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Adult 1 - Endocrine

TermDefinition
acromegaly definition too much growth hormone
main cause of acromegaly Pituitary benign adenoma (tumor) secretes too much growth hormone
acromegaly results in Overgrowth of everything HTN Hyperglycemia
Clinical Manifestations of Acromegaly Enlargement of everything Peripheral neuropathy HTN/Heart Failure Sleep Apnea HA/vision issues Menstrual disturbances
Diagnostics of Acromegaly Elevated growth factor in blood MRI/CT to detect tumors H&P Ophthalmologic exam
Treatment of Acromegaly Surgical Removal 1. Transsphenoidal Hypophysectomy: go through nose or upper lip; need replacement hormones for life: i.e. glucocorticoids, thyroid and sex hormone 2. Stereostatic radiosurgery: radiation for tumor
Post-Operative Care of Acromegaly HOB 30 Looking for neuro complications: speech, pupils, extremity strength Mouth & surgical site care Bleeding Observe any clear nasal drainage: test for glucose (greater than 30 = CSF); severe HA monitoring  all these indicate CSF leak
Definition of Goiter enlarged thyroid
Cause of Goiter lack of iodine in diet
Toxic Goiter leads to hypo or hyper
Non-toxic Goiter enlargement w/o malignancy; TH levels normal
Hyperthyroid definition Autoimmune disease that causes excess thyroid hormone secretion and enlarged thyroid
Clinical Manifestations speeds everything up
Anti-thyroid Medications 1. Iodine: PO; stops T3 & T4 from going into circulation; used before surgery to treat crisis; decreases vascularity of thyroid gland for bleeding 2. Beta-Adrenergic Blockers: treats symptoms of thyrotoxicosis
Radioactive Iodine Therapy (RAI): damage/destroy thyroid tissue; eventually get symptoms of hypothyroidism; teach patient about: separation from people b/c radiation exposure
Surgical Therapy for Hyperthyroidism Subtotal Thyroidectomy -- removes 90% of thyroid
Nutritional Therapy high calorie-diet; avoid fiber & caffeine
Thyrotoxicosis definition  Excessive amounts of hormones released  LIFE-THREATENING EMERGENCY  Results b/c stressors (infection, trauma, surgery)
Thyrotoxicosis manifestations  Same thing as hyperthyroidism, but elevated even higher
thyrotoxicosis collaborative care  Thyroidectomy  Manage respiratory distress – beta blockers  Reduce fever – Tylenol, cooling blankets, ice packs  Replace fluids  Eliminate or manage stressor
Thyroidectomy Post-Operative Care o Meds – Iodine and Analgesics o HOB 30-45 o Signs of Hypocalcemia: tingling of toes, fingers, and around mouth & muscle twitching & difficulty speaking & hoarseness) Trousseau’s and Chvostek’s signs o Hemorrhage o Thyrotoxic crisis o Infection
Hypothyroid Definition lack of thyroid hormone --> more common in women than men
Clinical Manifestations of Hypothyroid slows everything down
Collaborative Care for Hypothyroid o Low-calorie diet o Meds: levothyroxine  in morning on empty stomach, life-long therapy
myxedema term used w/hypothyroidism; ALSO  swelling/edema in skin and tissues o Opposite of thyroid storm: slows everything down to the point of possible death; emergency
Hyperparathyroidism Definition Increased secretion of PTH; leads to hypercalcemia & hypophosphatemia
Types of Hyperparathyroidism Secondary: b/c of other disease that causes low calcium Tertiary: renal transplant patients
Clinical Manifestations of Hyperparathyroidism Weakness Low appetite Constipation Fatigue Osteoporosis Kidney stones Hypercalcemia
Diagnostics of Hyperparathyroidism ^^ PTH levels Calcium above 10mg/dl Phosphate: <3mg/dl
Surgical Therapy of Hyperparathyroidism Partial or complete removal of parathyroid gland Supplements for life Monitor for hemorrhage, fluid & electrolyte imbalance, and tetany
Hypoparathyroidism definition Low parathyroid hormone; uncommon  results in hypocalcemia & increased phosphorus
Hypocalcemia management 1. IV infusions of calcium for tetany (10-20mL of 10% solution) 2. Vit D.  enhance gut absorption of calcium 3. Diet: dark green veggies, tofu, soybeans 4. Monitor Calcium levels
Created by: nicolemiele
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