NURS 5338 Final Comprehensive Resource To Help You Ace Exams Includes Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS Guaranteed Pass First Attempt!! Current Update!!

NURS 5338 Final Comprehensive Resource To Help You Ace Exams Includes Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS Guaranteed Pass First Attempt!! Current Update!! 1. Hypothyroidism - Correct Answer: hashimoto's insufficient thyroid hormones (T3 + T4) primary hypothyroid - elevated TSH, low T4, low T3 subclinical hypothyroid - elevated TSH, normal T4 & T3 congenital hypothyroidism - present at birth Causes - can be caused by meds like amiodarone or lithium, by iodine deficiency, iatrogenic (thyroidectomy or radioactive iodine) S/S -- Think "everything slows down" Fatigue, weight gain Cold intolerance Constipation Depression Dry skin, hair loss Bradycardia Menstrual irregularities Dry, coarse skin Periorbital edema S/S in babies: lethargy, poor feeding, hypotonia, jaundice, hoarse cry, macroglossia, coarse face hairs, constipation, umbilical hernia 2. Hypothyroid treatment - Correct Answer: Levothyroxine - healthy adults 60 - 1.6mcg/kg/day - Elderly/Comorbidities - 12.5-25mcg/kg/day TSH determines levothyroxine dosage subclinical - treat if TSH 10 Adjust dose q4-6 weeks, once stable every 6-12 months Pregnancy - increase levothyroxine dose by 30% Synthroid - synthetic treatment containing T4 Armour Thyroid (Desiccated) - unpredictable, derived from pig, less stable, contains T3+T4 Take first thing in the morning on an empty stomach Avoid taking with calcium or iron supplements 3. Myxedema Coma - Correct Answer: Emergency! Severe hypothyroidism AMS, hypothermia, bradycardia 4. Hyperthyroidism - Correct Answer: excess T3 and T4 Primary hyperthyroid - low TSH, elevated T3/T4 S/S: goiter, exophthalmos, pretibial myxedema, heat intolerance, weight loss, tremors, tachycardia, palpitations, tachycardia, fatigue, tremor, depression, light periods, hyperreflexia, insomnia, anxiety clonus: abnormal reflex movements of the foot by sudden dorsiflexion causing contraction and relaxation 5. Hyperthyroidism Treatment - Correct Answer: 1st line: methimazole inhibits thyroid hormone synthesis Pregnancy - use PTU in first trimester Other options: - Beta blocker to manage tachycardia - Radioactive iodine - treatment of graves - Surgery to remove goiter, nodules, malignancy 6. Addison's Disease - Correct Answer: Primary Adrenal Insufficiency - damage to the adrenal gland decreases cortisol and aldosterone Primary - caused by autoimmune, TB, HIV, CMV, fungal, tumors, congenital adrenal hyperplasia, hemorrhage Secondary - caused by pituitary dysfunction leading to decreased ACH and adrenal atrophy, can be from chronic steroid use with abrupt withdrawal S/S: fatigue, weight loss, hypotension, salt craving, hyperpigmentation 7. Addisonian Crisis - Correct Answer: life threatening cortisol deficiency triggered by stress, illness, steroid withdrawal s/s: hypotension, shock, hyponatremia, hyperkalemia Tx: IV hydrocortisone, fluids, correct electrolytes, give glucose 8. Cushing's Syndrome - Correct Answer: chronic cortisol excess Tx: gradual taper of steroids 9. Cushing's Disease - Correct Answer: pituitary adenoma causing increased ACTH leading to increased cortisol s/s: moon face, buffalo hump, central obesity, HTN, hyperglycemia, muscle weakness, purple striae, skin thinning, easy bruising, poor wound healing Untreated can cause osteoporosis, infections, severe hypertension Dx: 1st line tests - 24 hour urinary free cortisol and low dose dexamethasone suppression test Tx: transsphenoidal surgery (remove adenoma) 10. Hyperparathyroidism - Correct Answer: Primary: increased PTH and calcium, decreased Phos Secondary: increased PTH and phos, decreased or normal calcium Tx: parathyroidectomy