Ch 51: Endocrine Disorder Care Flashcards
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Questions and Answers

Which food is rich in iodine?

  • Eggs (correct)
  • Fruit
  • Bread and cereal
  • Dairy products
  • One of the side effects of administering calcium gluconate intravenously is?

  • Hypocalcemia
  • Extravasation at the site (correct)
  • Paralysis after infusion
  • Hyperglycemia
  • The primary clinical manifestation of hyperparathyroidism is?

  • Hypocalcemia
  • Hypercalcemia (correct)
  • Hypoglycemia
  • Hyperglycemia
  • Signs and symptoms of hypoglycemia include: (Select all that apply.)

    <p>Irritability</p> Signup and view all the answers

    The three major life-threatening complications postoperatively of a thyroidectomy are: (Select all that apply)

    <p>Tetany</p> Signup and view all the answers

    The adrenal cortex secretes glucocorticoids. The most important is cortisol. It is involved in: (Select all that apply)

    <p>Glucose metabolism</p> Signup and view all the answers

    What is the name of the long-acting insulin administered once a day?

    <p>Lantus</p> Signup and view all the answers

    Another term for hyperglycemic reaction is?

    <p>Diabetic ketoacidosis (DKA)</p> Signup and view all the answers

    Which type of insulin can be administered intravenously?

    <p>Regular insulin</p> Signup and view all the answers

    What is the condition with a deficiency in growth hormone called?

    <p>Hypopituitary dwarfism</p> Signup and view all the answers

    The amount of hormone released by any gland is controlled by?

    <p>A negative feedback system</p> Signup and view all the answers

    Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?

    <p>Glycosylated hemoglobin (HbA1c)</p> Signup and view all the answers

    The patient is a newly diagnosed diabetic. Until he has his diabetes under control, which test will furnish valuable immediate feedback information?

    <p>BS</p> Signup and view all the answers

    A patient on the medical floor has a diagnosis of adrenal hyperfunction (Cushing's syndrome). She will probably have to adhere to a diet that contains?

    <p>Less sodium</p> Signup and view all the answers

    The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening. Which adjustment in her treatment plan will the nurse help this patient make?

    <p>Monitor her glucose level before, during, and after swimming to determine the need for alterations in food or insulin.</p> Signup and view all the answers

    A long-term complication of diabetes mellitus is?

    <p>Renal failure</p> Signup and view all the answers

    During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potentially lethal complication of?

    <p>Congestive heart failure</p> Signup and view all the answers

    In diabetes insipidus, clinical manifestations are caused by a deficiency of?

    <p>Antidiuretic hormone (ADH)</p> Signup and view all the answers

    A patient has recently been diagnosed with acromegaly. Using Maslow's hierarchy, which of the nursing diagnoses listed below should be of the highest priority in caring for him?

    <p>Risk for trauma</p> Signup and view all the answers

    Which nursing diagnosis is appropriate for a patient diagnosed with hypothyroidism as the result of a newly developed goiter?

    <p>Disturbed body image</p> Signup and view all the answers

    The test that employs radioactive iodine and use of a scintillation camera is called?

    <p>Radioactive iodine uptake test (RAIU)</p> Signup and view all the answers

    In the treatment of hyperthyroidism, which one of these medications is likely to be prescribed to decrease the activity of the thyroid gland?

    <p>Propylthiouracil</p> Signup and view all the answers

    When a patient has completely recovered from anesthesia, which position would be most appropriate for a patient who has undergone a subtotal thyroidectomy?

    <p>Semi-Fowler's</p> Signup and view all the answers

    What would be most necessary to place postoperatively at the bedside of the patient with a subtotal thyroidectomy?

    <p>Tracheotomy tray</p> Signup and view all the answers

    A patient is depressed about the changes in her personal appearance related to Cushing's disease. She is particularly likely to exhibit which change?

    <p>Weight gain, moon face, and increased facial hair</p> Signup and view all the answers

    The human insulin whose onset of action occurs within minutes is?

    <p>15</p> Signup and view all the answers

    If the diabetic patient exercises, then the insulin requirement?

    <p>Decreases</p> Signup and view all the answers

    Chvostek's sign and Trousseau's sign are tests to determine?

    <p>Low levels of blood calcium</p> Signup and view all the answers

    A patient has undergone tests that indicate a deficiency of parathormone secretion. She should be informed of which potential complication?

    <p>Laryngeal spasms</p> Signup and view all the answers

    In applying moist packs to the ulcerated foot of a patient with diabetes mellitus, the nurse should use aseptic techniques to?

    <p>Prevent the introduction of additional microorganisms</p> Signup and view all the answers

    The physician orders an 1,800-calorie diabetic diet and 40 units of (Humulin N) insulin U-100 subcutaneously daily. A mid-afternoon snack of milk and crackers is given to?

    <p>Prevent an insulin reaction</p> Signup and view all the answers

    A patient has type 1 diabetes (IDDM). The early signs and symptoms of insulin reaction include?

    <p>Perspiration and a trembling sensation</p> Signup and view all the answers

    Common early signs and symptoms of diabetic ketoacidosis include?

    <p>Thirst and drowsiness</p> Signup and view all the answers

    A patient, age 28, has sought medical attention because her hands and feet have become enlarged. These symptoms most likely indicate problems with the?

    <p>Pituitary gland</p> Signup and view all the answers

    A patient, age 61, has had type II diabetes for 20 years. To prevent injury and infection to this patient's feet and legs, which instruction does the nurse include in teaching?

    <p>He should not go barefoot and should always wear shoes with soles.</p> Signup and view all the answers

    The physician prescribes glyburide (Micronase, DiaBeta, Glynase) for a patient when diet and exercise have not been able to control her type 2 diabetes. Which information does the nurse include when teaching her about glyburide?

    <p>Glyburide and other hypoglycemic agents are thought to stimulate insulin production and increase sensitivity to insulin at receptor sites.</p> Signup and view all the answers

    A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. Nutritional interventions should include?

    <p>Calorie-restricted meals</p> Signup and view all the answers

    A 47-year-old patient with hypothyroidism is being given discharge instructions. These should include?

    <p>Seeing his physician regularly for follow-up care</p> Signup and view all the answers

    To prevent lipodystrophy, the nurse should administer insulin?

    <p>At room temperature</p> Signup and view all the answers

    A patient with a history of Graves' disease is admitted with shortness of breath and vital signs indicating a possible medical emergency. The nurse suspects the patient has?

    <p>Thyroid storm</p> Signup and view all the answers

    The master gland of the endocrine system is the?

    <p>Pituitary</p> Signup and view all the answers

    Pregnant women should not be exposed to iodine-131 because of?

    <p>Danger to the fetus</p> Signup and view all the answers

    How is hypothyroidism treated?

    <p>With replacement therapy.</p> Signup and view all the answers

    Study Notes

    Hormone Release Regulation

    • Hormone secretion is primarily controlled by a negative feedback system, maintaining balance in the body’s endocrine functions.

    Diabetes Monitoring

    • Glycosylated hemoglobin (HbA1c) provides an overview of glucose levels over the previous 8 to 12 weeks and is essential for long-term diabetes management.
    • Immediate feedback for newly diagnosed diabetics should come from fingerstick blood glucose level tests.

    Cushing's Syndrome Dietary Management

    • A diet low in sodium is recommended for patients with Cushing's syndrome to mitigate edema.

    Exercise for Type 1 Diabetes

    • Diabetic patients like a 20-year-old swimmer should monitor glucose levels before, during, and after exercise to manage insulin needs and prevent hypoglycemia.

    Complications of Diabetes

    • Long-term diabetes complications include blindness, cardiovascular issues, and renal failure.

    Thyroid Crisis Symptoms

    • Thyroid crisis may result in severe complications such as congestive heart failure, highlighted by exaggerated hyperthyroid symptoms post-thyroidectomy.

    Diabetes Insipidus Cause

    • Characterized by a deficiency in antidiuretic hormone (ADH), leading to excessive urination and thirst.

    Acromegaly and Nursing Diagnoses

    • In acromegaly, prioritizing the risk for trauma is vital due to muscle weakness and joint pain affecting daily living activities.

    Hypothyroidism and Body Image

    • Disturbed body image may affect hypothyroidism patients, especially linked to physical changes from conditions like goiter.

    Thyroid Diagnostic Tests

    • The radioactive iodine uptake test (RAIU) is used to diagnose thyroid dysfunction by measuring radioactivity in the thyroid.

    Hyperthyroidism Treatment

    • Propylthiouracil may be prescribed to reduce thyroid activity by blocking hormone production.

    Post-Thyroidectomy Care

    • Keeping the patient in a semi-Fowler's position after subtotal thyroidectomy aids recovery.

    Emergency Equipment

    • A tracheotomy tray must be readily available post-thyroidectomy due to the potential for airway complications.

    Cushing's Disease Appearance Changes

    • Patients often exhibit weight gain, moon face, and increased facial hair, impacting their self-esteem.

    Insulin Administration Timing

    • Humalog (Lispro) provides rapid insulin action, effective within 15 minutes and can be administered shortly before meals.

    Diabetes and Exercise

    • Regular exercise decreases insulin requirements, enhancing glucose metabolism while managing blood pressure and lipid levels.

    Calcium Deficiency Tests

    • Chvostek's and Trousseau's signs help assess low blood calcium levels, indicating potential parathyroid issues.

    Hypoparathyroidism Complications

    • Severe hypocalcemia from parathormone deficiency can lead to dangerous laryngeal spasms.

    Diabetes Foot Care

    • Patients with diabetes should always wear shoes to prevent injury and infection due to neuropathy and vascular disease.

    Glyburide Education

    • Glyburide acts to stimulate insulin production and increase receptor sensitivity, crucial for managing type 2 diabetes.

    Hypothyroidism Dietary Recommendations

    • Suggested diets are high in protein and fiber while being lower in calories to manage the condition effectively.

    Lipodystrophy Prevention

    • Insulin should be administered at room temperature to prevent lipodystrophy, a common injection site complication.

    Thyroid Storm Indications

    • Signs like high fever and tachycardia in patients with a history of Graves' disease signal a thyroid storm, which may be life-threatening.

    Master Gland of the Endocrine System

    • The pituitary gland is deemed the master gland, regulating most other endocrine glands through hormonal signals.

    Iodine-131 Safety Precautions

    • Pregnant women must avoid exposure to iodine-131 due to severe risks to fetal development.

    Iodine-Rich Food Sources

    • Foods such as eggs and saltwater fish are good sources of iodine, essential for managing hypothyroidism.

    Calcium Gluconate IV Risks

    • Calcium gluconate administration risk includes extravasation, potentially causing tissue sloughing if improperly managed.

    Hyperparathyroidism Symptoms

    • The primary manifestation is hypercalcemia, resulting from excess parathyroid hormone secretion affecting calcium balance in bones.

    Hypoglycemia Signs

    • Signs include irritability, tremors, and personality changes, indicating low blood sugar levels that need urgent attention.

    Thyroidectomy Postoperative Complications

    • Major postoperative risks following thyroidectomy include hemorrhaging, tetany, and thyroid crisis, requiring careful monitoring.### Postoperative Complications of Thyroidectomy
    • Significant complications after thyroidectomy include tetany and thyroid crisis.
    • Manipulation of the thyroid during surgery may lead to excessive release of thyroid hormones, resulting in a thyroid storm.

    Glucocorticoids from the Adrenal Cortex

    • The adrenal cortex secretes glucocorticoids, with cortisol being the most significant.
    • Cortisol is involved in glucose metabolism and provides additional energy reserves during stressful situations.
    • Cortisol also plays a role in the retention of sodium but does not primarily function in releasing sex hormones (androgens and estrogens) or decreasing potassium levels.

    Long-Acting Insulin

    • Lantus is a long-acting insulin that provides consistent coverage for 24 hours.
    • Administered once daily, commonly at bedtime, Lantus maintains stable insulin levels throughout the night and day.

    Hyperglycemic Reactions

    • Hyperglycemic reactions can manifest as diabetic ketoacidosis (DKA), a severe condition involving high blood glucose and ketone accumulation leading to acidosis.
    • DKA can result in life-threatening complications, historically referred to as diabetic coma, due to acute insulin deficiency and increased fat metabolism.

    Insulin Administration

    • Only regular insulin can be given intravenously; all other types are typically administered subcutaneously.
    • IV administration is used when a rapid onset of insulin action is necessary.

    Growth Hormone Deficiency

    • A deficiency in growth hormone leads to a condition known as hypopituitary dwarfism.
    • Most cases are idiopathic, but some result from an autosomal-recessive trait.
    • Additional deficiencies may include adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), and gonadotropins.

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    Test your knowledge on the care of patients with endocrine disorders through these flashcards. This quiz includes questions on hormone release mechanisms and diagnostic tests for diabetes mellitus, helping to reinforce key concepts from Chapter 51.

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