endocrine

• patho of hypothyroidism

  decrease production of TH= low energy
• causes of hypothyroidism


  hashimotos, decreased iodine, thyroidectomy, anti-thyroid meds, side effects of amiodarone and lithium
• s/s of hypothyroidism


  no energy, fatigue, no expression, weight gain, cold intolerance, amenorrhea, slurred speech, dry skin, coarse hair, constipation, decreased HR and BS
• complication of hypothyroidism


  myxedema coma
• s/s of myxedema coma


  lethargy, stupor, coma, hypothermia, bradycardia, hypotnesion, hypoventilation
• tx for hypothyroidism


  synthetic levothyroxine (synthroid)
• t/f: pt taking synthroid are on this med forever


  true
• parathyroid (PTH) controls the levels of what electrolyte?

  calcium
• relationship between PTH and Ca

  direct
• primary cause of hyperparathyroidism

  parathyroid adenoma
• secondary cause of hyperparathyroidism

  chronic kidney failure
• s/s of hyperthyroidism (stones, bones, moans, and groans)


  stones--> kidney stones d/t increased calcium

  bones--> skeletal pain, pathological fractures d/t bone deformities, muscle weakness

  abdominal moans--> n/v, abdominal pain, weight loss, constipation

  psychic groans--> mental irritability, confusion, fatigue
• lab values in hyperparathyroidism

  increased PTH, Ca and decreased phosphorous
• tx of hyperthyroidism


  parathyroidectomy, removal of more than one gland
• what meds can we admin for hyperthyroidism

  phosphates, calcitonin, IV or PO biphosphate
• goal of calcitonin


  lower blood calcium levels
• common cause of hypoparathyroidism


  Accidental excision or injury during thyroidectomy, magnesium depletion
• clinical features of hypoparathyroidism

  s/s of hypocalcemia
• s/s of hypocalcemia


  tingling, numbness, trousseau and chovestok sign, muscle cramps, hyperactive DTR, prolonged QT intervals, severe tetany)
• severe tetany can lead to

  dysphagia, laryngospasm, seizures
• nursing interventions for hypoparathyroidism


  seizure precautions, monitor for dysrhythmias and mag levels
• diet for hypoparathyroidism


  increase intake of calcium and vit D, decrease intake of phosphorus,
• foods high in calcium and vit d


  dark green veggies, tofu, banana, oily fish(salmon, tuna, sardines), dairy products, almonds
• t/f: hypoparathyroidism pt should replace animal protein for plant protein

  true--> animal protein is high in phosphorous
• nursing interventions for mild hypocalcemia (>7.5)


  oral calcium and vit d (calcitriol)
• nursing interventions for severe hypocalcemia (<7.5)


  IV push calcium gluconate over 10-15 mins
• t/f: calcium gluconate is a vesicant


  true
• pt with acromegaly are at risk for


  CAD and HF
• s/s of acromegaly


  cardiomyopathy, large hands/feet/jaw, hyperglycemia, thickening of skin
• acromegaly is d/t


  overproduction of growth hormone
• normal function of pancreas


  releases digestive enzymes into digestive tract to aid in breakdown of fat and fat soluble vitamins; releases insulin and glucagon
• causes of pancreatitis


  damage to pancreatic cells or obstruction of pancreatic duct
• examples of damage to pancreatic celsl

  alcohol, virus, meds (thiazide diuretics), trauma
• examples of obstruction of pancreatic duct


  gallstones, mechanical obstruction from tumor
• result of obstruction of pancreatic duct

  traps enzymes within the pancreas--> autodigestion of pancreatic tissue (pancreatic suicide)
• clinical features of pancreatitis


  severe pain after eating, N/V, cullen sign
• where is the pain located in pancreatitis

  epigastric pain or upper left abdomen; sometimes referred back pain
• cullen sign


  bruising around umbilicus
• why might we see back pain with pancreatitis


  pancreas located behind tummy and directly against back muscles
• what position do pt with pancreatitis have pain in

  laying down