Diagnostic Testing
Measures the concentration of dissolved substances in urine, providing insights into hydration status and kidney function. A normal range is typically between 1.005 and 1.030.
What is Urine Specific Gravity?
Constipation, bradycardia, weight gain, slurred speech and prolonged DTRs.
What is clinical manifestations of Hypothyroidism?
Fluid Restriction if sodium is >125 mEq/L to 800-1000 mL/day; result in weight reduction and gradual rise in sodium. Loop diuretic (furosemide) only if sodium > 125 mEq/L
What is the treatment for Syndrome of inappropriate antidiuretic hormone (SIADH)?
SIADH results from an overproduction of ADH or the release of ADH despite normal or low plasma osmolality.
Adverse Effects of this medication include: Tachycardia, palpitations, angina, dysrhythmias, hypertension, insomnia, tremors, headache, anxiety, nausea, diarrhea, cramps, menstrual irregularities, weight loss, sweating, and heat intolerance.
What is Levothyroxine (Synthroid)?
Instruct patient/parents the necessity of long-term therapy for adrenocortical insufficiency (glucocorticoids and mineralocorticoids), salt additives for excess heat or humidity.
What is management of Addison's disease?
Baseline cortisol and ACTH levels are measured, and the patient is given an IV injection of synthetic ACTH (cosyntropin). Cortisol and ACTH levels are rechecked after 30 and 60 minutes.
What is the ACTH Stimulation Test?
The normal response is a rise in blood cortisol levels. No rise or minimal rise in plasma cortisol noted in Addison’s Disease.
Weight gain is the most common feature. (centripetal obesity, moon face, and cervical areas/buffalo hump), hyperglycemia, muscle wasting esp. in extremities, osteoporosis, skin thinner, and more easily bruised, and purplish red striae.
What are clinical manifestations of Cushing Syndrome?
Treatment is directed toward shock management and high-dose hydrocortisone replacement. Large volumes of 0.9% saline solution and 5% dextrose are given to reverse hypotension and electrolyte imbalances until BP returns to normal.
What condition?
What is Addisonian crisis?
Addisonian crisis is a life-threatening emergency requiring aggressive management.
Clinical Manifestations: Hypotension, nausea, vomiting, weakness, lethargy, fever, confusion, acute abdomen, and possibly coma
May be precipitated by physiologic stress, such as surgery, infection, trauma, and dehydration
Methimazole (Tapazole), Propylthiouracil (PTU), Beta-adrenergic Blocker (Propranolol)
What are medications to treat Hyperthyroidism?
Instruct the patient to take their medication in the morning before food (30 minutes) and that it may take up to 8 weeks before the full effect of hormone therapy is seen.
What is administration of Levothyroxine (Synthroid) for patients with Hypothyroidism?
Elevated Thyroid stimulating hormone and decreased thyroxine (T4).
What is Hypothyroidism?
Abdominal pain, diarrhea, anorexia, nausea, and weight loss, bronze-colored skin hyperpigmentation, headache, orthostatic hypotension, tachycardia, water loss, dehydration, hypovolemia, salt craving, hyponatremia, hyperkalemia, and hypoglycemia.
What is Addison's Disease?
Chlorpropamide and carbamazepine (Tegretol) can help decrease thirst for...
What is Diabetes Insipidus?
Hydrocortisone (Cortef) prednisone or methylprednisolone, the most common form of hormone therapy; Mineralocorticoids (Aldosterone) are replaced with fludrocortisone acetate.
Used to treat what condition?
What is Addison's disease?
Provide written and verbal instructions on when to change the dose. Review stress management techniques. If vomiting or diarrhea occurs, as may happen with gastroenteritis, the patient should notify the HCP at once. Electrolyte replacement and parenteral administration of cortisol may be needed.
What is education for a client with Addison's disease.
Pre-test: Check body weight, and urine osmolality, volume, and specific gravity.
Patient is deprived of water for 8 to 12 hours and then given desmopressin acetate (DDAVP) subcutaneously or nasally. Assess urine osmolality and urine output.
What is the Water Deprivation Test?
Patients with central DI have a dramatic increase in urine osmolality (from 100 to 600 mOsm/kg) and a significant decrease in urine volume
Goiter, exophthalmos, diarrhea, hyperactive DTRs, weight loss, moist skin.
What are clinical manifestations of Hyperthyroidism?
DDAVP (Desmopressin acetate) is the hormone replacement of choice.
What is the medication/hormone prescribed for Diabetes Insipidus?
Shortness of stature (child)
What is Growth Hormone? Used to treat hypopituitarism
The anterior pituitary gland secretes: Growth hormone (GH)
The health care provider prescribes levothyroxine for a patient with hypothyroidism. After teaching about this drug, the nurse determines that further instruction is needed when the patient says: a. “I can expect the medication dose may need to be adjusted.” b. “I only need to take this drug until my symptoms are improved.” c. “I can expect to return to normal function with the use of this drug.” d. “I will report any chest pain or difficulty breathing to the doctor right away.”
What is b. “I only need to take this drug until my symptoms are improved.”
Autoimmune etiology and associated with proptosis (exophthalmos), hypertrophy and hyperplasia of the thyroid gland, increased vascularity and blood flow and enlargement of the gland, increased metabolic rate with excessive heat production, increased neuromuscular and cardiovascular activity, hyperactivity of SNS.
What is Graves Disease?
The most damaging or serious adverse effects of the anti-thyroid medications are liver and bone marrow toxicity. It is a life-threatening blood disorder. It happens when the body doesn't make enough of a type of white blood cells called neutrophils.
What is Agranulocytosis?
The client is monitored in the Intensive Care Unit, IV fluids are administered cautiously, avoid rapid rewarming, and IV thyroid hormone replacement (levothyroxine) is administered.
What is ......?
What is Myxedema Coma?
This therapy destroys thyroid tissue.
What is Radioactive Iodine Therapy?
The nurse is educating the client about adverse effects of this medication, which include:
Suppressed inflammatory response, Glucose intolerance, ↑ Risk for infection, osteoporosis, and peptic ulcer disease.
What are Corticosteroids?
Used to treat: Hypercalcemia, Hashimoto’s thyroiditis, Thyrotoxicosis, Adrenal insufficiency, and Congenital adrenal hyperplasia