Endocrine

Question 1

what is the fnxn of the thyroid

Answer 1

• regulates metabolism

Question 2

hyperthyroidism leads to…

Answer 2

• hypermetabolism

Question 3

what are S&S of hyperthyroidism

Answer 3

• weight loss
• increased P
• increased BP
• irritable
• heat intolernce (they run hot)
• cold tolerance (bc they’re hot)
• exopthalamus (bulging eyes)
• graves disease

(think of what youd see if someone had a high metabolism)

Question 4

what is treatment for hyperthyroidism (3)

Answer 4

• radioactive iodine
• PTU (Propylthiouracil, think: Put Thyroid Under)
• thyroidectomy (surgical removal)

Question 5

what is included in teaching for pts on radioactive iodine

Answer 5

• must isolate for the 1st 24 hrs
• caution with urine –> flush 3 times, if spills need to call hospital hazmat urine, etc.

Question 6

what is the primary use of Propylthiouracil

Answer 6

• cancer
• special use = hyperthyroidism

Question 7

what is a risk associated with Propylthiouracil? what needs to be monitored?

Answer 7

• immunosuppression
  = monitor WBCs

Question 8

what are 2 types of thyroidectomy

Answer 8

1. total/complete
2. sub total/partial

Question 9

what is included in care after a total thyroidectomy

Answer 9

• will require lifelong hormone replacement
• risk of hypocalcemia (so look for S&S of hypocalcemia)

Question 10

what is included in care after a subtotal thyroidectomy

Answer 10

• no lifelong replacement, maybe temporary
• less risk of hypocalcemia
• risk of thyroid storm/crisis (medical emergency)

Question 11

what are S&S of thyroid storm (4)

Answer 11

• ++ increased temp
• ++ increased BP (stroke category)
• ++ HR
• psychic delirium

Question 12

what risk is associated with thyroid storm

Answer 12

• permanent brain damage

Question 13

what is treatment of thyroid storm

Answer 13

self-limiting, will eventually stop = goal: spare brain

• decrease temp
• increase O2 (O2 mask)

Question 14

how should you decrease a temp with thyroid storm

Answer 14

1. ice bath (first)
2. cooling blanket (best)

Question 15

what post-op risk is greatest within the first 24 hours after any type of thyroidectomy

Answer 15

1: risk of edema = airway compression

#2: hemorrhage

Question 16

what post-op risk is the greatest in the first 12-48 hours after a total thyroidectomy

Answer 16

• low Ca = tetany = risk of airway obstruction

Question 17

what post-op risk is the greatest in the first 12-48 hours after a partial thyroidectomy

Answer 17

• thyroid storm

Question 18

what post-op risk is the greatest after 48 hours after a total thyroidectomy

Answer 18

• infection

(exam tip: do not pick infection if question asks about the greatest concern before 48-72h postop)

Question 19

what impact does hypothyroidism have on metabolism

Answer 19

• low metabolism

Question 20

what are S&S of hypothyroidism

Answer 20

• obese
• lethargic
• flat, dull
• cold intol
• heat tolerance
• low P
• low BP
• slow
• myxedema

Question 21

what is treatment for hypothyroidism

Answer 21

• thyroid hormones
  ex. levothyroxine/synthroid

Question 22

what is a general rule regarding sedation and a pt with hypothyroidism

Answer 22

• DO NOT sedate (they are already lethargic)

Question 23

what 2 diseases have to do with the adrenal cortex

Answer 23

• addison’s
• cushings

Question 24

what is addison’s disease

Answer 24

• adrenal insufficiency

Question 25

what are S&S of addison's disease

Answer 25

- hyperpigmentation (tan) - unable to adapt to stress

Question 26

when a pt with addison's disease experiences stress, what can happen?

Answer 26

- drop in BG - drop in BP (shock) = risk of decreased perfusion to brain

Question 27

what is treatment for addison's

Answer 27

- steroids (glucocorticoids) (think: need to ADD steroids)

Question 28

glucocorticoids end in

Answer 28

____asone

Question 29

what is cushing's disease

Answer 29

- excess adrenal

Question 30

what are S&S of cushing's disease? (and therefore side effects of glucocorticoids)

Answer 30

- irritable - moon face - hirsituism (increased body hair) - buffalo hump - gynecomastia - skinny arms & legs (d/t atrophy) - trunkal/central obesity - straie - bruises - water & Na retention - decreased K+ - increased BG - immunosuppression

Question 31

what is treatment for cushing's disease

Answer 31

- adrenalectomy

Question 32

what risk is associated with bilat adrenalectomy

Answer 32

- risk of addison's disease = give steroids