NURS 435: Endocrine Questions and Answers 100%
Correct
Addison's disease correct answer - can be caused by insufficient cortisol production, sepsis, trauma,
adrenal hemorrhage, steroid withdrawal
- increased k, ca
- decreased na, glucose, cortisol
Note: not! Enough! Speedy!
Cushing's syndrome correct answer - can be caused by excess cortisol production or steroid use
- increased na, glucose, cortisol
- decreased k, ca
Note: too! Much! Speedy!
Grave's disease (hyperthyroidism) correct answer - more common in women and people with excessive
dietary iodine (amiodarone!)
- decreased tsh, increased t3 and t4
- monitor for cardiovascular compromise
- provide eye protection/lubrication
- encourage rest/decrease stimulation
- avoid iodine
Note: low tsh, high t3/t4, calm things down
Hypoparathyroidism correct answer - typically iatrogenic after thyroid or parathyroid surgery
- hypocalcemia
- hyperphosphatemia
- neuromuscular irritability/tetany
- tx with ca/vitamin d supplements
Note: low calcium, high phosphate, tetany
, Hypothyroidism correct answer - can be caused by pernicious anemia, autoimmune disease, lithium,
rifampin, iodine
- increased tsh, decreased t3/t4, increased cholesterol!
- may show sinus brady, flat, or inverted t waves on ekg
Note: increased cholesterol and tsh, decreased t3/t4, lithium, rifampin, iodine
Interventions: addison's correct answer - lifelong glucocorticoid therapy!!
- watch for electrolyte imbalances and hypoglycemia!
- increase corticosteroids during times of stress
- hydrocortisone boluses as needed
- monitor for hypovolemia (start a large-bore ns infusion)
- supplemental glucose if need be
- high protein, high carb, normal na diet
Note: kind of like what you do with insulin when someone's sick but different
Interventions: cushing's correct answer - monitor for electrolyte imbalances and hyperglycemia!
- monitor cardiac rhythm d/t decreased k
- strict handwashing
- skin care to avoid breakdown
Note: basically just be careful with electrolytes and a lack of wbcs
Interventions: di correct answer - i/os, daily weights
- hydration and electrolyte replacement
- meticulous skin/oral care
- bulk fruit juices in diet to decrease constipation
- restrict foods with a diuretic effect
- encourage oral intake of fluids
Note: rehydrate them but keep them drinking
Correct
Addison's disease correct answer - can be caused by insufficient cortisol production, sepsis, trauma,
adrenal hemorrhage, steroid withdrawal
- increased k, ca
- decreased na, glucose, cortisol
Note: not! Enough! Speedy!
Cushing's syndrome correct answer - can be caused by excess cortisol production or steroid use
- increased na, glucose, cortisol
- decreased k, ca
Note: too! Much! Speedy!
Grave's disease (hyperthyroidism) correct answer - more common in women and people with excessive
dietary iodine (amiodarone!)
- decreased tsh, increased t3 and t4
- monitor for cardiovascular compromise
- provide eye protection/lubrication
- encourage rest/decrease stimulation
- avoid iodine
Note: low tsh, high t3/t4, calm things down
Hypoparathyroidism correct answer - typically iatrogenic after thyroid or parathyroid surgery
- hypocalcemia
- hyperphosphatemia
- neuromuscular irritability/tetany
- tx with ca/vitamin d supplements
Note: low calcium, high phosphate, tetany
, Hypothyroidism correct answer - can be caused by pernicious anemia, autoimmune disease, lithium,
rifampin, iodine
- increased tsh, decreased t3/t4, increased cholesterol!
- may show sinus brady, flat, or inverted t waves on ekg
Note: increased cholesterol and tsh, decreased t3/t4, lithium, rifampin, iodine
Interventions: addison's correct answer - lifelong glucocorticoid therapy!!
- watch for electrolyte imbalances and hypoglycemia!
- increase corticosteroids during times of stress
- hydrocortisone boluses as needed
- monitor for hypovolemia (start a large-bore ns infusion)
- supplemental glucose if need be
- high protein, high carb, normal na diet
Note: kind of like what you do with insulin when someone's sick but different
Interventions: cushing's correct answer - monitor for electrolyte imbalances and hyperglycemia!
- monitor cardiac rhythm d/t decreased k
- strict handwashing
- skin care to avoid breakdown
Note: basically just be careful with electrolytes and a lack of wbcs
Interventions: di correct answer - i/os, daily weights
- hydration and electrolyte replacement
- meticulous skin/oral care
- bulk fruit juices in diet to decrease constipation
- restrict foods with a diuretic effect
- encourage oral intake of fluids
Note: rehydrate them but keep them drinking