Diabetes
One requires insulin administration, one does not.
What is DM-1 and DM-2
These labs will be drawn to assess the function of the thyroid gland
what are TSH, T3, T4 will be the first labs drawn
Pituitary hormones, name 4
What is...Anterior lobe: adrenocorticotropic hormone (ACTH), growth hormone (GH), TSH, melanocyte-stimulating hormone, FSH, LH, prolactin (PRL), somatotropin growth-stimulating hormone,
Posterior lobe: oxytocin, Vasopressin, antidiuretic hormone (ADH)
What is: Addison's disease--lethargy, fatigue, weight loss, hypoglycemia, hyponatremia, hypotension, hyperpigmentation of skin (bronzed skin)
What is: regular insulin
Your patient has a glucose of 58, is diaphoretic, cool, and clammy and is able to speak. Your next step as a nurse would be to....
What is provide carbohydrate source of 15g and monitor patient closely, repeating FS in 15 minutes.
Term used for an enlarged thyroid gland a
What is goiter
Hyperpituitarism (acromegaly) assessment findings
what is: organomegaly, large hands and feet, thickening and protrusion of the jaw, arthritic changes and joint pain, colon polyps, diaphoresis, visual disturbances, thickening of tongue and narrowing of the airway
Addisonian crisis--precipitating factors
What is: most commonly stress, infection, surgery, abrupt withdrawal of exogenous corticosteroid use
prepare to administer high-dose hydrocortisone replacement IV, fluid/electrolyte administration, protect pt from infection, bedrest and quite environment suggested, after crisis is over, administer glucocorticoid and mineralocorticoid as prescribed.
What is: when a patient is semiconscious or unconscious and is hypoglycemic.
Patient presents to ED with nearly unresponsive state, has hot/dry skin, has a fruity odor to breath. Your likely to assume the patient has...
What is Diabetic Ketoacidosis (DKA)
Autoimmune disease, most common form is Graves' disease and list causative factors
What is hyperthyroidism--excess thyroid hormone secretion
Causative factors include: lack of iodine, smoking, infection, stressful life events, that can interact with genetics to cause Graves'
what is: excretion of large amounts of dilute urine, polydipsia, dehydration, inability to concentrate urine, tachycardia
Hypercortisolism is also known as...
and the assessment
What is Cushing's syndrome--moon face, buffalo hump, truncal obesity with thin extremities, hirsutism, hyperglycemia, hypokalemia, HTN, fragile skin bruises easily, red/purple stare on the abdomen and upper thighs
Most appropriate time to administer levothyroxine
What is: in the am, on an empty stomach
what is metformin, causes diarrhea, and renal issues.
Common treatments for hyperthyroidism
What is antithyroid medications (propylthiouracil, methimazole (Tapazole), Iodine, Beta-blockers (propranolol or atenolol), radioactive iodine therapy (RAI), surgery
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) assessment and interventions
What is...assessment: fluid volume overload, changes in mental status, HTN, tachycardia, anorexia, n/v, hyponatremia, low urine output/concentrated urine
intereventions:monitor v/s, heart, neurological status. monitor for signs of ICP, begin seizure precautions, elevated HOB, I&O, monitor electrolytes, fluid restrictions of 800-1000ml/day, loop diuretics
What is...monitor VS, especially BP, I&O, labs--specifically WBC, glucose, Na, K, and Ca levels.
possible radiation/chemo, and surgery for removal of adrenal gland if from adrenal adenoma (will need glucocorticoid replacement if done)
encourage pt to wear a medical alert bracelet
What is: vitamin D, calcium, biphosphonates
Treatment for DKA includes...
What is...IV established, labs drawn, including BMP/CMP, CBC, ABG's, and urinalysis. Patient will be placed on a cardiac monitor, insulin administration either sub-q or IV. This would reflect the treatment for a patient presenting with...
What is...elevated TSH, need for thyroid replacement (levothyroxine), cold intolerance, dry skin, weight gain, bradycardia, constipation, menstrual disturbances
what is: craniotomy and sublabial transsphenoidal (endoscopic transnasal) approach. transnasal approach is preferred, d/t less complications
Drug alert with Corticosteroids
What is: do not stop abruptly, monitor for signs of infection, if dm pt, monitor glucose closely
The following chapters are on the exam
What is: Lewis 47, 48, 49; Lilley 30, 31, 32, 33 Grodner 15, Hockenberry 28