lOMoARcPSD|11232395
Addisons disease & Crisis: Addison and Cushing- based on crisis what is the nursing
interventions and complications
•In Addisonian crisis, the patient has extremely LOW CORTISOL levels (life
threatening).
•Shock management
•High-dose hydrocortisone replacement
•0.9% saline solution and 5% dextrose
•Addisonian crisis is a life-threatening emergency necessitating aggressive management.
•Treatment is directed toward shock management and high-dose hydrocortisone
replacement.
•Large volumes of 0.9% saline solution and 5% dextrose are given to reverse hypotension
and electrolyte imbalances until BP returns to normal.
Cushings syndrome
Thyroidectomy: Treatment of choice for Hyperthyroidism NCLEX NCLEX
• Postoperative complications include hypothyroidism; damage to or inadvertent removal
of parathyroid glands, causing hypoparathyroidism and hypocalcemia; hemorrhage;
injury to the recurrent or superior laryngeal nerve; thyrotoxic crisis; and infection.
• Although not common, airway obstruction after thyroid surgery is an emergency
situation.
• Oxygen, suction equipment, and a tracheostomy tray should be readily available in
the patient’s room.
• Important nursing interventions after a thyroidectomy include the following:
• Assess the patient every 2 hours for 24 hours for signs of hemorrhage or tracheal
compression such as irregular breathing, neck swelling, frequent swallowing, choking,
blood on the dressings, and sensations of fullness at the incision site. Expect some
hoarseness for 3 or 4 days after surgery because of edema.
• Place the patient in a semi-Fowler’s position, support the patient’s head with pillows, and
avoid flexion of the neck and any tension on the suture lines.
• DICHARGE TEACHING: Tell the patient who had a complete thyroidectomy about the
need for lifelong thyroid hormone replacement.
• Iodine rich foods:- Salt, seaweed, dairy eggs or any supplements
• Semi- fowlers position coz to help with swelling and drainage at the site
•
Downloaded by Purity Kimani ()
, lOMoARcPSD|11232395
Synthroid drug: Start with low dose/ Take first thing in the morning on empty stomach
• Monitor for cardiovascular side effects (chest pain, dysrhythmias), weight
loss, nervousness, tremors, insomnia
• Increase dose in 4- to 6-week intervals as needed
SIDE effects can lead to hyperthyroidism
Carefully monitor patients with cardiovascular disease who take this drug.
• Monitor heart rate and report pulse greater than 100 beats/min or an irregular
heartbeat.
• Promptly report chest pain, weight loss, nervousness, tremors, and/or insomnia.
•Very sensitive to Narcotics
•Drug to drug interactions: Do not take Synthroid with GI meds, like carfrate, aluminium
hydroxide, simethicone (decreases absorption of thyroid medication)
•S/S of toxicity: think hyper now (fast fast heart, feeling hot, sweating)
LIFE LONG THERAPY
DM – Insulin and pancrease issues
Type 1 – you can pass to your son
Patients with newly diagnosed type 1 diabetes may experience a remission, or
“honeymoon period,” for 3 to 12 months after treatment is initiated.
Type 2 – the Problem is you
Hypoglycemia: A bedtime snack, a reduction in the dose of insulin, or both can help to
prevent the Somogyi effect
• Rebound effect in which an overdose of insulin causes hypoglycemia
• A high dose of insulin produces a decline in blood glucose levels during the night.
• As a result, counterregulatory hormones (e.g., glucagon, epinephrine, growth
hormone, cortisol) are released, stimulating lipolysis, gluconeogenesis, and
glycogenolysis, which in turn produce rebound hyperglycemia.
Glipizide drug: drug for pancreatitis/diabetes and insulin (What does it do the pancrease)
Thyroid crisis (Myxedema Coma): Treated with IV thyroid hormone PRIORITY
TREATMENT!
Give thyroid hormone therapy and all other medications IV because severe gastric
HYPOMOTILITY may prevent the absorption of oral preparations.
Downloaded by Purity Kimani ()
Addisons disease & Crisis: Addison and Cushing- based on crisis what is the nursing
interventions and complications
•In Addisonian crisis, the patient has extremely LOW CORTISOL levels (life
threatening).
•Shock management
•High-dose hydrocortisone replacement
•0.9% saline solution and 5% dextrose
•Addisonian crisis is a life-threatening emergency necessitating aggressive management.
•Treatment is directed toward shock management and high-dose hydrocortisone
replacement.
•Large volumes of 0.9% saline solution and 5% dextrose are given to reverse hypotension
and electrolyte imbalances until BP returns to normal.
Cushings syndrome
Thyroidectomy: Treatment of choice for Hyperthyroidism NCLEX NCLEX
• Postoperative complications include hypothyroidism; damage to or inadvertent removal
of parathyroid glands, causing hypoparathyroidism and hypocalcemia; hemorrhage;
injury to the recurrent or superior laryngeal nerve; thyrotoxic crisis; and infection.
• Although not common, airway obstruction after thyroid surgery is an emergency
situation.
• Oxygen, suction equipment, and a tracheostomy tray should be readily available in
the patient’s room.
• Important nursing interventions after a thyroidectomy include the following:
• Assess the patient every 2 hours for 24 hours for signs of hemorrhage or tracheal
compression such as irregular breathing, neck swelling, frequent swallowing, choking,
blood on the dressings, and sensations of fullness at the incision site. Expect some
hoarseness for 3 or 4 days after surgery because of edema.
• Place the patient in a semi-Fowler’s position, support the patient’s head with pillows, and
avoid flexion of the neck and any tension on the suture lines.
• DICHARGE TEACHING: Tell the patient who had a complete thyroidectomy about the
need for lifelong thyroid hormone replacement.
• Iodine rich foods:- Salt, seaweed, dairy eggs or any supplements
• Semi- fowlers position coz to help with swelling and drainage at the site
•
Downloaded by Purity Kimani ()
, lOMoARcPSD|11232395
Synthroid drug: Start with low dose/ Take first thing in the morning on empty stomach
• Monitor for cardiovascular side effects (chest pain, dysrhythmias), weight
loss, nervousness, tremors, insomnia
• Increase dose in 4- to 6-week intervals as needed
SIDE effects can lead to hyperthyroidism
Carefully monitor patients with cardiovascular disease who take this drug.
• Monitor heart rate and report pulse greater than 100 beats/min or an irregular
heartbeat.
• Promptly report chest pain, weight loss, nervousness, tremors, and/or insomnia.
•Very sensitive to Narcotics
•Drug to drug interactions: Do not take Synthroid with GI meds, like carfrate, aluminium
hydroxide, simethicone (decreases absorption of thyroid medication)
•S/S of toxicity: think hyper now (fast fast heart, feeling hot, sweating)
LIFE LONG THERAPY
DM – Insulin and pancrease issues
Type 1 – you can pass to your son
Patients with newly diagnosed type 1 diabetes may experience a remission, or
“honeymoon period,” for 3 to 12 months after treatment is initiated.
Type 2 – the Problem is you
Hypoglycemia: A bedtime snack, a reduction in the dose of insulin, or both can help to
prevent the Somogyi effect
• Rebound effect in which an overdose of insulin causes hypoglycemia
• A high dose of insulin produces a decline in blood glucose levels during the night.
• As a result, counterregulatory hormones (e.g., glucagon, epinephrine, growth
hormone, cortisol) are released, stimulating lipolysis, gluconeogenesis, and
glycogenolysis, which in turn produce rebound hyperglycemia.
Glipizide drug: drug for pancreatitis/diabetes and insulin (What does it do the pancrease)
Thyroid crisis (Myxedema Coma): Treated with IV thyroid hormone PRIORITY
TREATMENT!
Give thyroid hormone therapy and all other medications IV because severe gastric
HYPOMOTILITY may prevent the absorption of oral preparations.
Downloaded by Purity Kimani ()
