question

Symptoms of syndrome of inappropriate antidiuretic hormone (SIADH)

answer

Fluid overload evidenced by weight gain, hyponatremia, low serum osmolality, concentrated urine, muscle cramps and weakness due to electrolyte imbalance; if untreated, lethargy, confusion, seizures, coma, death

question

Symptoms of hypothyroidism

answer

Bradycardia; cold intolerance; lethargy; memory loss; dry skin; brittle dry hair; decreased appetite; weight gain; constipation; increased serum lipids; decreased libido; erectile dysfunction

question

Nursing interventions for Activity intolerance related to fatigue secondary to hypothyroidism

answer

Assist with activities of daily living (ADLs), allow rest between activities, protect skin from breakdown related to immobility

question

Symptoms of hyperthyroidism

answer

Tachycardia; heat intolerance; fatigue; restlessness; tremor; emotional instability; insomnia; warm, moist skin; increased appetite, weight loss; frequent stools; decreased serum lipids; decreased libido; erectile dysfunction

question

Patient education for patients receiving low doses of radioactive iodine at home

answer

Use agency guidelines for education. In general, teach patient to avoid close contact with family for about a week; to use careful handwashing after urinating; to avoid oral contact with others; to wash eating utensils carefully; to treat sore throat with acetaminophen or lozenges; to increase oral fluid intake. Teach signs and symptoms of hypo- and hyperthyroidism to report.

question

Symptoms of thyrotoxic crisis

answer

Tachycardia, high fever, hypertension, dehydration, restlessness, delirium, coma, death if untreated

question

Symptoms and treatment of acute tetany

answer

Numbness and tingling around mouth and fingers, muscle spasms, cardiac dysrythmias; treat with IV calcium gluconate

question

Interventions for Risk for Injury related to calcium imbalance secondary to hyperparathyroidism

answer

Monitor calcium levels, encourage oral fluids, encourage weight-bearing exercises and ambulation with assistance, encourage smoking cessation, teach what symptoms to report

question

Patient education for Fluid Volume Deficit related to Addison's disease

answer

Assess knowledge base, teach hormone replacement (2/3 of dose in A.m. and 1/3 in p.m., as ordered), teach how to recognize stress and alter treatment during stressful times. Patient may need increased sodium intake during hot weather, should wear Medic Alert identification.

question

Symptoms of Cushing's syndrome

answer

Weight gain, truncal obesity, buffalo hump, moon face, glucose intolerance, muscle wasting, thin skin, osteoporosis, risk for infection, mental status changes, sodium and water retention

question

Autoimmune disorders in which the body attacks itself

answer

Hashimoto's thyroiditis, Grave's disease

question

Goitrogens

answer

Foods that can cause a goiter (ex. Turnips, cauliflower)

question

Ectopic hormones

answer

When hormones are produced outside of the endocrine gland where they are normally produced

question

Euthyroid state

answer

When the thyroid gland is functioning normally

question

Hyperplasia

answer

When excess tissue develops in the endocrine glands and produces too much hormone

question

Hypophysectomy

answer

Surgical removal of the pituitary gland. POST-OP- Monitor dressing for CSF. (CSF has glucose so drainage checked by a BS test with a glucose strip Use stool softeners and antitussives to prevent straining

question

Hypovolemic shock

answer

Occurs if fluid deficit is not corrected

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Myxedema

answer

Nonpitting edema that occurs in hypothyroidism

question

Nocturia

answer

excessive urination at night

question

Polydipsia

answer

Excessive thirst

question

Mr. Lloyd is admitted to your unit for severe end-stage respiratory disease. He has been on medication for many years to control his airway inflammation and now has Cushing's syndrome

answer

1. Cushing's syndrome is caused by exposure to excess cortisol. This can occur because of an adrenal problem, a pituitary problem, or from treatment with exogenous corticosteroids. 2. Hyperglycemia, moon face, thin skin, buffalo hump, truncal obesity, sodium and water retention and osteoporosis are common signs of Cushing's disease. 3. Mr. LLoyd should reposition every two hours & use a pressure-reducing mattress can help prevent pressure ulcers. Using a lift sheet prevents skin injury from friction and shear. Moisturizing cream prevents dry skin. 4. Glucocorticoids suppress immune system so Mr. LLoyd should be taught to avoid people who are ill and to use good handwashing techniques. 5. Mr. Lloyd is placed on high-dose IV glucocorticoids to relieve dyspnea and his blood glucose skyrockets. Insulin would be given to treat the hyperglycemia; (oral hypoglycemics typically are ineffective for steroid induced diabetes.

question

Positive Trousseau sign

answer

Is the indication of thumb and fingers spasm within 3 minutes of the sphygmomanometer is placed on the patients arm and pumped above the patients systolic pressure.

question

Malnutrition

answer

Worldwide, most common sign of dwarfism.

question

A patient treated for Hodgkin's disease and reports feeling better but has gained weight and has muscle cramps. The nurse knows that syndrome of inappropriate antidiuretic hormone can be a complication of cancer and cancer treatment. Which lab results would further assess the possibility?

answer

Serum calcium and phosphate

question

The nurse is collecting data on a patient who reports fatigue, weight gain, constipation and dry skin. The physician suspects primary hypothyroidism. Which of the following test results would the nurse expect to see.

answer

Low T3 and T4 levels, elevated thyroid-stimulating hormone levels

question

A patient with hyperthyroidism has been given an oral dose of radioactive iodine and is being released. The following should be included in discharge teaching.

answer

1. Advise the patient to avoid close contact with family members for about 1 week. 2. Encourage the patient to drink plenty of fluids. 3. Inform the patient of the symptoms of hypothyroidism to report. 4. Tell the patient to be vigilent about careful handwashing after urinating.

question

Which of the following assessment findings in a patient with hyperthyroidism being treated fro pneumonia should the nurse report to the physician immediately?

answer

Temperature of 104 degrees and Tachycardia

question

A patient reports he is having one of his "attacks" of rapid heart rate, palpitations, diaphoresis, tremors and severe pounding headache. Assessment reveals BP 160/120mm Hg and heart rate of 116 beats per minute, other vitals are within normal limits. Preliminary blood tests indicate elevated blood glucose. Which other lab test should the nurse expect to be ordered to help diagnose the patient?

answer

24-hour urine test for metanephrine and vanillylmandellic acid.

question

The nurse is assisting with the teaching for Addison's disease about new orders for hydrocortisone and fludrocortisone. This statements by the patient indicates that more teaching is necessary.

answer

I will eat a low-sodium diet.

question

The nurse is caring for the patient 6-hours post-transsphenoidal hypophysectomy. What sign should the nurse report to the physician immediately?

answer

The mustache dressing tests positive for glucose.

question

A patient who reports frequent urination and excessive thirst is being evaluated for possible diabetes insipidus. During the assessment the nurse notes poor skin turgor, BP 95/65 mm Hg and pale urine. What complication should the nurse be most concerned about?

answer

Hypovolemic shock

question

Which disorder results from too much cortisol secretion?

answer

Cushing's syndrome (regardless of exogenous or endogenous, it is caused by excess cortisol)

question

A patient with SIADH asks the nurse why he has gained 10 lbs. What is the best response for the nurse?

answer

"You have too much of a hormone in your system that causes you to retain water. The extra 10 lbs. is likely water weight." Antidiuretic hormone causes water retention without sodium or potassium retention.

question

Which assessment finding should the nurse expect to see in the patient with uncontrolled diabetes insipidus?

answer

Polyuria, Polydipsia and Dehydration. (Diabetes insipidus is caused by lack of antidiuretic hormone, which results in excess urination, thirst and dehydration.)

question

Which of the following nursing assessments is most important in the patient with hyperthyroidism and risk for thyrotoxic crisis.

answer

Vital signs - Elevated vital signs can signal the onset of thyrotoxic crisis

question

What instructions should the nurse provide to the patient who is being discharged after a thyroidectomy?

answer

"You must take your thyroid replacement everyday just as the physician prescribed." Thyroid hormone is essential to survival. If the thyroid gland has been removed, exogenous hormone replacement is required for life.

question

Which action by the nurse is most important following hypophysectomy?

answer

Performing a routine neurologic assessment. They are important to detect complications after surgery involving the central nervous system.

question

What statement by the patient with hypothyroidism indicates to the nurse that the plan of care is effective?

answer

"I feel so much better now that my energy is returning." A patient with hypothyroidism typically is fatigued; returning energy is a sign of effective therapy.

question

Amenorrhea

answer

Absence of menses

question

Dysphagia

answer

Difficulty swallowing

question

Ectopic

answer

When hormones are made outside of the endocrine gland.

question

Euthyroid state

answer

A normal functioning thyroid gland.

question

Goiter

answer

Enlargement of the thyroid gland. Usually non-toxic. (called endemic goiter when caused by iodine deficiency or other environmental factors.) SIGNS AND SYMPTOMS- Enlarged thyroid, swelling at base of neck

question

Myxedema coma

answer

Is caused by untreated hypothyroidism

question

Nocturia

answer

Excessive urination at night

question

Polydipsea

answer

Excessive thirst

question

Polyuria

answer

Excessive urination

question

Pheochromocytoma

answer

Tumor in the adrenal medulla

question

Diabeted Insipidus

answer

HORMONE PROBLEM: -antidiuretic hormone (ADH) deficiency MAJOR SIGNS & SYMPTOMS -Polyuria

question

(SIADH) syndrome of inappropriate ADH Secretion

answer

HORMONE PROBLEM: -ADH excess MAJOR SIGNS & SYMPTOMS -Water retention

question

Cushing's syndrome

answer

HORMONE PROBLEM: -Steroid excess MAJOR SIGNS & SYMPTOMS -Moon Face

question

Addison's disease

answer

HORMONE PROBLEM: -Deficient steroids MAJOR SIGNS & SYMPTOMS -Hypotension

question

Graves' Disease

answer

HORMONE PROBLEM: -High T3 and T4 MAJOR SIGNS & SYMPTOMS -Exophthalmos

question

Hypothyroidism

answer

HORMONE PROBLEM: -Low T3 and T4 MAJOR SIGNS & SYMPTOMS -Weight gain and fatigue

question

Pheochromocytoma

answer

HORMONE PROBLEM: -Epinephrine Excess MAJOR SIGNS & SYMPTOMS -Labile Hypertension

question

Hyperparathyroidism

answer

HORMONE PROBLEM: -High serum calcium MAJOR SIGNS & SYMPTOMS -Muscle weakness, brittle bones

question

Short stature

answer

HORMONE PROBLEM: -Growth hormone (GH) deficiency MAJOR SIGNS & SYMPTOMS -Failure to grow and develop

question

Acromegaly

answer

HORMONE PROBLEM: -Excess Growth hormone (GH) MAJOR SIGNS & SYMPTOMS -Growing hands and feet -Curvature of spine ________________________________________(dopamine is an agonist to GH) (Can cause swallowing problems or patients may need speech therapy) THERAPEUTIC MEASURES-aimed to treat cause. Use vasopressins.

question

Hypoparathyroidism

answer

HORMONE PROBLEM: -Low serum calcium MAJOR SIGNS & SYMPTOMS -Tetany

question

Hyperthyroidism symptoms

answer

*Results in excessive amounts of circulating thyroid hormone (thyrotoxicosis) *Autoimmune disease that can be caused by Graves disease *more common in young woman *Multimodular goiter is more common in older women. *Eyes wide open (Exophthalmos) caused by Graves Disease CARDIOVASCULAR- Tachycardia, increased cardiac output, warm skin, heat intolerance NEUROLOGIC- Fatigue, restlessness, hyperactive reflexes, tremor, insomnia, emotional stability PULMONARY- Dyspnea INTUGUMENTARY- Diaphoresis, Warm, moist skin; fine, soft hair GASTROINTESTINAL- Increased appetite, weight loss, frequent stools, decreased serum lipid levels REPRODUCTIVE- Decreased libido, erectile dysfunction, amenorrhea. PRIMARY- Increased TH, Decreased TSH SECONDARY (pituitary cause)- Increased TH, Increased TSH Therapeutic measures- Check thyroid hormone levels, antifibroid meds, radioactive iodine, use eyedrops to keep moist, may have to use tape to close eyes to sleep

question

Hypothyroidism symptoms

answer

*Be careful, the thyroid is in front of the parathyroid. *Can be caused by hyperthyroid treatments CARDIOVASCULAR- Bradycardia, decreased cardiac output, cool skin, cold intolerance NEUROLOGIC- Lethargy, slowed movements, memory loss, mental dullness, confusion PULMONARY- Dyspnea, hypoventilation INTUGUMENTARY- Cool, dry skin; brittle, dry hair GASTROINTESTINAL- Decreased appetite, weight gain, constipation, increased serum lipid levels REPRODUCTIVE- Decreased libido, erectile dysfunction. Hypercholesterolemia PRIMARY- Decreased TH, Increased TSH SECONDARY (pituitary cause)- Decreased TH, Decreased TSH *Can cause coma when not treated. *Monitor and record bowel movements.

question

Following thyroidectomy, the nurse watches carefully for which signs of tetany?

answer

Numb fingers and muscle cramps (caused by change in PH and low serum calcium)

question

What assessment findings should the nurse monitor to detect the onset of thyrotoxicosis in a patient with hyperthyroidism?

answer

Vital Signs (Thyrotoxicosis causes increases in BP, pulse, temp and respirations)

question

What dietary recommendations will reduce the risk of kidney stones in the patient with hyperparathyroidism?

answer

Increase fluids

question

An excess of which hormone is responsible for acromegaly?

answer

Growth hormone

question

Which nursing diagnosis is most appropriate for the patient admitted in addisonian crisis?

answer

Addison's is associated with fluid loss so the nursing diagnosis would be Deficient fluid volume.

question

A 42-year old woman enters an outpatient clinic with symptoms of weight gain and fatigue. Lab studies are done, and she is diagnosed with primary hypothyroidism. She asks why her thyroid-stimulating hormone (TSH) level is elevated. How should the nurse respond?

answer

"The pituitary makes more TSH to try to stimulate the underactive thyroid."

question

Which nursing diagnosis is most appropriate for a patient with weight gain and fatigue related to hypothyroidism.

answer

Activity Intolerance related to fatique.

question

A patient with hypothyroidism is started on levothyroxine (Synthroid), a synthetic thyroid hormone. You know she understands the side effects of this medication when she makes the following statement:

answer

"I know I should call my doctor if my heart races."

question

A 26-year old female patient is hospitalized for radioactive iodine treatment for hyperthyroidism. Which of the following precautions by the nurse is appropriate?

answer

Wear gloves when changing bedside commode. (Output will be radioactive.)

question

The nurse needs to accomplish all the following interventions for a patient who is 24-hours post-thyroidectomy in this order:

answer

1. Verify the airway is patent 2. Assess vital signs 3. Check the surgical site dressing for signs of bleeding 4. Administer and analgesic for post-operative pain. 5. Assist with range of motion exercises 6. Teach the patient about synthroid (levothyroxine) use after discharge

question

The nurse develops the nursing diagnosis of Acute pain r/t bone demineralization for a patient with hypoparathyroidism. What goal is most appropriate?

answer

Patient will verbalize acceptable pain level. (The nurse should address the pain)

question

A patient enters a clinic with possible Cushing's syndrome. Which of the following physical examination findings support this diagnosis?

answer

Buffalo hump and easy bruising

question

What data is important for the nurse to monitor in a patient with a pheochromocytoma?

answer

Vital signs

question

Goitrogenic

answer

Medications like propylthiouracil, sulfonamides, lithium and salicylates that are goiter producing.

question

Hyperplasia

answer

Excessive increase in the number of normal cells

question

Hypophysectomy

answer

Surgical removal of the pituitary gland

question

Nephrogenic

answer

Produced by the kidney

question

Osmolality

answer

Osmotic concentration; ionic concentration of the dissolved substances per unit of solvent.

question

Pheochromocytoma

answer

Rare tumor of he adrenal system that secretes catecholamines. Causes hypersecretion of epinephrine and norepinephrine Therapeutic measures-alpha-blocking meds phenoxybenzamine (Dibenzaline) to dilate blood vessels to control hypertension (blocks epinephrine)

question

Psychogenic

answer

Related to the mind.

question

Tetany

answer

Muscle spasms, numbness and tingling caused by changes in PH and low serum calcium.

question

Colorless urine

answer

Can be caused by dehydration which can cause you to go into shock

question

Therapeutic measures for DM

answer

Hydration medications (Hypotonic IV fluids) can be ordered to replace intravascular volume without adding excess sodium. Vasopressins - nasal spray

question

If a tumor is surgically removed...

answer

Test electrolyte measures

question

Insufficient ADH

answer

DISORDER- Diabetes Insipidus SIGNS AND SYMPTOMS-Polyuria, polydipsia, dehydration, dilute urine DIAGNOSTIC TESTS-Urine specific gravity, urine and plasma osmolality, water deprivation test THERAPEUTIC MEASURES- Synthetic ADH replacement PRIORITY NURSING DIAGNOSES- Deficient fluid volume, Risk for Ineffective Self Health Management

question

Excess ADH

answer

DISORDER- SIADH SIGNS AND SYMPTOMS-Fluid retention, weight gain, concentrated urine DIAGNOSTIC TESTS-Serum and urine sodium osmolality; water load tes THERAPEUTIC MEASURES- Treat cause PRIORITY NURSING DIAGNOSES- Excess fluid volume, Risk for Ineffective Self Health Management

question

Manifestations of Dilutional Hyponatremia

answer

Bounding pulse Elevated or Normal BP Muscle weakness Headache Personality changes Nausea Diarrhea Convulsions Coma

question

Insufficient PTH

answer

DISORDER- Hypoparathyroidism SIGNS AND SYMPTOMS- Hypocalcemia, neuromuscular irritability, tetany, positive Chvostek's and Trousseau's signs DIAGNOSTIC TESTS- Serum PTH, calcium and phosphate THERAPEUTIC MEASURES- Calcium and Vitamin D replacement; High calcium, low phosphorous diet PRIORITY NURSING DIAGNOSIS- Risk for Injury related to tetany

question

Excess PTH

answer

DISORDER- Hyperparathyroidism SIGNS AND SYMPTOMS- Hypercalcemia, fatigue, pathological fractures DIAGNOSTIC TESTS- Serum PTH, calcium and phosphate THERAPEUTIC MEASURES- Calcitonin, parathyroidectomy. PRIORITY NURSING DIAGNOSIS- Risk for Injury related to bone demineralization

question

HYPOFUNCTION of Adrenal Cortex Hormone

answer

DISORDER- Adrenocortical insufficiency, Addison's disease SIGNS AND SYMPTOMS- Sodium and water loss, hypotension, hypoglycemia, fatigue DIAGNOSTIC TESTS- Serum and Urine Cortisol THERAPEUTIC MEASURES- Glucocorticoid and mineralocorticoid replacement PRIORITY NURSING DIAGNOSIS- Risk for Deficient Fluid Volume

question

HYPERFUNCTION of Adrenal Cortex Hormone

answer

DISORDER- Cushing's syndrome SIGNS AND SYMPTOMS- Weight gain, sodium and water retention, hyperglycemia, buffalo hump, moon face DIAGNOSTIC TESTS- Serum and Urine Cortisol THERAPEUTIC MEASURES- Alter steroid therapy dose or schedule; surgery if tumor PRIORITY NURSING DIAGNOSIS- Risk for Excess Fluid Volume, Unstable Blood Glucose Level, Infection

question

To remember adrenal cortex hormones think Salt, Sugar and Sex

answer

Aldosterone promotes salt retention Cortisol affects sugar (carbohydrate) metabolism Androgens are sex hormones

Chapter 39 – Care of patients with endocrine disorders – Flashcards

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