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81 Cards in this Set
- Front
- Back
What is the overall function of the endocrine system
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To maintain homeostasis
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What are endocrine hormones composed of
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Proteins and Steroids
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Problems are either
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Hypo/hyper activity
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What are the major Thyroid hormones?
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T3, T4, TSH
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How is RAI given?
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Orally
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High uptake of RAI is
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hyperthyroidism
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Low uptake of RAI is
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Hypothryroidism
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What is the mineral needed for normal thyroid function?
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Iodine
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When a patient or caregiver discards the urine after a RAI what should they do?
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Patient should wash hands and caregiver should use gloves
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Should pregnant women go near patients doing a RAI study?
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No they should avoid patients for 24 hours
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This refers to facial edema that develops with severe, long term hypothyroidism
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Myxedema
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This results from untreated hypothryroidism in infants
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Creatinism
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What type of skin/hair/nails will a patient have with hypothyroidism?
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Dry skin, thinning hair, and thick brittle nails
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What type of cardiovascular s/s will a patient have with hypothyroidism?
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Bruising and anemia
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Patients with this will have slowing down in body functions...
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Hypothryroidism
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Patients will have lethargy, slowed mental processes, and forgetfullness with this disorder
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Hypothryroidism
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Patients will have anorexia, constipation and weight gain with this disorder
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Hypothryroidism
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Patients with these disorders will have menstrual irregularities and decreased libido
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Hypothryroidism and Hyperthyroidism
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Patients with this will be cold and they will have edema on their hands and feet
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Hypothryroidism
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Patients with this will have smooth and moist skin
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Hyperthyroidism
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Patients with this disorder will be sped up in their body functions
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Hyperthyroidism
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Patients with this will have diarrhea, nervousness, agitation, and fine tremors
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Hyperthyroidism
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Patients with this disorder will have increased body temp and exopthalmos
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Hyperthyroidism
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What is the location of they thyroid gland?
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The lower portion of the anterior neck
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What is the bridge called where the tissues are connected of the thyroid gland?
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isthmus
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What is the function of the thyroid gland?
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To regulate the body's metabolism and growth and development
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Thyroid glands secrete hormones that affect the production and use of
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Energy (metabolism)
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What is the most common type of hyperthyroidism
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Graves disease
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What is the major complication of hypothyroidism?
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Myxedema Coma
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What do you want to make sure patients know when they have hypothryroidism?
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To report rapid heart beats and chest pain
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What is the thyroid hormone replacement drug
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Synthroid
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When do you withhold synthroid and notify the dr?
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When the patients pulse is 100 or greater
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What are antithryorid drugs used to treat?
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Hyperthyroidism
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Why would you monitor bleeding when patients are on PTU, a antithyroid drug?
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Because of agranulocytes due to decreased platelets and prothrombin
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When patients are taking SSKI, an antithryoid drug, what is it used for?
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To control bleeding during surgery and is given before surgery
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When/how do you give SSKI, an antithryoid drug?
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Dilute with liquids and give after meals
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RAI 131I, a antithryoid drug, what are patients on?
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Radiation precautions
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What do higher therapeutic doses do of RAI 131I?
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Destroys thyroid tissue in hyperthyroidism and thyroid malignancies
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What disease do you monitor V/S (pulse and RES), sedate, give beta blockers, give rest periods, make sure they avoid caffeine, monitor for CHF, adjust room temp, protect eyes with drops-etc, decrease salt intake, give antidiarrheals, do drug therapy, and surgery
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Hyperthyroidism
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How should patients sleep with hyperthyroidism and why?
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They may have exopthalmos so the head of their bed needs to be elevated to relieve pressure on their eyes
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What do they need to wear when they go outside (for people with hyperthyroidism)
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Dark glasses
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What do patients with Hyperthyroidism need to do for nutrition?
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Increase cals, vitamins, minerals-due to diarrhea and trouble absorbing
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What do you need to instruct the patient to do after thyroidectomy?
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Raise their head without straining their neck
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Where do you check for bleeding after a thyroidectomy?
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Behind the neck because blood will drain that way
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What do you assess after a thyroidectomy besides dressing?
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Voice quality, they may have a laryngospasm which can cause hoarsness
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What are the signs of hypocalcemia
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Chvostek and Trousseaus signs
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This sign is indicated by a facial twitch
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Chvosteks
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This sign is indicated by a carpopedal spasm
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Trousseaus
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What are the normal levels of calcium?
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9-11
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What position do you put your patient in after a thyroidectomy?
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Semifowlers
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What is the number 1 complication after a thryoidectomy?
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Hemorrhage
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You will have your patient to do 2 things after a thyroidectomy?
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Turn and deep breathe
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This happens 12 hours after a thyroidectomy and it is when large amounts of hormones enter into the blood stream
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Thyroid Crisis
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What are the signs of thyroid crisis?
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Tachycardia, cardiac dysrhythmias, vomiting, fever, confusion, heart failure
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What is a major sign of thyroid crisis?
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Severe tachycardia- beats 200 plus
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What are the dietary needs for a patient with hyperthyroidism?
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Avoid dairy and calcium products, take sodium and phosphorus, maintain a high fluid intake
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What is the drug Calcimar for?
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Treats hypercalcemia, do a sensitivity
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What is the drug Mithracin for?
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Treats hypercalcemia and is usually for people with cancer
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This is a S/S of hypoparathyroidism
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Tetany
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Patients with this will also have contractures, spasms, numbness, tingling, laryngospasms, anxiety, dysrhythmias, convulsions, chvosteks sign, and trousseaus sign, if this is not corrected it can be fatal
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Hypoparathyroidism
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This is indicated when the patient has muscle cramps, tingling and twitching of the face and hands
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Tetany
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What are calcium products?
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Milk, cheese, yogert, green leafy vegs, and fish oil
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What are the classic s/s of Pheochromocytoma?
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Diaphoresis, severe headache, and HYPERTENSION
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What is Pheochromocytoma?
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Adrenal Medulla Hypersecretion
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What is the major s/s of pheochromocytoma?
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Hypertension ( may be 300/175)
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What are the 3 hormones produced by the adrenal cortex?
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Glucocorticoids, mineralocorticoids, and sex hormones
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What is the most abundant glucocorticoid?
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Cortisol, sugar-anti-inflammatory process
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What is the most abundant mineralocorticoid?
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Aldosterone, salt
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For mineralocorticoids what is retained and what is excreted?
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Sodium is retained and postassium is excreted
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What are the two sex hormones?
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Androgens and Estrogen
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What e-lyte is needed in large amounts with Addisons disease?
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Sodium -causes confusion
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What is a major sign of Addisons Disease when concerning skin?
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Bronzing in areas exposed to the sun
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What is the treatment for Addisons Disease?
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Replacement of gluco/mineralocorticoids
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Shortages of fluid and e-lytes in Addisons disease will cause
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Confusion, dizziness, decreased BP, parasthesia, rhythm distrubances
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What is the major sign of Addisons Crisis?
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Hypotension
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What are s/s of Addisons Crisis?
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Hypotension, tachycardia, dehydration, confusion, hyponatremia, hyperkalemia, hypercalcemia, and hypoglycemia-similar to shock
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When a patient has Addisons Disease and they have hyperkalemia what will their T waves look like?
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They will be increased
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What are the s/s of Cushing Syndrome
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Trunical obesity ( excess body fat in trunk and back), protein wasting (thin legs and arms), moon face, purple striae ( on belly, breasts, butt, and thighs), osteoporosis, fragile sking with brusing, hypokalemia, hirsutism, mentral disorders, mood swings, fluid and e-lyte changes
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What will the T waves look like with a patient who has hypokalemia in Cushing Syndrome
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They will be flat
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What do you need to do as a nurse for a patient who has Cushing Syndrome?
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Fluids and e-lytes, decreased calories, avoid infection, may need psych evaluation, good skin care, protect from falls, remove tumor from pituitary and adrenal glands, give emotional support, and teach to gradually withdrawal of glucocorticoids
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What will you need to decrease/increase for a patient who has Cushing Syndrome?
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Decrease Calorie and salt and increase potassium
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