytic infiltration of thyroid gland which may occur postpartum is r/t... silent thyroiditis
bacterial of fungal infection of the thyroid gland is r/t... acute thyroiditis
malignant or benign deformity of the thyroid gland is r/t... thyroid nodules
the most common form of hyperthyroidism are Graves dz, and toxic nodular goiters (T/F) true
Exophalmos may occur in any form of _______. Graves dz.
clinical manifestations of hyperthyroidism occur as a result of inc metabolic rate and an inc # of B-adrenergic receptors (T/F) true
dx testing in the pt w/graves dz will reveal a _______ TSH leveland a radioactive iodine uptake of _________% decreased, 25-95%
Goitrogens are substances that ________ thyroid fx, and should be ________ in pts w/hypothyroidism. inhibit, avoided
A pt w/Graves dz asks what caused this disorder. The nurse replies... In genetically susceptible people, Ab are formed that cause excessive thyroid H secretion
A pt is admitted to the hospital w/thyrotoxic crisis. On assessment, the nurse expects to find... elevated temp. and signs of HF
often used w/iodine to produce euthyroid before surgery propylthiouracil (PTU)
should be taken w/a straw to avoid staining teeth K+ iodide
is not used in pts of childbearing age radioactive iodine
decreases release of thyroid H K+ iodide
may cause agranulocytosis propylthiouracil (PTU)
used to decrease size and vascularity of thyroid gland preoperatively K+ iodide
used to control sympathetic symptoms propanalol
blocks peripheral conversion of T3 to T4 propylthiouracil (PTU)
decreases thyroid secretion by damaging the thyroid gland radioactive iodine
indication of toxicity are excessive salivation and skin rx K+ iodide
often causes hypothyroidism over time radioactive iodine
Identify rational as to why a traecheostomy tray would be in the room post thyroidectomy in case of airway obstruction d/t vocal cord paralysis from recurrent laryngeal nerve damage or laryngeal stridor occurs w/tetany
Identify rational as to why Ca + salts for IV administration would be in the room post thyroidectomy in case of hypocalcemia d/t parathyroid removal or damage during surgery resulting in tetany
Identify rational as to why oxygen equipment would be in the room post thyroidectomy In case of airway obstruction, laryngeal stridor or edema around trachea
preoperative instructions before a thyroidectomy includes... how to support the head w/the hands when moving
when providing d/c instructions following a subtotal thyroidectomy, the nurse advises... to reduce caloric intake to about 1/2 of what is was before surgery
Nursing dx for exothalmos... risk for injury: corneal ulceration r/t inability to close eyelid
Nursing dx for wt loss & hunger... Imbalanced nutrition: < body requirements r/t hypermetabolism
Nursing dx for hair loss & vitiligo... Disturbed body image r/t change in body appearance
Nursing dx for exhaustion & dyspnea... Activity intolerance r/t fatigue & dyspnea.
causes for hypothyroidism in adults include... autoimmune-induced atrophy of the thyroid gland
Disturbed sleep pattern r/t _______ as manifested by ___________ and _____________. depression & altered metabolism; AMB excessive sleeping; no relief of somnolence & altered sleep stages
Imbalanced nutrition: more than body requirements r/t________as manifested by ________and _________. hypometabolism; AMB wt gain; myxedema facies
Disturbed thought processes r/t _________ as manifested by ____________ and __________. diminished cerebral blood flow secondary to dec C/O; AMB forgetfullness, stupor, memory loss & personality changes
Activity intolerance r/t_________ manifested by ___________ and _________. dec metabolic rate & mucin deposits in the joints; AMB fatigue, weakness, muscular aches and pains
when meds are started for the pt w/hypothyroidism, the nurse should monitor for... dysrhythmias
A pt recieving tx w/levothyroxine recieves... written instructions for all info r/t the drug
An appropriate nursing intervention for the pt w/hyperparathyroidism is... inc fluid intake to 3000-4000 ml a day
dec bone density hyperparathyroidism
muscle spasms and stiffness hypoparathyroidism
psychomotor retardation hyperparathyroidism
Ca+ nephrolithiasis hyperparathyroidism
anorexia & abdominal pain hyperparathyroidism
dec contractility of the myocardium hypoparathyroidism
laryngeal spasm hypoparathyroidism
skeletal pain hyperparathyroidism
abdominal cramping hypoparathyroidism
cardiac irritability hyperparathyroidism
when a pt w/parathyroid dz experiences hypocalcemia, a temp intervention would be... rebreathing in a paper bag
A pt w/hypoparathydism from hyperparathyroid surgery is taught what upon discharge? Ca+ supplements w/vitamin C
The nurse expects to find what in a pt w/cushings syndrome? HTN, peripheral edema, and petechiae
to prevent complications in a pt w/Cushings, the nurse monitors what? for dysrhythmias
A pt had an adrenalectomy. During post-op, the nurse expects administration of corticosteroids to be inc to promote adequate response to the stress of surgery
A pt w/Addisons comes in to the ER w/ N/V, diahrrea, and fever. The nurse expects to give... IV hydrocortisone
During d/c of a pt w/Addisons, the nurse realizes the pt needs more teaching when he says... If my wt goes down, my dosage of steroid is probably too high
A pt w/mild iatrogenig Cushings syndrome is on an alternate day corticosteroid tx. The nurse explains... it is to minimize hypothalmic-pituitary-addrenal suppression
When caring for a pt w/yperaldosteronism, the nurse questions which med? foresemide (Lasix)
the most important intervention for monitoring the pt w/pheochromocytoma is... monitoring B/P
a pt w/an autoimmune disorder is taking corticosteroids and Lasix/foresimide for what reason? Fluid and sodium retention d/t mineralcorticoid effect
a pt w/an autoimmune disorder is taking corticosteroids and Ranitidine/zantac for what reason? GI irritation w/ an increase in secretion of HCl and pepsin
a pt w/an autoimmune disorder is taking corticosteroids and Alendronate/fosamax for what reason? corticosteroid induced osteoperosis
a pt w/an autoimmune disorder is taking corticosteroids and insulin for what reason? glucose intolerance w/hyperglycemia
a pt w/an autoimmune disorder is taking corticosteroids and K+ for what reason? hypokalemia d/t mineralcorticoid effect
a pt w/an autoimmune disorder is taking corticosteroids and Isoniazid (INH) for what reason? inhibition of inflammation and immune response, may reactivate latent Tb
A pt w/a head injury developes SIADH. S/S the nurse expects to find include... low urinary output & thirst
floowing a levothyoxine prescription, the nurse provides more teaching when the pt says... I can take this med only till my s/s have improved
Following thyroid surgery, the nurse expects damage or removal of the parathyroid glands when the pt develops laryngeal stridor and tingling in the hands and feet
An important intervention when caring for a pt w/cushings is... prevent the pt from exposure to infx
After adrenalectomy for pheochromocytoma, the pt is likely to experience what? marked fluctuations in B/P
To control the side effects of a pt taking corticosteroids, the nurse teaches the pt to... increase Ca+ intake to 1500 mg/day
The nurse teaches the pt taking corticosteroid replacement tx to take it when? upon arising and in late afternoon
Created by: arsho453
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