DI/SIADH
True or false?
Hypotension, tachycardia, and edema are expected manifestations
False
True or false?
Hyperkalemia is often seen in Cushing's disease
False
Hypernatremia can be a risk
True or false?
TSH is typically decreased in the setting of Grave's Disease
True
*Remember Grave's Disease is autoimmune disorder affecting the thyroid gland
True of False?
Parathyroid hormone tells the bones to absorb calcium from the blood stream
False- controls release of calcium from bones
-helps absorb calcium from food
-helps kidneys retain calcium
True or False?
It is important for a client to blow their nose frequently after a hypophysectomy
False :)
Which would be a decline in the patient's condition?
a. polydipsia
b. Light, clear urine
c. BP 90/55 --> 80/40
d. dry mucous membranes
C. Declining blood pressure
(Risk for circulatory collapse and hypovolemic shock)
Which symptoms could cause suspicion for adrenal crisis?
a. HTN & abdominal pain
b. widened pulse pressure & shortness of breath
c. Confusion & tachycardia
d. Bradycardia & nausea
c. Confusion & tachycardia
Name 2 safety considerations for radioactive iodine therapy
-time, distance
-do not share toilet for 2 weeks
-flush 3 times
-do not share laundry load, run full cycle after washing contaminated clothing
-Avoid saliva contamination
Name 2 treatments for hyperparathyroidism
-phosphate supplementation
-Diuretics
-Thyroid lobectomy
Name 2 Diseases that may require a hypophysectomy
-Acromegaly
-Cushing's Disease
List 4 causes/risk factors that can cause Diabetes Insipidus
*Head injury
*Tumors/lesions
*Surgery/irradiation near or around pituitary gland
*Lithium carbonate & Demeclocycline
(Neurogenic or nephrogenic causes)
Name 3 dietary considerations for a client with Cushing's disease.
-ensure adequate potassium
-decrease sodium intake
-low calorie diet
-low carbohydrate diet
Name 4 medications/treatments for Hyperthyroidism
-Methimazole
-Propylthiouracil
-Propranolol
-potassium iodine
-radioactive iodine (ablation)
-Thyroidectomy (partial or total)
Name 3 complications the nurse should monitor for in a client with hyperparathyroidism
-pathological fractures
-renal calculi
-osteomalacia
-Depression
A patient following a hypophysectomy is presenting with clear drainage from their nasal packing, what is your next action?
a. notify provider
b. test drainage for ketones
c. test drainage for glucose
d. have them wipe their nose with a sterile gauze
c. test drainage for glucose
(Then notify provider)
Which of the following is true for a client with SIADH?
a. decreased blood sodium
b. increased urine specific gravity
c. decreased urine specific gravity
d. increased Hgb, BUN, Hct.
e. decreased blood osmolarity
a. decreased blood sodium
b. increased urine specific gravity
e. decreased blood osmolarity
Nursing Care after adrenalectomy, SATA:
a. provide glucocorticoid/hormone replacement
b. Restrict Fluids and electrolytes
c. monitor abdomen for distention
d. Monitor for hypotension, tachycardia, tachypnea, nausea, headache
e. expect to discharge patient as a same-day procedure
a. provide glucocorticoids/hormone replacement
c. monitor abdomen for distention (& bowel sounds)
d. Monitor for hypotension, tachycardia, tachypnea, nausea, headache (signs of adrenal crisis)
Which of the following should the nurse report immediately for a client with hypothyroidism?
a. joint pain
b. decreased level of consciousness
c. hoarse speech
d. HR 57
b. decreased level of consciousness
Name 5 signs of HYPOparathyroidism
-tremors
-tetany
-brittle nails
-cardiac arrythmias
-decreased cardiac output
A patient following a thyroidectomy has a calcium level of 7.5, what is the next anticipated action?
-What should be monitored?
administer IV calcium gluconate
-Monitor signs of hypotension, monitor signs of hypocalcemia, monitor for arrythmias, monitor for seizures
Which medications can be used for SIADH? SATA
a. Furosemide
b. Desmopressin (DDAVP)
c. demeclocycline
d. Hypotonic IV fluid
e. Fluoroquinolones
a. Furosemide
c. demeclocycline
*HYPERtonic fluids
*Fluoroquinolone use is risk factor
*DDAVP is for DI
S/S for Cushing's disease, SATA:
a. Obese extremities
b. Moon face
c. Purple Striae
d. Tremors
e. Buffalo hump
f. increased bone strength
g. Weight loss
b. moon face
c. purple striae
e. buffalo hump
Name 8 signs of a thyroid storm
Which will this happen in, hypo or hyper?
-hyperthermia
-hypertension
-delirium
-vomiting
-abdominal pain
-tachydysrhythmias
-chest pain
-dyspnea
-palpitations
Why does increased calcium cause decreased phosphorus?
phosphate binds to calcium --> reduces amount of free calcium in the blood stream
Inverse relationship
Name 5 Nursing care considerations after a thyroidectomy
-positioning (semi-fowlers)
-assess dressing & at back of neck
-assess voice (hoarseness/sore throat)
-monitor for laryngospasm
-Keep emergency equipment at bedside: Tracheostomy tray, endotracheal supplies, O2, suction, IV calcium