| Term | Definition |
| acromegaly definition | too much growth hormone |
| main cause of acromegaly | Pituitary benign adenoma (tumor) secretes too much growth hormone |
| acromegaly results in | Overgrowth of everything
HTN
Hyperglycemia |
| Clinical Manifestations of Acromegaly | Enlargement of everything
Peripheral neuropathy
HTN/Heart Failure
Sleep Apnea
HA/vision issues
Menstrual disturbances |
| Diagnostics of Acromegaly | Elevated growth factor in blood
MRI/CT to detect tumors
H&P
Ophthalmologic exam |
| Treatment of Acromegaly | Surgical Removal
1. Transsphenoidal Hypophysectomy: go through nose or upper lip; need replacement hormones for life:
i.e. glucocorticoids, thyroid and sex hormone
2. Stereostatic radiosurgery: radiation for tumor |
| Post-Operative Care of Acromegaly | HOB 30
Looking for neuro complications: speech, pupils, extremity strength
Mouth & surgical site care
Bleeding
Observe any clear nasal drainage: test for glucose (greater than 30 = CSF); severe HA monitoring all these indicate CSF leak |
| Definition of Goiter | enlarged thyroid |
| Cause of Goiter | lack of iodine in diet |
| Toxic Goiter | leads to hypo or hyper |
| Non-toxic Goiter | enlargement w/o malignancy; TH levels normal |
| Hyperthyroid definition | Autoimmune disease that causes excess thyroid hormone secretion and enlarged thyroid |
| Clinical Manifestations | speeds everything up |
| Anti-thyroid Medications | 1. Iodine: PO; stops T3 & T4 from going into circulation; used before surgery to treat crisis; decreases vascularity of thyroid gland for bleeding
2. Beta-Adrenergic Blockers: treats symptoms of thyrotoxicosis |
| Radioactive Iodine Therapy (RAI): | damage/destroy thyroid tissue; eventually get symptoms of hypothyroidism; teach patient about: separation from people b/c radiation exposure |
| Surgical Therapy for Hyperthyroidism | Subtotal Thyroidectomy -- removes 90% of thyroid |
| Nutritional Therapy | high calorie-diet; avoid fiber & caffeine |
| Thyrotoxicosis definition | Excessive amounts of hormones released
LIFE-THREATENING EMERGENCY
Results b/c stressors (infection, trauma, surgery) |
| Thyrotoxicosis manifestations | Same thing as hyperthyroidism, but elevated even higher |
| thyrotoxicosis collaborative care | Thyroidectomy
Manage respiratory distress – beta blockers
Reduce fever – Tylenol, cooling blankets, ice packs
Replace fluids
Eliminate or manage stressor |
| Thyroidectomy Post-Operative Care | o Meds – Iodine and Analgesics
o HOB 30-45
o Signs of Hypocalcemia: tingling of toes, fingers, and around mouth & muscle twitching & difficulty speaking & hoarseness) Trousseau’s and Chvostek’s signs
o Hemorrhage
o Thyrotoxic crisis
o Infection |
| Hypothyroid Definition | lack of thyroid hormone --> more common in women than men |
| Clinical Manifestations of Hypothyroid | slows everything down |
| Collaborative Care for Hypothyroid | o Low-calorie diet
o Meds: levothyroxine in morning on empty stomach, life-long therapy |
| myxedema | term used w/hypothyroidism; ALSO swelling/edema in skin and tissues
o Opposite of thyroid storm: slows everything down to the point of possible death; emergency |
| Hyperparathyroidism Definition | Increased secretion of PTH; leads to hypercalcemia & hypophosphatemia |
| Types of Hyperparathyroidism | Secondary: b/c of other disease that causes low calcium
Tertiary: renal transplant patients |
| Clinical Manifestations of Hyperparathyroidism | Weakness
Low appetite
Constipation
Fatigue
Osteoporosis
Kidney stones
Hypercalcemia |
| Diagnostics of Hyperparathyroidism | ^^ PTH levels
Calcium above 10mg/dl
Phosphate: <3mg/dl |
| Surgical Therapy of Hyperparathyroidism | Partial or complete removal of parathyroid gland
Supplements for life
Monitor for hemorrhage, fluid & electrolyte imbalance, and tetany |
| Hypoparathyroidism definition | Low parathyroid hormone; uncommon results in hypocalcemia & increased phosphorus |
| Hypocalcemia management | 1. IV infusions of calcium for tetany (10-20mL of 10% solution)
2. Vit D. enhance gut absorption of calcium
3. Diet: dark green veggies, tofu, soybeans
4. Monitor Calcium levels |
