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Med Surg II

Endocrine System

The master gland of the endocrine system that controls the other glands in the body Pituitary gland
What is another name for the anterior pituitary gland? Adenohypophysis
What is another name for the posterior pituitary gland? Neurohypophysis
What is responsible for growth, development, and metabolism - lies on either side of the trachea? Thyroid gland
What is active in maintenance of calcium balance? Parathyroid glands
What releases mineralocorticoids, glucocorticoids, and sex hormones? Adrenal cortex
What is the most important glucocorticoid secreted which is responsible for glucose metabolism and providing extra energy during stress? Cortisol
What does negative feedback mean? An increase in the expected activity will lead to a decrease in the release of the hormone causing that effect
What plays an integral role in immune function and is located in the chest? Thymus gland
What secretes melatonin and is located in the brain? Pineal glands
What causes the kidneys to conserve water by decreasing the amount of urine produced? Antidiuretic Hormone (ADH)
What does parathyroid hormone (PTH) serve as an antagonist to? Calcitonin
What tends to increase calcium concentration in the blood and also regulates the amount of phosphorus in the blood? PTH
What is the result of an overproduction of growth hormone after puberty that is a problem with the pituitary gland? Acromegaly
What is the nursing care for acromegaly? Keep patients safe, joints may become stiff and muscles become weak
What is an overproduction of growth hormone before the close of growth plates? Gigantism
What is hypopituitary dwarfism caused by? Growth hormone deficiency - can be genetic or related to pituitary
What is a disorder of the posterior pituitary in which ADH is deficient and results in electrolyte and fluid imbalances? Diabetes Insipidus
What is diabetes insipidus characterized by? Significant polyuria and intense polydipsia
What is the urinary output for a patient with diabetes insipidus? Exceed 5-20 L per 24hrs
How does a patient with diabetes insipidus feel? Weak, tired, and lethargic; specific gravity is altered and skin turgor is poor
What is patient care for a patient with diabetes insipidus? Involves protecting the patient from injury
What is hyperthyroidism treated with? Tapazole or propyithiouracil
What is the diet therapy for patient with hyperthyroidism? Requires more calories due to increased metabolism, increased vitamin intake
What are the foods that aid in easing the burden of Graves' disease? Lean meat, leafy greens, and supplemental vitamin D
What is the postoperative care for a patient with a thyroidectomy? Maintain airway, monitor for Chvostek's sign and Trousseau's sign, and monitor for thyroid storm
What are possible complications of thyroidectomy? Hemorrhage, tetany, and thyroid storm (crisis)
What can occur if the parathyroid is sometimes removed? Hypocalcemia
What is the diet for hypocalcemia? Canned fish with bones, tofu, cucumbers, and vitamin D
What are the NI for thyroidectomy? Keep patient in semi-fowlers, have trach tray available, monitor for tetany (deficiency in calcium), maintain anatomic positioning of head, do voice check q 2 hours, hoarseness and a weak voice are normal, laryngeal stridor requires immediate attention
What is a rare but serious complication of a thyroidectomy due to manipulation of the thyroid? Thyroid storm
What occurs during a thyroid storm? Thyroid releases large amount of hormones & patient has all s/s of hyperthyroid such as N/V, tachycardia, increased BP, increased temp., restlessness, delirium, dysrhythmias (all v/s increase)
What can a thyroid storm lead to? Congestive Heart failure
What is patients diet needs for simple goiter? Adequate intake of iodine found in saltwater fish, milk, and eggs
What kind of therapy is used for thyroid cancer? Radioactive iodine
What is important for a patient undergoing radioactive iodine therapy to remember? Avoid pregnant people and sometimes children for several days after treatment
What is Chvostek's sign? Abnormal reaction to the stimulation of the facial nerve (facial nerve is tapped at the angle of the jaw, facial muscles on the same side of face will contract; twitch of nose or lips)
What is Trousseau's sign? Carpal spasms that occur when the upper arm is compressed, as by a tourniquet or a blood pressure cuff
What do the signs of hypocalcemia include? Chvostek's & Trousseau's signs, carpopedal spasms
What is the treatment for hypocalcemia? Calcium gluconate
What is a life threatening complication of hypothyroidism that involves multiple organ abnormalities? Myexedema coma
What is the most important NI for Myexedema coma? Maintain airway
What is dietary needs for patient with hypothyroidism? High protein, low calorie meals
Why is it important for patient with hypothyroidism to follow up with physician? Adjust medications as needed
What is the patient teaching for Cushing's Syndrome? Eat foods high in potassium and low in sodium, gentle handling of skin and frequent observations for skin infection and breakdown
What are the three cardinal signs for DM? Polydipsia, polyphagia, and polyuria
What are the NI and patient teaching aimed at for DM? Diet & exercise education; medication dosage, type, & route; alternate injection sites to avoid lipodystrophy; notify HCP when glucose is over 250; glucose may be abnormal when ill; and certain meds (cortisone) may increase glucose levels
What does a glycosylated hemoglobin (HbA1c) do? Gives an average glucose level over the last 120 days; is an indication if the patient is being compliant with glucose monitoring
What are the glucose levels for hyperglycemia? Fasting blood glucose > 126 Random blood glucose > 200
What is treatment aimed at for hypoglycemia (aka insulin reaction)? Replacing glucose in the body by oral intake (give 6 oz of orange juice), IV intake, and IM injection
What is it called when a patient blood glucose is > 400? DKA - Diabetic Ketoacidosis
What is a diabetic diet? Low concentrated sweets, moderate carbs, low fat, high protein, small meals with frequent snacks
When do you monitor glucose when starting a new exercise program? Before, during, and after
What is the patient teaching for diabetic foot care? Wear good shoes, don't go barefoot, don't soak feet for long periods, apply lotion but not between toes
What oral hypoglycemic agent cannot be given with insulin? Byetta
What are the steps to preparing insulin? Wash hands, assemble equipment, turn insulin vial in hands, clean rubber stopper w/alcohol, insert air into vial, withdrawal insulin, inspect for air bubbles, have another nurse verify amount
This insulin has a short onset and peak of action Rapid- or short acting
What is a mixed insulin? Combination of short-acting and long acting insulin
What insulin has an onset of about 30 minutes and 6-12 hour effect? Intermediate insulin
What insulin has a long duration? Long-acting
What are the steps to combining insulin's? Withdrawal regular insulin first, then withdrawal longer-acting insulin
What are the steps to insulin injection? Don gloves, clean injection site, quickly insert needle in subcutaneous tissue, inject insulin slowly, dispose of syringe appropriately
What are short term DM complications? Hypoglycemia, HHNC, and DKA
What are long term DM complications? Blindness, kidney disease and/or renal failure, heart disease, and poor circulation
What are the side effects of Tapazole? Rash, pruritus, nausea, vomiting, loss of taste, paresthesia, and abdominal pain
What is Tapazole used to treat? Hyperthyroidism
What is the actions of Byetta? Insulin enhancing: gut hormone that promotes insulin secretions during meal, suppresses glucagon release, and delays gastric emptying which reduces blood sugar levels
What is the action of Sulfonylureas? Stimulate beta cells of pancreas to release insulin
What are some examples of sulfonylureas? Glyburide and Glimepiride
What is the action of Biguanides? Reduces hepatic glucose production and lowers fasting blood glucose levels. Also, enhances tissue response to insulin and improves glucose transport into cells
What is an example of a biguanide? Metformin
What type of insulin is Humulin NPH? Intermediate
What are the onset, peak, and duration times for Humulin NPH? O: 1.5-4 hours P: 4-12 hours D: 12-18 hours
What is the time frame that a patient would get hypoglycemic while taking Humulin NPH? 4-12 hours
What type of insulin are Lantus and Levamir? Long Acting
What are the onset, peak, and duration times for Lantus and Levamir? O: 0.8-4 hours P: no peak time D: 24 + hours
What is the first step of negative feedback system for glucose control? Low levels of blood glucose stimulate the secretion of glucagon
What is the second step of negative feedback system for glucose control? Increased glucagon causes stored glycogen in liver to be converted into glucose for release into blood stream
What is the third step of negative feedback system for glucose control? As blood sugar levels rise the glucagon stops; but the high blood glucose levels result in the release of insulin
What is the fourth step of negative feedback system for glucose control? Increased insulin levels cause the intake of glucose into muscle cells and convert excess glucose into glycogen for storage in the liver
What is the fifth step of negative feedback system for glucose control? When blood glucose levels drop, the cycle starts again
Created by: tandkhopkins
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