Managing Endocrine Disorders and Patient Assessment
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Questions and Answers

What are the symptoms associated with Addison's disease?

  • Hypoglycemia and decreased blood volume (correct)
  • Increased blood volume and hyperkalemia
  • Hypertension and hyperglycemia
  • Hypernatremia and tachycardia

    • Which of the following is NOT a symptom of Cushing's syndrome?

  • Hypernatremia
  • Hypertension
  • Hypoglycemia (correct)
  • Increased blood volume

    • What precaution is required for a patient with airborne-transmitted diseases?

  • Cohort with other patients
  • Standard room with regular ventilation
  • Private room with negative pressure (correct)
  • Private room with positive pressure

    • Which positioning should be used for a patient experiencing a pulmonary embolism?

    <p>Left side lying position</p> Signup and view all the answers

    What should be done for a woman in labor with an unreliable fetal heart rate?

    <p>Turn her to the left side</p> Signup and view all the answers

    What should a patient be positioned for tube feeding with decreased level of consciousness?

    <p>Right side lying position</p> Signup and view all the answers

    What is the proper position for a patient after a lumbar puncture?

    <p>Flat supine position</p> Signup and view all the answers

    During continuous bladder irrigation (CBI), what is one important positioning consideration?

    <p>Tape the catheter to the thigh and keep the leg straight</p> Signup and view all the answers

    What are the key characteristics of droplet precaution diseases?

    <p>Transmission by large respiratory particles</p> Signup and view all the answers

    Which condition requires monitoring for adequate urine output before administering potassium?

    <p>Addison's disease</p> Signup and view all the answers

    What position should a patient be placed in after a myringotomy procedure?

    <p>On the side of the affected ear</p> Signup and view all the answers

    After cataract surgery, how should the patient be positioned while sleeping?

    <p>On the unaffected side with a night shield</p> Signup and view all the answers

    What is the recommended position for an infant with spina bifida?

    <p>Prone (on abdomen)</p> Signup and view all the answers

    After a total hip replacement, which of the following is NOT recommended?

    <p>Sleeping on the operated side</p> Signup and view all the answers

    Which position should a patient be placed in to manage autonomic dysreflexia?

    <p>Sitting position (elevate HOB)</p> Signup and view all the answers

    How should a patient be positioned for peritoneal dialysis when outflow is inadequate?

    <p>Turned from side to side</p> Signup and view all the answers

    For a patient who has had infratentorial surgery, how should they be positioned post-operatively?

    <p>Flat and lateral on either side</p> Signup and view all the answers

    What is the appropriate position for administering an enema?

    <p>Left side-lying (Sim's) with knee flexed</p> Signup and view all the answers

    Which dietary recommendation would you follow for a patient with hypoparathyroidism?

    <p>High calcium and low phosphorus</p> Signup and view all the answers

    What position is recommended for a patient in shock?

    <p>Supine with legs elevated 20 degrees</p> Signup and view all the answers

    What intervention is recommended for a patient experiencing heat stroke?

    <p>Lie flat with legs elevated.</p> Signup and view all the answers

    Which group of diseases is classified under droplet precautions as per the mnemonic SPIDERMAN?

    <p>Scarlet fever, Streptococcal pharyngitis, Influenza.</p> Signup and view all the answers

    What is a symptom associated with Cushing's syndrome?

    <p>Hypertension.</p> Signup and view all the answers

    What is the proper position for a patient undergoing an epidural puncture?

    <p>Side-lying.</p> Signup and view all the answers

    What is the correct action for a patient with a pulmonary embolism experiencing chest pain?

    <p>Turn the patient to the left side.</p> Signup and view all the answers

    For which of the following conditions should potassium administration be carefully monitored for urine output?

    <p>Addison's disease.</p> Signup and view all the answers

    Which disease requires private room placement with a negative pressure system due to airborne transmission?

    <p>Measles.</p> Signup and view all the answers

    What positioning should be used for a patient after a lumbar puncture?

    <p>Supine and flat.</p> Signup and view all the answers

    What dietary concern is common for patients with Addison's disease?

    <p>Low sodium.</p> Signup and view all the answers

    Which common condition is associated with increased blood volume and hyperglycemia?

    <p>Cushing's syndrome.</p> Signup and view all the answers

    What is the proper position for a patient after thyroidectomy?

    <p>Low or semi-Fowler's with head support</p> Signup and view all the answers

    How should an infant with cleft lip be positioned to prevent trauma to the suture line?

    <p>On back or in an infant seat</p> Signup and view all the answers

    Which position should be maintained for a patient experiencing autonomic dysreflexia?

    <p>Sitting position with head elevated</p> Signup and view all the answers

    What dietary approach is recommended to prevent dumping syndrome after stomach surgeries?

    <p>Reclining position during meals</p> Signup and view all the answers

    After a total hip replacement, what is an important positioning guideline?

    <p>Maintain hip abduction with pillows</p> Signup and view all the answers

    In which position should a patient be placed for a lumbar puncture after the procedure?

    <p>Supine for 4 to 12 hours</p> Signup and view all the answers

    What is the recommended position for a patient with a detached retina?

    <p>With the area of detachment in the dependent position</p> Signup and view all the answers

    What position is recommended for a patient experiencing shock?

    <p>Flat with legs elevated</p> Signup and view all the answers

    For a patient who has had infratentorial surgery, what positioning is necessary post-operatively?

    <p>Flat and lateral on either side</p> Signup and view all the answers

    What position should be used when administering an enema?

    <p>Left side-lying (Sim's) with knees flexed</p> Signup and view all the answers

    Study Notes

    Managing Endocrine Disorders

    • Addison's Disease: Characterized by decreased hormone levels. Symptoms include hyponatremia, hypotension, decreased blood volume, hyperkalemia, and hypoglycemia.

    • Cushing's Syndrome: Characterized by increased hormone levels. Symptoms include hypernatremia, hypertension, increased blood volume, hypokalemia, and hyperglycemia.

    Fluid and Electrolyte Imbalances

    • No Pee, No K: Do not administer potassium without adequate urine output.

    Patient Assessment

    • Appearance (A): Assess for color (all pink, pink and blue, or blue/pale).

    • Pulse (P): Assess pulse rate (>100 bpm, <100 bpm, or absent).

    • Grimace (G): Assess for signs of distress (coughing, grimacing, or no response).

    • Activity (A): Assess for activity level (flexed, flaccid, or limp).

    • Respiration (R): Assess respiratory effort (strong cry, weak cry, or absent).

    Transmission-Based Precautions

    Airborne

    • MTV: Measles, Tuberculosis, Varicella (Chicken Pox), Herpes Zoster (Shingles). Use private negative-pressure rooms with 6-12 air exchanges per hour. TB requires N95 masks.

    Droplet

    • SPIDERMAN: Sepsis, Scarlet Fever, Streptococcal Pharyngitis, Parvovirus B19, Pneumonia, Pertussis, Influenza, Diptheria (Pharyngeal), Epiglottitis, Rubella, Mumps, Meningitis, Mycoplasma pneumonia, Adenovirus. Use private rooms or cohorting. Masks are typically necessary.

    Contact

    • MRS.WEE: Multidrug-resistant organisms, Respiratory infections, Skin infections, Wound infections, Enteric infections (e.g., C. difficile), Eye infections (e.g., conjunctivitis).

    Skin Infections

    • VCHIPS: Varicella (chickenpox), Cutaneous diphtheria, Herpes simplex, Impetigo, Pediculosis (lice), Scabies.

    Positioning for Specific Conditions

    • Pulmonary Embolism: Left side-lying, lower head of bed.
    • Unreassuring FHR: Left side-lying, Supplemental oxygen, stop Pitocin, increase IV fluids.
    • Tube Feeding/Decreased LOC: Right side-lying, HOB elevated.
    • Epidural Puncture: Side-lying.
    • Lumbar Puncture/Myelogram: Flat supine.
    • Heat Stroke: Flat, legs elevated.
    • CBI: Thigh taped, leg straight.
    • Myringotomy: Side-lying on affected side.
    • Cataract Surgery: Unaffected side, night shield.
    • Thyroidectomy: Semi-Fowler's position, support head, neck, and shoulders.
    • Spina Bifida: Prone.
    • Buck's Traction: Elevate foot of bed.
    • Total Hip Replacement: Avoid operated side, <45-60° hip flexion, <45° HOB elevation, maintain abduction.
    • Prolapsed Cord: Knee-chest position or Trendelenburg.
    • Cleft Lip: Back position or infant seat; upright feeding position.
    • Dumping Syndrome: Reclining position after meals, lie down, restrict fluids, low CHO/fiber diet, small frequent meals.
    • Above Knee Amputation: Elevate for 24 hrs, prone positioning for hip extension.
    • Below Knee Amputation: Elevated foot of bed, prone positioning.
    • Detached Retina: Area of detachment in dependent position.
    • Enema: Left side-lying with flexed knee (Sims').
    • Supratentorial Surgery: HOB 30-45 degrees.
    • Infratentorial Surgery: Flat, either side-lying.
    • Internal Radiation: Bedrest.
    • Autonomic Dysreflexia: Sitting position (elevate HOB) first.
    • Shock: Bedrest with extremities elevated 20 degrees, knees straight, slightly elevated head.
    • Head Injury: HOB elevated 30 degrees.
    • Peritoneal Dialysis (inadequate outflow): Side-to-side turning before checking for kinks in tubing.
    • Lumbar Puncture (post-procedure): Supine for 4-12 hours.

    Medications

    • Demerol: For pancreatitis, not morphine sulfate.

    Neurological Conditions

    • Myasthenia Gravis: Worsens with exercise, improves with rest. Myasthenia Crisis: Positive Tensilon response (symptoms improve), Cholinergic Crisis: Excessive medication; stop medication, Tensilon worsens symptoms.

    Medications and procedures

    • Head injury medications: Mannitol (an osmotic diuretic) - Use filter needle always because it crystallizes at room temp.
    • Liver biopsy: Assess prothrombin time prior.

    Gastrointestinal Issues

    • Diarrhea: Metabolic acidosis.
    • Vomiting: Metabolic alkalosis.

    Thyroid Disorders

    • Hypothyroidism (Myxedema): Slowed physical and mental function, cold sensitivity, dry skin and hair.
    • Hyperthyroidism (Graves' disease): Accelerated physical and mental function, heat sensitivity, fine/soft hair.
    • Thyroid Storm: Increased temperature, pulse, and hypertension.
    • Post-thyroidectomy: Semi-Fowler's position; prevent neck flexion/hyperextension; tracheostomy at bedside.

    Parathyroid Disorders

    • Hypoparathyroidism: CATS (convulsions, arrhythmias, tetany, spasms, stridor). Associated with decreased calcium, high calcium and low phosphorus diet.
    • Hyperparathyroidism: Fatigue, muscle weakness, renal calculi, back and joint pain. Associated with increased calcium, low calcium and high phosphorus diet..

    Fluid Volume Imbalances

    • Hypovolemia: Increased temperature, rapid/weak pulse, increased respiration, hypotension, anxiety, urine specific gravity >1.030.
    • Hypervolemia: Bounding pulse, shortness of breath, dyspnea, rales/crackles, peripheral edema, hypertension, urine specific gravity < 1.030.

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    Description

    This quiz covers the essential aspects of managing endocrine disorders such as Addison's disease and Cushing's syndrome. It also addresses fluid and electrolyte imbalances, patient assessment techniques, and transmission-based precautions. Test your knowledge on these vital health topics to ensure proper patient care.

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