endocrine- thyroid, pituitary, adrenal

primary aldosteronism

-a condition in which the adrenal glands produce too much aldosterone because of hyperplasia or tumor -results in a profound decline in the serum levels of potassium and hydrogen ions -treatment usually involves surgical removal of the adrenal tumor through adrenalectomy

nursing process: the patient with hyperthyroidism

-assessment focuses on symptoms related to accelerated or exaggerated metabolism -goals and interventions focus on: -improved nutritional status -improved coping ability and self-esteem -maintenance of normal body temperature -absence of complications.

addison's disease

-bronze pigmentation of skin -changes in distribution of body hair -GI disturbances -weight loss -weakness -hypoglycemia -postural hypotension -adrenal crisis: -profound fatigue -dehydration -vascular collapse -renal shut down -low serum NA -high serum K

cushing syndrome

-due to excess cortisol-like medication or tumor that produces or results in production of excessive cortisol -enlarged supraclavicular fat pads -osteoporosis -hypertension -muscle wasting in the extremities -poor wound healing -moon face -dark facial hair -cardiac hypertrophy -obesity -abdominal striae -amenorrhea

thyroid tumor and cancer

-often accompanied by a goiter -presentation depends on the etiology of the growth -treatments include medications and surgery -nursing interventions after thyroidectomy include: -airway maintenance -pain management -fluid balance -monitoring for complications, especially hemorrhage, hematoma formation, edema of the glottis, and hypoparathyroidism

b) signs and symptoms of tetany include numbness and tingling, which may be present in the patient's extremities or around the mouth. confusion, pain, and changes in respiratory status are not characteristic of tetany.

which of the following assessment findings is a post-thyroidectomy patient would be suggestive of tetany? a) the patient complains of diffuse muscle pain. b) the patient complains of numbness and tingling around his mouth. c) the patient's oxygen saturation level is 90% on room air. d) the patient is oriented to person and place but not to time.

pheochromocytoma

-involves the benign growth of a catecholamine-secreting tumor inside the adrenal gland that results in hypertension -surgical removal of the tumor is necessary -nursing management includes close monitoring of the patient's vital signs and monitoring of mental status, acute ECG changes, arterial pressures, fluid and electrolyte balance, and blood glucose levels

hyperthyroidism

-intolerance to heat -fine, straight hair -bulging eyes -facial flushing -enlarged thyroid -tachycardia -increased systolic BP -breast enlargement -weight loss -muscle wasting -localized edema -finger clubbing -tremors -increased diarrhea -menstrual changes

true) cushing syndrome is often caused by the overuse of corticosteroid medications. when combined with endogenous steroid production, the patient is likely to have dangerously elevated levels of corticosteroids.

-is the following statement true or false? -if a patient has been taking corticosteroids for several years to treat and autoimmune condition, the patient is at and increased risk of developing cushing's syndrome.

false) hyperthyroidism is characterized by a hypermetabolic state. this is likely to cause irritability, restlessness, and diarrhea.

-is the following statement true or false? -the patient with hyperthyroidism is prone to constipation and apathy.

hypothyroidism

-lack of thyroid hormones -decreased metabolic rate -primary- thyroid gland: not making enough thyroid hormone -secondary- stimulated fibroblasts in skin & soft tissues: increased levels of TSH

2) the initial nursing action would be to maintain a patent airway. oxygen would be administered, followed by fluid replacement. the nurse would also keep the client warm, monitor intravenous fluids, and administer thyroid hormones.

a client is admitted to the emergency department, and a diagnosis of myxedema coma is made. which action would the nurse prepare to carry out initially? 1) warm the client. 2) maintain a patent airway. 3) monitor intravenous fluids. 4) administer thyroid hormone.

3) hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. manifestations develop 1 to 7 days after surgery. if the client develops numbness and tingling around the mouth, fingertips, or toes, or muscle spasms or twitching, the primary health care provider is notified immediately. calcium gluconate must be accessible for the client who underwent thyroidectomy.

the nurse is caring for a client after a thyroidectomy and notes that calcium gluconate is prescribed. the nurse determines that this medication has been prescribed for which reason? 1) treat thyroid storm 2) prevent cardiac irritability 3) treat hypocalcemia tetany 4) stimulate the release of parathyroid hormone

2) during the postoperative period, the nurse carefully observes the client for signs of hemorrhage, which causes swelling and the compression of adjacent tissue. laryngeal stridor is a harsh, high-pitched sound heard during inspiration and expiration that is caused by the compression of the trachea and leads to respiratory distress. it is an acute emergency situation that requires immediate attention to avoid the complete obstruction of the airway.

the nurse is caring for a postoperative parathyroidectomy client. which would require the nurse's immediate attention? 1) incisional pain 2) laryngeal stridor 3) difficulty voiding 4) abdominal cramps

4) weakness and hoarseness of the voice can occur as a result of trauma to the laryngeal nerve. if this develops, the client would be reassured that the problem will subside in a few days. unnecessary talking would be discouraged. it is not necessary to notify the registered nurse immediately. these signs do not indicate bleeding or the need to administer calcium gluconate.

the nurse is collecting data regarding a client after a thyroidectomy and notes the development of a hoarse and weak voice. which nursing action is appropriate? 1) check for signs of bleeding. 2) administer calcium gluconate. 3) notify the registered nurse immediately. 4) reassure the client that this is usually a temporary condition.

1) 2) 5) insomnia, weight loss, and mild heat intolerance are side effects of levothyroxine sodium. bradycardia and constipations are not side effects associated with this medication, but rather are associated with hypothyroidism, which is the disorder that this medication is prescribed to treat.

the nurse is monitoring a client receiving levothyroxine sodium to treat hypothyroidism. which findings indicate the presence of a side effect associated with this medication? select all that apply. 1) insomnia 2) weight loss 3) bradycardia 4) constipation 5) mild heat intolerance

1) a diet that is low in calories, carbohydrates, and sodium but ample in protein and potassium content is encouraged for a client with cushing's syndrome. such a diet promotes weight loss, the reduction of edema and hypertension, the control of hypokalemia, and the rebuilding of wasted tissue.

the nurse is reinforcing discharge teaching to a client who has cushing's syndrome. which statement by the client indicates that the instructions related to dietary management were understood? 1) "i can eat foods that contain potassium." 2) "i will need to limit the amount of protein in my diet." 3) "i am fortunate that i can eat all the salty foods i enjoy." 4) "i am fortunate that i do not need to follow any special diet.."

1) aspirin and other over-the-counter medications would not be taken unless the client consults with the primary health care provider. the client needs to take the medication at the same time every day and needs to be instructed not to stop. a slight weight gain as a result of an improved appetite is expected, but after the dosage is stabilized, a weight gain of 5 lb or more weekly needs to be reported to the PHCP. caffeine-containing foods and fluids need to be avoided because they may contribute to steroid-ulcer development.

the home care nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. the nurse reinforces teaching for the client about the medication. which statement made by the client indicated a need for further teaching? 1) "i can take aspirin or my antihistamine if i need it." 2) "i need to take the medication every day at the same time." 3) "i need to avoid coffee, tea, cola, and chocolate in my diet." 4) "if i gain more than 5 pounds a week, i will call my doctor."

1) 5) 6) signs of hypothyroidism include dry skin, hair, and loss of body hair; constipation; cold intolerance; lethargy and fatigue; weakness; muscle aches; paresthesia; weight gain; bradycardia; generalized puffiness and edema around the eyes and face; forgetfulness; menstrual disturbances; cardiac enlargement; and goiter. irritability, palpitations, and weight loss are signs of hyperthyroidism.

the nurse educator is asking the nursing student to recall the signs/symptoms of hypothyroidism. the nurse educator determines that the student understands this disorder if which are included in the student's response? select all that apply. 1) dry skin 2) irritability 3) palpitations 4) weight loss 5) constipation 6) cold intolerance