Med Surg Quiz Endo
Pts with hypothyroidism are very sensitive to what medications?
-Pt is very sensitive to sedatives and opioids. -Go with non narcotics like tylenol.
What is your parathyroid responsible for?
Calcium levels
Toxic nodular goiter (Cause of hyperthyroidism)
Cause of Hyperthyroidism -Nodular growths on neck, that independly work that secrete T3 and T4 which causes hyperthyroidism symptoms
S/S of Graves disease
Exopthalamus (protruding eyeballs) Goiter Myexedema pretibial (waxy orange peel skin appearance on skin of feet or legs)
Too much iodine can cause what?
Hyperthyroidism
Hyperthyroidism S&S
Weight loss (burning calories!) Heat intolerance (feel hot and sweating and can't tolerate heat d/t body temp increase) Increase in HR and BP Diarrhea (GI system is in overdrive) Smooth hair and soft skin (d/t increased blood flow) at risk for Cardiac dysrrhthmias Personality changes (moody, restless)
a nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism?
a client who has a phosphate of 5.7 mg/dl -this level is above the expected reference range of 3.0 to 4.5 mg/dl. Phosphorus levels are increased in a client who has hypoparathyroidism.
a nurse is planning care for a client who is post-operative following a thyroidectomy. Which of the following interventions should the nurse include in the plan?
check the clients voice every 2 hours -the nurse should assess the client's voice every 2 hours to monitor for horses, which is the manifestation of laryngeal nerve
a nurse is assessing a client who has hypoparathyroidism. Which of the following findings should the nurse expect?
client report of numbness in his hands -numbness and tingling in the clients hands and feet are manifestations of hypoparathyroidism do to hypocalcemia
a nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect?
hyperpigmentation -Addison's disease is an endocrine disorder that occurs when the adrenal glands do not produce enough of the hormones cortisol, and in some cases the hormone aldosterone. The disease is characterized by weight loss muscle weakness fatigue low blood pressure and hyperpigmentation (darkening) of the skin in both exposed and not expose parts of the body
a nurse is assessing a client who has Cushing's syndrome. which of the following findings should the nurse expect?
hyperpigmentation -hyperpigmentation, bruising, and striae or stretch marks, are manifestations of Cushing's syndrome
Synthroid can cause what?
Adrenal insufficiency (because it increases metabolism of glucocorticoids)
How is hyperthyroidism dianosed?
Blood tests T3, T4 + TSH Levels
Graves disease S&S
Weight loss Heat intolence Tachy and HTN Diarrhea Irratabliity -Smooth skin/hair -Red swelling, orang peel kind of skin UNIQUIE: Eye changes (exophthalamus) [protruding eyeballs] -Goiter of neck (d/t overstimulation of thyroid hormone) -
Addisonian crisis
adrenal gland crisis -BARELY ANY CORTISOL LEVELS LEFT 5 S's -Sudden pain in stomach, back and legs -Syncope -Shock -Super low blood pressure -Severe vomiting, diarrhea and headache
a nurse is assessing a client who is receiving liothyronine for treatment of hypothyroidism. The nurse should recognize which of the following findings is a therapeutic response to this medication?
increase in energy -an increase in energy is the therapeutic response to liothyronine. Depression, lethargy, and fatigue are manifestations of hypothyroidism and effective treatment will improve these manifestations
Thyroiditis (Cause of hyperthyroidism)
inflammation of thyroid gland. Inflammation of thyroid gland causes it to release more thyroid hormones into the blood.
a nurse is providing teaching to a client who has a new diagnosis of hypothyroidism. Which of the following medication should the nurse prepare to instruct the client?
levothyroxine -levothyroxine is a synthetic thyroid hormone that is chemically identical to thyroxine T4. it is used in the treatment of hypothyroidism. The nurse should prepare to instruct the client on use of this medication.
Cushing's DISEASE cause
An INSIDE source producing too much CORTISOL (Ex. Pituitary gland secreting too much ACTH)
Adrenal crisis aka (Addisonian crisis) causes
-Damaged adrenal cortex -Adrenalectomy --Tx for Cushings. --Pt has to take adrenal corticoids post op adrenalextomy -Adrenal gland damage -Not able to produce enough ACTH which results in cortisol not being released
Treatment for hyperthyroidism
Antithyroid meds Radioactie iodine beta blockers thyroidectomy
a staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make?
"It is caused by the lack of production of aldosterone by the adrenal gland" -Addison's disease is caused by the lack of production of adrenocorticotropic hormones (cortisol and aldosterone) by the adrenal gland.
Hypothyroidism pt education
-Don't stop meds abruptly -take synthroid in the morning no food just water one hour before you eat. Same time every day. -Lifelong medication -Monitor for hyperthyroid symptoms (chest pain, heat intollerance etc) [If pt experiences these, they are probably at toxic levels with their meds] -Don't take within 4 hours of taking GI drugs like carafate, aluminum hydroxide, simoconine. -They can decrease the absorption of the drugs
Myxedema coma S&S
-Hypothermia (not just intolerant to cold) -Myxedema: swelling of the tissues that has a waxy appearance or orange peel texture of eyes and face -Decrease BP and HR to dangerous levels HYPONATREMIA (d/t increase of ADH hormone which causes body to conserve water ultimately sodium is watered down) HYPOGLYCEMIA (d/t decrease in metabolism rate)[decreases need for glucogenesis]
Graves disease meds
Antithyroid meds Tapazole (Mithimezoe) PTU (Watch out for agranulocytosis and thrombocytopenia) -Beta blockers (Inderal) -Radioactive iodine -S/E: [Iodinism] -taste change, metal taste, nausea, swollen saliva glands
Meds for hyperthyroidism
Antithyroid meds (stop thyroid from synthesizing T3T4) [DONT DAMAGE THYROID] -Tapazole (methemazole) (Can't be used in first trimester in pregnancy) -PTU (propythiourocil) (Safe in first trimester) [can cause liver failure] Side effects of these meds: -Agranulocytosis, aplastic anemia -Tell pt to not stop taking meds abruptly -take med at same time everyday -Tell them the medication takes a while to work -Monitor themselves for thyroid storm (if they experience this, they need more anti-thyroid medication) -Restrict iodine intake (Seaweed, eggs, dairy) -NO salycilates like ASPIRIN -Aspirin increases thyroid hormone Watch out for signs of medication toxicity (hypothyroid symptoms!)
Graves disease (Cause of hyperthyroidism)
Auto immune that causes hyperthyroidism. TSI (from autoimmune response) is produced which acts like TSH. [body thinks TSI is TSH and allows excessive amounts of T3 and T4 to be produced] -Runs in families
Graves disease
Common in hyperthyroidism due to an autoimmune condition (present with excessive thyroid hormone)
Addisons disease
DECREASED AMOUNT OF ALDOSTERONE AND CORTISOL You have to ADD some! Add aldosterone and cortisol
Hypoparathyroidism causes
Damage or manipulation to thyroid gland or parathyroid gland -Thyroidectomy -Low magnesium level (Magnesium plays a role in how the parathyroid hormone works) -Autoimmune -Body is resistant to PTH (kidneys and bones don't react to PTH)
Hypoparathyroidism
Hypocalcemia and High PHOSPHATE LEVEL
Nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations?
Frequent mood changes. -Hyperthyroidism develops when the thyroid gland produces an excess of the thyroid hormones that regulate the metabolic rate. Clients experience emotional lability that fluctuates between emotional hyperexcitability and irritability. They often cannot sit quetly.
If anterior pituitary gland has a tumor or something else wrong with it, it won't be able to produce TSH which will cause what?
Hypothyroidism. Because T3 and T4 are not able to be produced.
Cushing's disease
INCREASE IN CORTISOL (Cushing, an increased amount)
Nurse is caring for a client who has chronic hypothyroidism. For which of the following conditions should the nurse monitor?
Lethargy -Lethargy is an early sign of mexeema coma, which can progress to stupor and respiratory failure.
Thyroid storm
Life threatening complication that develop in a person with Hyperthyroidism (excessive thyroid hormone)
Myxedema coma
Life threatening condition that occurs in hypothyroidism (presents with severely low thyroid hormones)
Hypoparathyroidism
Low secretion of PTH by parathyroid gland
Nurse is caring for a pt who is experiencing cushing's triad following a subdural hematoma. Which of the following meds should the nurse plan to administer?
Mannitol 25% -Cushing's triad is an indication that the client is experiencing increased intracrania pressure. The nurse should administer mannitol 25%, an osmotic diuretic that promotes diuresis to treat cerebral edema.
Hypothyroidism nursing interventions
Monitor Myexedema coma (life threatening): -Caused by uncontrolled hypothyroidism, abruptly stopping thyroiid replacement meds, or removal of thyroid gland -Body is shutting down -Hypothermia, resp failure, bradycardia, extreme drowsiness. -Hypoglycemia & hyponatremia -Progresses to coma
Thyroid storm Nursing interventions
Monitor vitals (At risk for resp failure) -Watch ECG (At risk for arrhythmias) -Monitor Temp -Keep environment quiet and cool -Possible sedative to keep them calm -NO FOOD HIGH IN IODINE
Nurse is caring for a pt who has Cushing's syndrome. THe nurse should recognize that which of the following are manifestations of Cushing's syndrome?
Moon face Purple striations Buffalo hump -Moon face is manifested by round, red, full face, is a common manifestion of cushing's syndrome. Pruple straitions on the skin of the abdome, thighs, and breasts are common manifestation. Buffalo hump which is a colection of fat between the shoulder baldes is a common manifestation.
Addisonian crisis treatment
Need cortisol via IV (Solu-Cortef) -Start on IV fluids too since their BP is low and they are going into shock (D5 Normal saline)
Can thyroid make thyroid hormones without iodine?
No. Your thyroid needs iodine to produce T3 and T4. -You get iodine through your food
Hypoparathyroidism S&S
PTH! -Parasthesia -Positive trouseu or chevostek sign -Tetany (involuntary muscle spasm or cramping) -Hypocalcemia or hypophosphatemic
Nurse is teaching a client who has a new diagnosis of hyperparathyroidism. Nurse should include teaching that the client is at risk for which of the following complications?
Pathologic fractures -pt who has hyerparathyroidism is at risk for patholigical fractures due to the release of calcium and phosphate into the blood, which reduced bone density and places the pt at risk for pathological fractures.
A nurse if caring for a pt who is in a myexedema coma. Which of the following actions should the nurse take?
Place the client on aspiration precautions. -The nurse should place the client on aspiration precautions because the client can have decreased mental status and is at risk for laryngeal edema and tongue thickening.
Cushing's Nursing interventions
Prep pt for Hypophysectomy to remove pituitary tumor -Adrenalectomy (if tumor on pituitary gland) -Educate pt about cortisol replacement therapy after surgery [won't be able to produce those hormones anymore] -Watch for increased BS -Low potassium levels -S/S of infection -Skin breakdown -Emotional support
Cushing's S&S
STRESS! -Skin fragile -Truncal obesity -ROund face "moon face" -Ecchymosis, Elevated blood prssure -Striae on the extremities & abdomen (purplish) -Sugar extremely high (hyperglycemia from high cortisol levels) -Excessive body hair (hirsutism in women) -Buffalo hump -Depression
What meds increase thyroid hormones
Salysilates (Aspirin) DON'T TAKE WITH throid issues
Nurse is caring for a pt who is 8hr post op following a subtotal thyroidectomy. In which of the following positions should the nurse keep the client?
Semi fowlers with the neck in a neutral position -It is the most comfortable position for a pt who had thyroid surgery. Neck flexion could compromise the airway, and neck extension could place excessive tension on the operative area and the suture. A neutral position is essential.
Hypothyroidism medications
Synthroid (levothyroxine) -cytomel (Liothyronine sodium) -Thyolar (liotrix)
A nurse is caring for a client who had total thyroidectomy and a serum calcium level of 7.6 mg/dl. Which of the following fings should the nurse expect?
Tingling of the extremities. -Serum calcium level of 7.6 is below the expected reference range, indicating hypocalcemia. The nurse should monitor the client for reports of tingling and numbness of the extremities and around the mouth, muscle tremors, cramps and cardiac dysryhythmias
Thyroid storm meds
To decrease thyroid hormone Anti-thyroid medications (Block SYNTHESIS of thyroid hormone) -Tapazole "methimazole" -PTU "Propylthiouracil" (Watch for agranulocytosis and thrombocytopenia and s&s of hypothyroidism) Iodide solution (Lugol's solution) -Blocks SECRETION of thyroid hormone -SE: taste change in mouth -Tylenol Beta blockers[indurol] (relieve htn, tachycardia -Don't give to pts with asthma or hx of bronchospasms -Watch out for masking symptoms of hypoglycemia in diabetics with this drug Glucocorticoids for immune suppression.
Hypothyroidism
Under active thyroid gland (low T3T4)
Nurse is assessing a pt with hypothyroidism. The nurse should expect which of the following findings?
Weight gain -Nurse should expect to find weight gain in clients who have hypothyroidism, even with no change in dietary intake.
Hypothryroidism S&S
Weight gain Cold intolerence (Metabolism isn't working quick enough) Goiter (thyroid wanting T3T4 to be released) Hashimotos Tired and fatigued Constipation Memory loss Myexdema -Dry skin -mestrual problems
a nurse is providing dietary teaching for a client who has Cushing's Disease. Which of the following recommendations should the nurse include in the teaching?
restrict sodium intake -the nurse should recommend the client to restrict sodium intake to control fluid volume. This restriction can range from "no added salt" to table foods to a restriction of 2 grams per day
a nurse is caring for a client 1 hour following a subtotal thyroidectomy. And which of the following positions should the nurse place the client?
semi Fowler's -positioning the client semi-fowlers with a head supported with a pillow, is the appropriate position to decrease pressure on the suture line and prevent edema formation, which could cause respiratory distress
a nurse is providing teaching to a client who has a new prescription for levothyroxine for hypothyroidism. The nurse should instruct the client to avoid which of the following herbal supplements?
soy -the nurse should instruct the client to avoid soy because it can reduce the effectiveness of the Levothyroxine.
a nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?
teach the parents about cortisol replacement therapy -the nurse should plan to teach the child's parents about cortisol replacement therapy. Administration of glucocorticoids and mineralocorticoids is necessary because inadequate supplies of a sudden cessation of the medications can cause acute adrenal crisis.
Addison's disease S&S
think STEROID -Sodium and sugar levels will be low -Tired and weak -Electrolyte imbalance (K+ & Ca) -Reproductive changes -iOw blood pressure -Increased pigmentation -Diarrhea depression, nausea
a nurse is caring for a client who is 1-day post-operative following a thyroidectomy reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?
verify the most recent calcium level -the client who has had a thyroidectomy is at risk of hypocalcemia due to the possible disruption of the parathyroid gland during surgery. The parathyroid glands are the four small glands located inside the thyroid gland that are responsible for calcium regulation. If they are damaged during a thyroidectomy, there is a risk of hypocalcemia. low calcium levels can be manifested as numbness and tingling of the fingers and around the mouth, muscle spasms particularly of the hands and feet, and hyperactive reflexes. If a client develops any of these manifestations following a thyroidectomy, the nurse should check the clients latest calcium level. The expected reference range for calcium is 8. 5 to 10. 5 milligrams per deciliter. if the calcium level is low, the provider should be notified, and oral or intravenous calcium replacement should be administered.
a nurse is caring for a client who has Addison's disease in this at risk for addisonian crisis. Which of the following actions should the nurse take?
weigh the client daily -Addison's disease is an endocrine disorder that causes weight loss, muscle weakness, fatigue, low blood pressure, and hyperpigmentation of the skin. Obtaining the client's daily weight will alert the nurse a dehydration is developing, which could indicate an impending crisis.
a nurse is assisting a client who has hypothyroidism with meal planning. Which of the following foods should the nurse recommend that the client add to her diet?
whole grains -constipation is a classic manifestation of hypothyroidism, therefore, this client should increase her fluid and fiber intake. Whole grains provide ample amounts of fiber.
Nurse is teaching about levothyroxine with a pt who has primary hypothyroidism. Which of the following statements shoudl the nurse use when teaching the client?
"Tremors, nervousness and insomnia may indicate your dose is too high" -The nurse should teach that tremors, nervousness, and insomnia may indicate an overdose of the medication and to notify the provider
a nurse is talking with a client who's thyroid stimulating hormone (TSH) level will be measured. Which of the following statements by the nurse explains the purpose of this test?
"this test determines whether your thyroid glands overactive, appropriately active, or underactive." -this describes the TSH test, which helps determine thyroid status and helps monitor the effectiveness and dosage of thyroid hormone replacement therapy.
Post op thyroidectomy
-If pt is coughing after thyroidectomy they need to splint surgical site -Watch out for respiratory distress in pt -Swelling and bleeding can cause resp distress -Have trach kit and oxygen and suction at bedside just in case. -Semi fowlers is best position.
Thyroid storm causes
-Untreated or undianosed hyperthyroidism -Not taking antithyroid meds properly -Illness, stress, trauma -Taking meds that increase thyroid hormones (Aspirin) -Pregnancy -Readioactive iodine
Adrenal crisis aka (Addisonian crisis) S&S
5Ss and 3H's #1. SUPER LOW BLOOD PRESSURE -Pt complains of sudden pain in stomch or back and legs -Syncope -Shock -Severe vomiting, diarrhea and headache -Hyponatremia (<135) -Hypoglycemia (<70) -[cortisol increase blood sugar. If our body doesn't produce cortisol, our blood sugar is not metabolized] -Hyperkalemia (>5.1)
Graves disease Cause
Autoimmune disorder causing the body to produce an antibody called TSI (Thyroid-stimulating immunoglobulin) that produces same effects on the body as TSH
Nurse is monitoring pt who is post op following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor?
Airway patency -When using ABCs approach to client care, the nurse should determine it is the priority to monitor the client's airway. Nerve damage, hypocalcemia induced tetany, and edema can all impair the airway following thyroidectomy.
Cushing's SYNDROME cause
An OUTSIDE cause due to medical treatment of glucocorticoids like prednisone
Addison's disease causes
Autoimmune causing body to attack the cortex due to: -cancer -TB -Trauma
Hyperparathyroidism S&S
Bone fractures (Excess calcium leaked into the blood) -Constipation -Renal calculi -Epigastric pain -Excessive urination
Adrenal cortex releases what?
Corticosteroids: Aldosterone and cortisol (glucocorticoid)
Thyroid storm S&S
Everything is to the extreme! -High fever (Instead of heat intolerance) -HTN and tachycardia (Could lead to CHF or MI) -Tachypnea (progresses to resp failure) -Restless, irratability, cofusion ->Can lead to seizures, delirium and coma -Diarrhea
Most common cause of hyperthyroidism
Graves disease (autoimmune)
Does myxedema coma cause hyponatremia or hypernatremia and hypoglycemia or hyperglycemia?
HYPONATREMIA (d/t increase of ADH hormone which causes body to conserve water ultimately sodium is watered down) HYPOGLYCEMIA (d/t decrease in metabolism rate)[decreases need for glucogenesis]
Hypothyroidism causes
Hashimotos thyroiditis (autoimmune) [Most common] -Attacks thyroid -Goiter is seen in this Pt being treated for hyperthyroidism and is taking antithyroid mes (Pt would be taking antithyroid meds)
Nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect?
Heat intolerance -Pt who has an acute overdose of levothyroxine will exhibit heat intolerance, sweating, and hyperthermia. These manifestations are indications of excessive levels of thyroid hormone that could lead to death.
Hyperparathyroidism
High secretion of PTH by parathyroid gland
Hyperthyroidism
High secretion of thyroid hormone
Hyerparathyroidism
Hypercalcemia and LOW PHOSPHATE LEVEL
Nurse is assessing a client who was admitted with Cushing's syndrome. Which of the following manifestations should the nurse expect?
Increased bruising -Pt who has Cushing's syndrome will have thin skin that is fragile and easily bruised or traumatized. Ecchymoses, petechiae (amall intradermal or submucosal bleeds), and straie (purple lines on the skin of the abdomen, thighs, and breasts) will often develop as well.
A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions?
Infection -Agranulocytosis is a failure of the bone marrow to make enough white blood cells, causing neutropenia and lowering the body defenses against infection.
Lithium can do what to thyroid hormones?
Inhibits thyroid function
What food do you recommend for people with hypothyroidism?
Iodine rich foods (seaweed, eggs, dairy)
Hyperthyroidism nursing interventions
Keep them comfortable. -KEEP ENVIRONMENT COOL AND QUIET -Monitor weight -Monitor HR, BP, ECK -Monitor for thyroid storm (life threatening condition of untreated thyroid condition or thyroidectomy -Has exaggerated symptoms of hyperthyroidism -Educate pt on treatments
Addision's disease Nursing interventions
Monitor for hypoglycemia and hyperkalemia -Replace cortisol via Prednisone or Hydrocortisone -Report stress such as illness, surgery, or extra stress in life will need to increase dosage change -Take the medication regularly and as prescribed -If Florinef is prescribed - consume adequate salt -Get medic alert bracelet -Diet high in PROTEIN and carbs and normal sodium -Avoid stress, illness, stenuous exercise
Hyperparathyroid nursing interventions
Monitor vitals -Strain urine for any kidney stones -Encourage fluids as tolerated (to prevent dehydration or renal stone formatoion) -Parathyroidectomy (Removing affected gland that is causing issues) Meds: (Goal is to decrease calcium levels and parathyroid hormone levels and hydrate) -Calcimometics (Sensipar) [for pts with chronic renal failure] -Calcitonin (Decreased calcium levels and protects bones) -Lasix (decreases calcium levels by inhibiting reabsorption of calcium) [also watch potassium] -Biphosphates (fosamax) --Slows down osteoclasts and builds up the bones (Take it all by itself, no food, sit up 30 minutes after taking it)
Myxedema coma Nursing interventions
Monitor vitals IV fluids for hyponatremia Corticosteroids Synthroid (always watch out for toxicity since you are now replacing their thyroid hormone with drug) -No sedatives -IV glucose -Warming blankets
Hypoparathyroid nursing interventions
Monitor vitals and Airway -Monitor labs Meds: -Give meds to increase calcium levels (IV calcium [calcium gluconate] {can increse dig toxicity}] -Vitamin D (helps absorb calcium) -Phosphate binders -Parathyroid hormone replacement
Graves disease nursing interventions
Monitor vitals, weight -Keep the environment cool and quiet -Educate about meds, monitor for S/E and monitor for thyroid storm -Don't eat foods high in iodine (seaweed, diary, eggs)
Hyperparathyroidism causes
Primary: Something wrong with gland itself. Hyperplasia (enlargment), tumor, cancer Secondary: Parathyroid is working but disease is causing parathyroid to mess up. -Chronic Renal failure -Hypocalcemia -Vitamin D deficiency
TSH (Thyroid stimulating hormone)
Produced from anterior pituitary gland. [Stimulated t3 and T4 production]
Nurse is assessing a pt who is admitted with hyperthyroidism. Pt reports a weight loss of 5.4kg in the last 2 months, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness. Which of the following actions should the nurse take to prevent a thyroid crisis?
Provide a quite low stimuli environment -Thyroid crisis can occur in response to a stressor, so the nurse should minimize stressful stimuli in the client's environment.
Treatment for hyperthyroidism
Radioactive iodine (destroys thyroid hormone over time) [permanent cure] -Not for women that are pregnant -Taste changes, nausea, swollen glands (watch out for these) Thyroidectomy (sometimes people can experience thyroid storm after this because some T3T4 leaked during removal) -Watch out for parathyroid gland problems (since it regulates calcium) -Hypocalcemia could occur Sodium iodine solution (lugols solution), beta blocker (Indurol)[helps pt cope with symptoms they are getting}, glucocorticoids [to suppress the immune system]
Aldosterone does what?
Regulates BP through RAAS REGULATES SODIUM, secretes potassium
Myxedema coma Causes
Risk factor: Elderly family Respiratory stress removal of thyroid sedatives toxicity of antithyroid meds
Cortisol does what
STRESS hormone. -Helps body deal with stress -Increases blood sugar. -breaks down fats, proteins and carbs, regulates electrolytes
Adrenal crisis aka (Addisonian crisis) Nursing interventions
Stabilize pt. - Give them cortisol (solucortef iv) [similar to hyrdocortisone] -IV fluids to replenish from excessive vomiting drop in bp -Oral glucocorticoids (prednisone or hydrocortisone) -Mineral corticoids which helps replace aldosterone -Education for prednisone or hydrocortisone: -Take it routinely -Let doctor know if pt is experiencing more stress or sick so they can adjust the dose of meds so pt can have increase in cortisol -If on mineralcorticoid, they need to consume enough sodium while on it -Monitor glucose levels -potassium levels
A nurse is reviewing the lab values fora pt who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following lab values?
Thyroid stimulating hormone -The nurse should anticipate that TSH will be elevated
a nurse is reviewing the laboratory results for four clients. The nurse should recognize that which of the following clients has a manifestation of primary hyperparathyroidism?
the client who has an increased magnesium level -magnesium level is increased in a client who has primary hyperparathyroidism