Term
Acromegaly is an excess of growth hormone in adults.
True
False |
|
Definition
|
|
Term
Synthetic levothyroxine (Synthroid or Levothroid) is the preferred preparation for treating hypothyroidism.
True
False |
|
Definition
|
|
Term
The effects of thyroid hormone may be decreased by phenytoin (Dilantin).
True
False |
|
Definition
|
|
Term
Tetany is usually treated with IV calcium gluconate.
True
False |
|
Definition
|
|
Term
The most common cause of hypoparathyroidism is from surgical removal of the thyroid gland tissue during thyroidectomy.
True
False |
|
Definition
|
|
Term
__________ using the transsphenoidal approach is the treatment of choice for patients with pituitary tumor.
Craniotomy
Hypophysectomy
Transnasal |
|
Definition
|
|
Term
Patients diagnosed with __________ cannot excrete a dilute urine.
Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone
Ketoacidosis |
|
Definition
| Syndrome of inappropriate antidiuretic hormone |
|
|
Term
__________ is a term referring to the bulging eyes associated with fluid accumulation behind the eyes, which is seen in hyperthyroidism.
Hashimoto’s disease
Goiter
Exophthalmus |
|
Definition
|
|
Term
Simple goiter is often encountered in geographic regions where there is a lack of __________.
Iodine
Fluoride
Salt |
|
Definition
|
|
Term
Hyperparathyroidism leads to a markedly increased level of serum _________ that can present as a potentially life-threatening situation.
T3
Calcium
Sodium |
|
Definition
|
|
Term
| What is the most common cause of pituitary gland disorders? |
|
Definition
|
|
Term
| What is the patho of hypersecetion? |
|
Definition
| Involves hypersecretion of ACTH that leads to Cushing’s syndrome or oversecretion of growth hormone leading to acromegaly (gigantism) |
|
|
Term
| What does hyposecretion of ACTH cause? |
|
Definition
| causes the thyroid gland, the adrenal cortex, and the gonads to atrophy |
|
|
Term
| What does hypo secretion of ADH cause? |
|
Definition
| results in diabetes insipidus |
|
|
Term
| What does hyper secretion of ADH cause? |
|
Definition
| leads to syndrome of inappropriate ADH (SIADH) |
|
|
Term
| What is another cause of pituitary gland disorders? |
|
Definition
pituitary tumor
Treated with medications and/or surgery
Hypophysectomy |
|
|
Term
| What is Diabetes Insipidus? |
|
Definition
| A deficiency of ADH is characterized by excessive thirst (polydipsia) and large volumes of dilute urine. |
|
|
Term
| What are the 3 types of DI? |
|
Definition
Neurogenic: Results from damage to the posterior pituitary gland
Nephrogenic: Results from drug-related damage to the renal tubules
Psychogenic: Results from excessive water intake |
|
|
Term
| What part of the pituitary gland would be damaged for DI? |
|
Definition
|
|
Term
|
Definition
Vasopressin for excess fluid loss
DDAVP (nasal spray) which stops urination |
|
|
Term
|
Definition
Up to 20 L of urinary output a day
Lowered specific gravity
Lowered osmolarity
Hypovolemia
Excess thirst
Tachycardia (low blood volume)
Decreased BP |
|
|
Term
|
Definition
Monitor fluids
Replace fluids
Neuro status checks
Vital signs
Mucus membranes |
|
|
Term
| What is the diagnostic testing for DI? |
|
Definition
Need to obtain a 24 hr urine collection for volume and creatinine.
Vasopressin challenge test if neurogenic (DDAVP)
Fluid deprivation test-NPO 8-12 hrs, monitor weight changes
Additional labs such as glucose, BUN, calcium, potassium, and uric acid |
|
|
Term
Which of the following nursing diagnoses should be prioritized in the care of a patient with diabetes insipidus?
Risk for urge urinary incontinence
Overflow urinary incontinence
Deficient fluid volume
Excess fluid volume |
|
Definition
C. Deficient fluid volume
Rationale: Without the action of ADH on the distal nephron of the kidney, an enormous daily output of very dilute urine occurs. Signs and symptoms of fluid volume deficit occur as patients are unable to compensate for the massive urinary loss. Incontinence is not a priority problem. |
|
|
Term
|
Definition
| Syndrome of Inappropriate Antidiuretic Hormone |
|
|
Term
|
Definition
| Patients with this disorder cannot excrete diluted urine and develop dilutional hyponatremia |
|
|
Term
|
Definition
| Often non-endocrine origin (carcinomas, lung disease, CNS disorder) |
|
|
Term
| What is the nursing management of SIADH? |
|
Definition
| close monitoring of fluid intake and output, daily weight, urine and blood chemistries, and neurological status |
|
|
Term
| What is the main side effect of SIADH? |
|
Definition
|
|
Term
|
Definition
-Weight loss
-Poor skin tug or
-Dry mm
-Tachy
-Hypotension
-High serum osmolality
-Low urine osmolality
-High serum sodium
-Low serum ADH |
|
|
Term
| What are the s/s of SIADH? |
|
Definition
-Fatigue
-weakness
-Muscle cramps
-loss of appetite
-Normal vitals
-Low serum osmolality
-Increase urine osmolality
-Low serum sodium
-Excessive ADH |
|
|
Term
| What is the most common cause of hypothyroidism? |
|
Definition
| Most common cause is autoimmune thyroiditis (Hashimoto’s disease) |
|
|
Term
| what is the result of hypothyroidism? |
|
Definition
|
|
Term
| What is hypothyroidism treated w/? |
|
Definition
| Treated with levothyroxine (Synthroid or Levothroid) |
|
|
Term
| What are the nursing priorities with hypothyroidism? |
|
Definition
| monitoring vital signs and cognitive level, preventing medication interactions, and promoting function |
|
|
Term
| What hormones are decreased in hypothyroidism? |
|
Definition
|
|
Term
| What hormones are elevated in hypothyroidism? |
|
Definition
|
|
Term
| What part of the pituitary gland must be damaged in hypothyroidism? |
|
Definition
|
|
Term
| What causes the hormone imbalance in hypothyroidism? |
|
Definition
| , decreased T4 production leads to the stimulation of TSH in the pituitary gland. TSH stimulates the production of T3 to increase production T4, leading to hypertrophy of the thyroid gland |
|
|
Term
| What are the symptoms of hypothyroidism? |
|
Definition
| fatigue, muscles aches, confusion at times. Long term effects of hypothyroidism is decreased metabolism, and underlying CAD which may present when the patient is treated with thyroid hormone. |
|
|
Term
| What are physical manifestations of hypothyroidism? |
|
Definition
-Hair loss
-Apathy
-Lethargy
-Dry skin
-Muscle weakness
-Constipation
-Intolerance to cold
-Receding hairline
-Facial and eyelid edema
-Dull-blank expression
-Thick tongue
-Anorexia
-Brittle nails and hair
-Menstrual disturbances |
|
|
Term
|
Definition
Life threatening complication of Hypothyroidism
Metabolic and cardiac emergency |
|
|
Term
| What is the clinical presentation of a myxedema coma? |
|
Definition
Stupor/coma w/
-Hypothermia
-Bradycarida
-Hypoventilation
-Hyporeflexia
-Severe cardiac failure
-Shock
-Death |
|
|
Term
| How is myxedema coma treated? |
|
Definition
| Treat with IV levothyroxine |
|
|
Term
| What is the result of myxedema coma? |
|
Definition
|
|
Term
| Who often gets myxedema coma? |
|
Definition
| Condition often seen in elderly women with long-standing undiagnosed or undertreated hypothyroidism and precipitated by infection, medication, environmental exposure, or other metabolic related stresses |
|
|
Term
|
Definition
| Manifested by a greatly increased metabolic rate |
|
|
Term
| What is a common cause of hyperthyroidism? |
|
Definition
| Graves’ disease is a common cause |
|
|
Term
| How is hyperthyroidism treated? |
|
Definition
| Treated with radioactive iodine, antithyroid agents, and surgery |
|
|
Term
| What are the s/s of hyperthyroidism? |
|
Definition
-Finger clubbing
-Tremors
-Diarrhea
-Menstrual changes
-Intolerance to heat
-Bulging eyes
-Facial flushing
-Enlarged thyroid
-Tachycardia
-Increase in systolic BP
-Breast enlargement
-Weight loss
-Muscle wasting
-Localized edema |
|
|
Term
|
Definition
| Thyroid storm is a rare and potentially fatal complication of hyperthyroidism. It typically occurs in patients with untreated or partially treated thyrotoxicosis who experience a precipitating event such as surgery, infection, or trauma. |
|
|
Term
| How is thyroid storm treated? |
|
Definition
| radioisotope which destroys overactive thyroid cells, PTU, tapazole (both meds block conversion of T4 to T3, can’t be taken with decongestants). Synthroid is given to rest the thyoid cells. Thyroidectomy is less popular. 95% are cured by one dose of the radioisotope. |
|
|
Term
| What are the s/s of thyroid storm? |
|
Definition
| with high fevers, tachycardia, nausea and vomiting, tremulousness, agitation, and psychosis. Late in the progression of disease, patients may become stuporous or comatose with hypotension. |
|
|
Term
Is the following statement true or false?
The patient with hyperthyroidism is prone to constipation and apathy. |
|
Definition
False
Rationale: Hyperthyroidism is characterized by a hypermetabolic state. This is likely to cause irritability, restlessness, and diarrhea |
|
|
Term
| What are the nursing goals of hyperthyroidism? |
|
Definition
Improved nutritional status
Improved coping ability and self-esteem
Maintenance of normal body temperature
Absence of complications. |
|
|
Term
| What often accompanies thyroid cancer? |
|
Definition
|
|
Term
| What is the nursing management post thyroidectomy? |
|
Definition
Airway maintenance
Pain management
Fluid balance
Monitoring for complications, especially hemorrhage, hematoma formation, edema of the glottis, and hypoparathyroidism (hypocalcemia) |
|
|
Term
| What is hyperparathyroidsm? |
|
Definition
| Characterized by having excess parathormone (PTH), leading to a markedly increased level of serum calcium |
|
|
Term
| What is the treatment of hyperparathyroidsm/ |
|
Definition
| Recommended treatment of primary hyperparathyroidism is the surgical removal of abnormal parathyroid tissue (parathyroidectomy) |
|
|
Term
| What is the nursing management of hyperparathyroidsm? |
|
Definition
| providing hydration, encouraging mobility, administering nutrition and medications, providing emotional support, and observing for and managing hypercalcemic crisis |
|
|
Term
| What does hypoparathyroidism caused by? |
|
Definition
| hyposecretion of the parathyroid glands, leading to low levels of PTH, which eventually results in hypocalcemia and hyperphosphatemia |
|
|
Term
| What is the most common cause of hypoparathyroidism? |
|
Definition
| surgical removal of parathyroid gland tissue during thyroidectomy |
|
|
Term
| What is the major sign of hypoparathyroidism? |
|
Definition
| tetany: General muscle hypertonia, with tremor and spasmodic or uncoordinated contractions |
|
|
Term
| What is the treatment goal of hypoparathyroidism? |
|
Definition
| increase the serum calcium level to 9 to 10 mg/dL |
|
|
Term
| What is the nursing care associated with hypoparathyroidism? |
|
Definition
| early signs of hypocalcemia and anticipating signs of tetany, seizures, and respiratory difficulties |
|
|
Term
Which of the following assessment findings in a post-thyroidectomy patient would be suggestive of tetany?
The patient complains of diffuse muscle pain.
The patient complains of numbness and tingling around his mouth.
The patient’s oxygen saturation level is 90% on room air.
The patient is oriented to person and place but not to time. |
|
Definition
The patient complains of numbness and tingling around his mouth.
Rationale: Signs and symptoms of tetany include numbness and tingling, which may be present in the patient’s extremities or around the mouth. Confusion, pain, and changes in respiratory status are not characteristic of tetany. |
|
|
Term
| What is Pheochromocytoma? |
|
Definition
| Involves the benign growth of a catecholamine-secreting tumor inside the adrenal gland that results in hypertension |
|
|
Term
| How is Pheochromocytoma treated? |
|
Definition
| Surgical removal of the tumor is necessary |
|
|
Term
| What is the nursing management of Pheochromocytoma? |
|
Definition
| close monitoring of the patient’s vital signs (especially heart rate and blood pressure) and monitoring of mental status, acute ECG changes, arterial pressures, fluid and electrolyte balance, and blood glucose levels |
|
|
Term
| What is Addison's disease? |
|
Definition
NEED TO ADD MORE CORTISOL!
Primary adrenocortical insufficiency that occurs when adrenal cortex function is inadequate to meet the need for cortical hormones
Decrease in adrenal corticosteroids (cortisol, aldosterone, androgens. |
|
|
Term
| What are the risk factors of addison's disease? |
|
Definition
| surgical removal or infection of the adrenal glands and abrupt cessation of exogenous steroid therapy |
|
|
Term
| What are the s/s of Addison's disease? |
|
Definition
| muscle weakness, anorexia, gastrointestinal symptoms, fatigue, emaciation, skin pigmentation changes, hypotension, low blood glucose, hyponatremia, and hyperkalemia |
|
|
Term
| What are the nursing priorities of Addison's Disease? |
|
Definition
| maintaining fluid balance, minimizing stress, and promoting self-care |
|
|
Term
| What are the physical manifestations of Addison's disease? |
|
Definition
-Bronze pigmentation of disease
-GI disturbance
-Weakness
-Hypoglycemia
-Postural hypotension
-Weight loss |
|
|
Term
| What is Adrenal/Addison's crisis |
|
Definition
| acute hypotension, cyanosis, shock. Tx with hydrocortisone (synthetic cortisol), IVF, monitor sodium. Longer term tx is prednisone. In these patients monitor for s/sxs of fluid imbalance, orthostatic BP changes greater than 20 mmHg. Pt education is lifelong replacement of hormones, carry single injection corticosteroid for emergency. |
|
|
Term
| What is Cushing's syndrome? |
|
Definition
| A disorder that is characterized by high levels of serum cortisol |
|
|
Term
| What are the s/s of Cushing's? |
|
Definition
| arrest of height, obesity, musculoskeletal changes, and glucose intolerance |
|
|
Term
| What are the nursing priorities of cushing's? |
|
Definition
| promoting safety, preventing infection, promoting skin integrity, and promoting body image |
|
|
Term
| What causes an increase in cortisol in Cushing's? |
|
Definition
| Increase in cortisol can be due to a pituitary tumor or adrenal tumor or long term glucocorticoid therapy. Retention of sodium and water, increase BS, weight gain, decrease potassium. |
|
|
Term
| What are the physical manifestations of Cushings? |
|
Definition
-Personality changes
-Moon face
-Increased infection rate
-Gynecomastia
-Fat deposits on back
-Osteoperosis
-Hyperglycemia
-Hypernatremia
-Thin extremities
-GI distress, increased acid
-Thin skin
-Purple striae
-Bruises and petechiae |
|
|
Term
Is the following statement true or false?
If a patient has been taking corticosteroids for several years to treat an autoimmune condition, the patient is at an increased risk of developing Cushing’s syndrome. |
|
Definition
True
Rationale: Cushing’s syndrome is often caused by the overuse of corticosteroid medications. When combined with endogenous steroid production, the patient is likely to have dangerously elevated levels of corticosteroids. |
|
|
Term
|
Definition
| A condition in which the adrenal glands produce too much aldosterone because of hyperplasia or tumor |
|
|
Term
| What is the result of aldosteronism? |
|
Definition
| Results in a profound decline in the serum levels of potassium (hypokalemia) and hydrogen ions (alkalosis) |
|
|
Term
| What is the treatment for aldosteronism? |
|
Definition
| Treatment usually involves surgical removal of the adrenal tumor through adrenalectomy |
|
|
