What's the diagnosis?
Symptoms include:
-Palpitations
-Tachycardia
-Weight loss with increased appetite
-Heat intolerance
Hyperthyroidsim
The patient is experiencing high fever, sever tachycardia, delirium, and extreme irritability. What complication is this?
Thyroid storm
A nurse is caring for a patient with hypoparathyroidism and hypocalcemia. What are some signs of low calcium the nurse should monitor for?
Tetany, +chovstek/trousseau signs, laryngeal spasms
A patient is being prescribed synthroid for hypothyroidism. The provider orders the initial dose to be 1.7 mcg/kg/day. The patient weighs 180 pounds. What is the patient's daily dose in mcg? Round to the nearest tenths place.
139.1 mcg
A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect?
A. Hyperpigmentation
B. Intention tremors
C. Hirsutism
D. Purple striations
A. Hyperpigmentation
B-MS; C- Addison's=loss of hair; D=cushings
Symptoms include:
-Dehydration
-Hyperpigmentation
-Weight loss and loss of appetite
-Low Cortisol
Addison's Disease
The patient is experiencing hypothermia, bradycardia, and hypotension.
Myxedema coma
What diet should the nurse encourage for a patient with Cushing's disease?
Low calories, low NA
High protein, K, calcium, and vitamin D
A patient in a myxedema coma has been presribed 137 mcg of IV Synthroid. Available is 100 mcg/mL. How many mLs should the nurse administer? Round to the hundredths place.
1.37 mL
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client?
A. Chvostek's sign
B. Babinski's sign
C. Brudzinski's sign
D. Kernig's sign
A. Chvosetek's sign (sign of hypoCa after thyroidectomy)
Symptoms include:
-Obese trunk with think extremeties
-Depression/Mood swings
-Think Skin
-Osteoporosis
Cushing's Disease
The patient is experiencing severe hypotension, hypovolemia, shock, seizures, and severe generalized muscle weakness. What complication is this?
Adrenal Crisis.
What are the interventions for a patient with SIADH?
Fluid restrictions
I&O, DW
Diuretics
F/E monitoring
Monitor Neuro status
45 gtt/min
A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose?
A. Insomnia
B. Constipation
C. Drowsiness
D. Hypoactive deep-tendon reflexes
A. Insomnia
Symptoms include:
-Hyperhidrosis
-Hyperglycemia
-HTN
-Hyperetabolism
Pheochromocytoma
A complication of hypoparathyroidism is low ____ and high ____.
calcium;phosphate
BONUS QUESTION!
How many total questions on the endocrine content will be on Exam 3?
A patient admitted for HTN emergency is ordered 10 mcg/min of continuous IV Nitroglycerin. Available is 50 mg/250 mL. What should the nurse set the pump at in mL/hour?
3 mL/hour
A nurse is assessing a client who is admitted with hyperthyroidism. The client reports a weight loss of 5.4 kg (12 lb) in the last 2 months, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness. Which of the following actions should the nurse take to prevent a thyroid crisis?
A. Provide a quiet, low-stimulus environment
B. Administer aspirin as prescribed
C. Keep client NPO
D. Observe client for s/s of hypocalcemia
A. Provide a quiet, low-stimulus environment
The nurse would administer Acetaminophen; encourage a high protein, high calorie diet, and enourage fluids. Hypocalcemia is not a concern with thyroid crisis.
Symptoms include:
-Low specific gravity
-Tachycardia
-Polydipsia
-Polyuria
Diabetes Insipidus (DI)
A complication of antithyroid medications (i.e. PTU) is
Agranulocytosis (dec. WBCs) leading to increase risk of infection
Your patient is experiencing thyroid storm. What are 4 nursing interventions for this complication?
Hypothermia blanket, cold packs, hydrocortisone, Tylenol, IVF w/ dextrose, PTU/methimazole, Iodine, propranlol, digoxin
A nurse is preparing to administer a medication to a 154 pound patient. The order read 0.5 mcg/kg/min. Available is 50 mg/250 mL. What should the nurse set the pump at in mL/hour?
10.5 mL/hour
A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective?
A. A decrease in blood sugar
B. A decrease in blood pressure
C. A decrease in urine output
D. A decrease in urine specific gravity.