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sueostermeyer endocrine 1 nclex Inglês 62 flashcards

Flashcards do conjunto (62)

  1. 1Nursing diagnosis for Diabetes Insipadus 1 2 3fluid vol deficit
    Decreased cardiac output
    impaired tissue perfusion
  2. 2medication for diabetes insipidus isDesmopressin DDAVP a nasal spray causes increased water resabsorption
  3. 3diabetes insipidus 1. deficit of what hormone 2. pt becomes ___ and what electrolyte is effected and how 3 the specific gravity is1. ADH
    2 dehydrated and hyPERnatremic
    3. Low
  4. 4this type of diabetes insipidus is from renal tubules are not sensitive to ADH. this is familar in renal failurenephrogenic diabetes insipidus
  5. 5this type of diabetes insipidus is a result from either disruption of the hypothalmus and pitutary glands from trauma irrdiation or cranial surgery or idiopathicNeurogenic diabetes insipidus
  6. 6Two types of Diabetes insipidus areNeurogenic and Nephrogenic
  7. 7Syndrome of inappropriate antidiuretic hormone secretion Nursing Diagnosis for SAIDH are 1 2 3 4Fluid vol. excess
    increased cardiact out put
    fluid vol. overload
    fall risk
  8. 8Some common causes of SIADH includeMeningitis
    Head injury Subarachnoid hemorrhage
    Cancers Lung cancer (especially small-cell lung cancer, as well as other small-cell malignancies of other organs)
    Infections Brain abscess
    Pneumonia
    Lung abscess
    Guillain-Barré syndrome
    Drugs Chlorpropamide
    Clofibrate
    Phenothiazine
    Ifosfamide
    Cyclophosphamide
    Carbamazepine
    Selective serotonin reuptake inhibitors (SSRIs, a class of antidepressants)
    Methylenedioxymethamphetamine (MDMA, commonly called Ecstasy. SIADH due to taking ecstasy was cited as a factor in the death of Leah Betts)
    Oxytocin
    Vincristine
    Morphine
    Amitriptyline
    Hypothyroidism
    Sarcoidosis
  9. 9HyPERfunction of anterior pitutary gland GH during Adulthood causes GH before pubertyAcromegaly
    Gigantism
  10. 10Drugs used for SIADS areDemeclycycline (tetracycline)
  11. 11Treatment and nursing practices of SIADS iskeep pt safe, restrict fluids to 1 L a day for 3 - 10 days Demecloycycline a(tetracycline) antibiotic , correct underlying cause
  12. 12signs and symptoms brain cells, causing neurologic symptoms including headache, changes in mental status or personalit, lethargy and irriatability, weight gain from retention of fludea with no edemaSIADA
  13. 13Manifestation of SIADH are usually nonspecific but are related to ___ and __ __hyponatremia and water intoxication and lung cancer
  14. 14what is suppressed as a result of renal excretions of sodium increasesAldosterone
  15. 15SIADH is most often caused by Other causes may beectopic production of ADH by maligant tumor oat cell carcinoma of lung, pancreatic carcinoma, leukemia and Hodgkins.
    follow a head injury, pituitary surgery or use of medications such as barbiturates, anesthetics or diuretics
  16. 16Treatment of addisonian crisis israpid fluid and glucorcorticoids replacement
  17. 17Regular symptoms of addison disease + high fever, severe pain in the abdomen, lower back pain, legs, severe vomitting, diarrhea, circulatory collapse, shock, coma this isAddisonian crisis
  18. 18typical symptoms of addisonsMuscle weakness and fatigue
    Weight loss and decreased appetite
    Darkening of your skin (hyperpigmentation)
    Low blood pressure, even fainting
    Salt craving
    Low blood sugar (hypoglycemia)
    Nausea, diarrhea or vomiting
    Muscle or joint pains
    Irritability
    Depression
    Body hair loss or sexual dysfunction in women
  19. 19results when your adrenal glands are damaged, producing insufficient amounts of the hormone cortisol and often aldosterone as well. These glands are located just above your kidneysAddison's disease
  20. 20addisions disease is loss of what hormonescortisol and often aldosterone
  21. 21Medication for acromegaly is called ? It suppresses the anterior pituitary gland and decreases the? Side effects of the medication are1. Octreotide Sandostatin
    2 GH levesl
    3 GI first few weeks and 25% pt develop cholesterol gallstones in a year
  22. 22acromegaly is treated by surgical removal or irradiation of the ? the two types of surgery are called1 pituitary tumor
    2 transspheonidal or transfrontal
  23. 23The patient is admitted to the critical care unit because of uncontrolled chest pain , radiating to the shoulder. Think about what interventions will be carried on ? What medications will be administered and why ? What laboratory tests will be done and why? What is the nurses/ yours higest priority ? What nursing diagnosis will be the highest priority ?Medication administration (ASA, nitroglycerin, morphine), O2 supplementation initially. Fibrinolysis or Percutaneous Coronary Intervention via balloon angiography and stent deployment may be indicated.
    In the acute phase…
    ASA: to inhibit platelet activity, and thus clot formation.
    Nitroglycerin: a vasodilator, to possibly reduce chest pain and determine whether the episode is an actual MI or just angina.
    Morphine sulfate: for pain relief if nitro is contraindicated or ineffective. Also, relief of anxiety.
    Fibrinolytics: to dissolve clots. Patients have to qualify. Recent history of bleeding is one important exclusion criteria.
    Glycoprotein IIb/IIIa Antagonists: often used in conjunction with PCI to inhibit platelet aggregation.
    Long-term…
    Beta blockers: to decrease incidence of ventricular arrythmias, recurrent ischemia and infarction, size of infarct, and short-term mortality.
    Heparin: until the ruptured plaque has resolved.
    Warfarin: in certain cases only (e.g. atrial fibrillation) to reduce recurrence. Pradaxa is a newer “replacement” for Warfarin.
    ACE inhibitors: decreases afterload through vasodilation.
    Statins: reduces serum cholesterol to decrease progress of atherosclerosis
    CBC: RBCs, H&H could be down due to hypoxia. WBC could be up due to infection.
    CK/CK-MB: indicator of myocardial injury.
    Troponins: most specific indicator for myocardial damage.
    Myoglobin: indicator of any muscle injury, including cardiac.
    Electrolytes: could be off due to MI
    Immediately, relief of pain would be the highest priority.
    Acute pain
  24. 24Sodium polystyrene sulfonate also known as Kayexalate is medication treats whatHyperkalemia Sodium polystyrene sulfonate is used to treat increased amounts of potassium in the body
  25. 25Manifestation of acromegalyManifestations of this include peripheral nerve damage from entrapment of nerves, headache, hypertension, congestive heart failure, seizures and visual disturbances. impaired glucose tolerance and diebetes many occure. Arthritis
  26. 26Signs of Large forehead, maxilla lengthens ,tongue enlarges and voice deepens. Overgrowth of bone and soft tissue in the hands and feet.Acromegaly
  27. 27Acromegaly usually begins duringAdulthood
  28. 28This occurs when GH hypersecretion begins before puberty and the closure of the epephyseal plate. Height and body proportions are relatively normal. Usually tumor involvedGiantism
  29. 29Nursing diagnosis with addison1 fluid volume deficit
  30. 30Medication for Addison is 1.coticosteroid called and used for 2. Mineralocorticoids 3 diet is1. hydrocortisone (cortef) to replace cortisol
    2. fludrocortisone florinef to replace mineralocorticoids
    also INcrease Sodium in diet
  31. 31blood and urine test for Addison's 1. cortisol 2. BUN 3. sodium 4. Potassium 5. glucose 6 Urine 17-5s1. decreased
    2. increased
    3. decreased
    4 increased
    5decreased
    6 low or absent
    **all are decreased except for Bun and Potassium
  32. 32Manifestation of addisons are 1.Integumentary system 2.Cardiovascular 3. Central nervous system 4. Musculoskeletal 5. Gastronintestinal system 6. reporductive 7. Metabolic effects1.Delayed wound healing and Hyperigmentation
    2. postural hypotension, arrhythmias and tachycardia
    3. Lethargy, tremors, emotional labilty, confusion
    4. weakness, muscle wasting, joint pain, muscle pain
    5. anorexia, nausea and vomiting and diarrhea
    6. Menstrual changes
    7. HyPERKalemia, hyPOnatremia, HyPOglycemia
  33. 33in Addison disease results in a chronic deficiency of accompanied by age is usually more common incortisol, aldosterone, and adreanl androgens
    skin pigmentations
    under 60
    women
  34. 34this is a disorder resulting from destruction or dysfunctino of the adrenal cortexaddisons disease
  35. 35Nursing diagnosis and interventions for Cushing's syndrome isFluid volume excess because of excess cortisol
    Risk for injury
    Risk for infection
    Distrubed body image
  36. 36Drugs used for cushing syndrom are 1. used to treat matastic adrenal cancer 2. This is used for ectopic ACTH secreting tumors that cannot be surgicall removed 3. This durgs suppresses ACTH secretions in some clinets1. Mitotane suppresses activity of the adrenal cortes
    2. Aminogluthemide or Ketoconazole or both they inhibit cortisol synthesis by the adrenal cortex
    3. Somatostatin analog Octreotide suppresses ACTH secretion
  37. 37in primary Cushing syndrome ACTH levels areDecreased
  38. 38in secondary cushing sydrome ACTH leves areelevated
  39. 39other changes in cushing syndrome are electrolytes imbalances and they are 1. calcium changes cause 2. potassium is 3.sodium is 4. risk for peptic ulcers 5 cardiovascular system changes 6. Reporductive system1. osteoporosis, compression fractures, reanl calculi
    2. lost
    3. retained
    4. increases
    5. Hypertension
    6 Oligomenorrhea or amenorrhea, impotence and decreased libido
  40. 40steroid excess inhibits fibroblast resulting in loss of collagen and connective tissue results arethinning of skin, abdominal strie red purple stretch marks, easy bruising, poor wound healing and frequent skin infections
  41. 41cushing syndrom obesity and redistribution of body fate is in what regionsAbdominal region, fat pads under clavical, buffalow hump over upper back and round moon face
  42. 42this type of cushings is from long term glucocorticoid useIatrogenic Cushing syndrome
  43. 43this type of cushing is resulting from excessive cortisol secretion by a benign or malignant adrenal tumor. Excess secretation supresses pituitary ACTH production, resulting in atrophy of the uninvolved adrenal cortex. Thirty two percento of cushing disease is due to excessive autonomous secretion of cortisol by adrenal glandsAdrenal form
  44. 44type of cushing caused by ACTH secreting tumor such as small cell lung cancerEctopic form of cushing
  45. 45this form of cushing is is associaqted with ACTH hypersecretation by tumor of pituitary. This si most commonly causecd by a small pitutiary adenoma with persistent but disorderly and random overproduction of ACTH. Forty three persent of cushing is due to hypersecretation of ACTH by pituitaryPituitary form
  46. 464 types of cushing syndrome ispituitary form, ectopic form adrenal form, and iatrogenic
  47. 47which is the only endocrine organ that can be palpated during physical assessmentthyroid gland
  48. 48When conductring a health history focused on the endocrin system, which of the following questions should be includedHave you noticed any increased signs of thirst.
  49. 49What assessment might be made to identify low calcium levelsTrousseaus and is done by inflating a blood pressure cuff above the antecubital area, higher than the systolic blood pressure, for two to five minutes, A positive test causes carpal spasmn and the fingers and hand will contract on the arm where the blood pressure cuff is inflated
    Chvostek’stroke of face and get a nose or lip twitch
  50. 50stroke face and get a lip twitch or nose twitch on same side of faceChvostek’stroke
  51. 51inflating a blood pressure cuff above the anticubital area, higher than the systolic blood pressure, for two to five minutes, A positive test causes carpal spasm and the fingers and hand will contract on the arm where the blood pressure cuff is inflatedTrousseaus
  52. 52Trousseaus and Chvostek’stroke used to check forHypocalcaemia low calcium
  53. 53what physiologic response is expected if the pituitary produces and increased amount of ADHdecreased urine out put because adh antiduret hormone helps to concentrate urine, which would decrease urin output. the adh couses the distal tubules in the kidney to reablsorb water which will concentrate the urinie
  54. 54extreme larg bones may indicateacromegaly
  55. 55ultered sensation may be seen in what three endo disordersdiabetes, hypothyroidism and acromegaly
  56. 56increased pigmentatin of the nails is seen in what diseaseAddisons
  57. 57Purple striae over the abdomen and brusing may be sinn in what syndromecushing syndrome
  58. 58corticosteroids Glucocorticosteroids and minerocorticosteriods have effects on endocrine areasAdreal glands the cortex
  59. 59What gland posterior gland stimulates retention of waterADH
  60. 60What posterior gland stimulates uterine contractions, milk ejection reflex in the mammary glandsOxytosin
  61. 61What gland stimulates development of testes and ovariesLH
  62. 62what gland stimulates Thyroid gland to produce hormonesTSH

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nclex endocrine 1 FlashCards sobre Untitled_2, criado por sueostermeyer em 27-09-2013.
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