Flashcards
Endocrine Disorders
Cards in this deck (22)
- 11)When you have too much thyroid T4 you have a thyroid storm what are my clinical manifestations? 2)what meds do I give? 3)What am I monitoring?1) tachy, heart fail, hyperthermia (high body temp) leading to seizures, N/V, shock, & then coma
2) beta blockers
3) Cardiac monitoring (tele), iodine levels, and IV fluids - 21)When you have too little thyroid T4 you have a myxedema coma what are my clinical manifestations? 2)what meds do I give? 3)What am I monitoring?1) low BP, hypothermia (low body temp), shallow breath, low na, low sugar, high lactic acid.
2) meds-IV thyroid replacement immediately
3) ventilator possibly - 3Endocrine disorder- This is a endocrine disorder most common in women 20-40 years may be autoimmune, lack of iodine, smoker, has infections, and is stressed? What is the mjr. complication?1) Hyperthyroidism
2) thyroid storm - 4What are the signs and symptoms of hyperthyroidism?1). everything goes up because this is speeding up your metabolism.
2) intolerance to heat (hyper)
3) Goiter
4) exo eyes
5) LOC-confused and agitated
6) nervous
7) club fingers
8) wt. loss - 5how do I diagnose hyperthyroidism?1) Low TSH
2) HIGH T4
Radioactive iodine uptake test + for those with Graves Disease. - 6how do I treat hyperthyroidism?1). Antithyroid drugs: Propylthiouracil (PTU) & Methimazole (never stop abruptly)
2) *Iodine makes thyroid less vascular, lowers risk of post op bleeding
3) *beta blockers reduce sympathetic nerve system
4). radioactive iodine destroys thyroid tissue (precautions must be taken takes 3 months to work, pt. is radioactive)
5) surgery-thyroidectomy, or subtotal thyroidectomy - 7What is priority care or consideration for hyperthyroidism?1) take meds as RX and avoid stopping them abruptly
2) rest in cold quiet room with eyelids taped closed (hyper-not heat tolerant)
3) avoid salt and keep HOB elevated
4) watch for laryngeal nerve damage or edema post sx
5) watch for bleeding and low ca levels
6) exo-keep the eyes lubricated with eye drops to avoid corneal damage - 8endocrine disorder with complications that increase with age particularly in women with a severe complication of myxedema comahypothyroidism
- 9What are the signs and symptoms of hypothyroidism?Think sedentary and lethargic:
1) lethargy
2) wt gain
3) depression
4) intolerance hypothermia (low body temp) to cold
5) cardio
6) low cardiac output
7) low cardiac contractility
8) High cholesterol
9) High triglycerides - 10how do I diagnose hypothyroidism?High TSH=problem with Thyroid
Low TSH=problem with Pit
Low T4, High cholesterol, High Trig, High Creatinine - 11how do I treat hypothyroidism?1) Life long thyroid hormone levothyroxine replacement
2) start a low dose to avoid cardiac problems - 12What is priority care or consideration for hypothyroidism?Acronym: WITE
1) wt
2) I&O
3) Temp
4) Edema
5) Use gentle soaps and lotions because the skin breaks down easily
6) write down instructions and be prepared to repeat because patient might forget.
7) a diabetic should test their blood sugar at least once a day - 13An endocrine disorder that again women are at highest risk and seen quiet frequently in kidney transplant patients on dialysis?Hyperparathyroidism
- 14What are the signs and symptoms of hyperparathyroidism?Acronym BC FM CLock
1) bone fractures
2) Cardiac problems
3) Fatigue
4) Muscle weakness
5) High Ca levels
6) loss of appetite
7) Osteoporosis
8) constipation
9) Kidney stones - 15how do I diagnose hyperparathyroidism?1) PTH HIGH
2) Ca HIGH
3) Po Low - 16how do I treat hyperparathyroidism?1) sx is the most effective tx
2) autotransplantation of parathyroid tissue to forearm
3) IV NS
4) loop diuretic to help excrete Ca
5) Calcimimetic agents; Sensipar (cinacalcet) increases Ca receptors; decreases PTH secretion and decreases Ca blood levels - 17What is priority care or consideration for hyperparathyroidism?1) monitor PTH
2) monitor Ca
3) monitor Po
4) may need IV NS
5) loop diuretics
6) post-op parathyroidectomy; watch for signs of hypocalcemia (tetany, or the tingling of lips) assess for Chvostek's and trousseau's sign
7) wt bearing exercise
8) IV calcium gluconate if acute tetany - 18What is an endocrine disorder that is idiopathic (unknown cause or mechanism, spontaneous) where you can have an accidental removal of parathyroid?Hypoparathyroidism
- 19What are the signs and symptoms of hypoparathyroidism?1) acute
2) tingling of the lippers
3) painful muscle spasms
4) dysphagia-difficult to swallow
5) laryngospasms-asthma, gerd or cord dysfunction - 20how do I diagnose hypoparathyroidism?1) PTH low
2) Ca low
3) Po high - 21how do I treat hypoparathyroidism?1) Ca supplements
2) Dark green veggies, soybean, and TOFU
Acute
1) IV Ca
2) monitor cardiac fx
3) rebreathing into a paper bag increases Ca availability - 22What is priority care or consideration for hypoparathyroidism?1) High Ca meal plan w/ vitamin D
2) Ca supplements
3) Emergency IV Ca give slowly to avoid dysrhythmias and HTN