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Endocrine Study Guide NURS 131 Exam I


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Describe the Disease that Affects Adults who Secrete too much Growth Hormone? (P.629)
- Acromegaly – Rare Excess of GH affects Adults in the 30’s & 40’s
- Etiology – Pituitary Hyperplasia, Benign Tumor, or Hypothalamic Dysfunction
Consider Nursing Diagnoses for an Individual with Diabetes Insipidus? (P.626)
- Deficient Fluid Volume Related to Failure of Regulatory Mechanism
- Deficient Knowledge Related to Lack of Information
List the S/S of Hypothyroidism, Hyperthyroidism? (P.631, 634)
- Hypothyroidism – Occurs in Women Ages 30 to 60
- S/S Include – Low Metabolism; Fatigue; Weight Gain; Bradycardia; Constipation
- Heart Failure; Hyperlipidemia; Myxedema

- Hyperthyroidism – Diagnosed in Young Women; Grave’s Disease
- Heat Intolerance; Increased Appetite; Weight Loss; Increased Bowel Movements
Discuss General Guidelines when Caring for a Client with Recent Radioactive Iodine Treatment? (P.635)
- Limit Time Spent with Pt; Pregnant Nurses Not Allowed;
- Dispose Body Excretions to Facility Policy; Double Flush Toilet
- Oral Contact with Others Should be Avoided
Describe the Purpose of Glucagons? (P.647)
- Raises Blood Sugar when Needed by Releasing Stored Glucose from Liver
- Insulin and Glucose Work to Keep Blood Glucose at Constant Level
Signs of Ketoacidosis? (P.658)
- Occurs when Blood Glucose Levels are High & Insulin is Deficient
- Typically with Type I Diabetes and Low Levels of Insulin
- Because Cells Cannot Uptake Glucose, Fat is Broken Releasing Ketones
- Body Attempts to Reduce Acidosis by Pattern Called Kussmaul’s Respiration
Etiology of Diabetic Nephropathy? (P.659)
- Damage to Tiny Blood Vessels of Kidneys
- Poor Control of Blood Glucose
- Kidneys Become Unable to Remove Waste Products and Fluid from Blood
Give an Example of a Sulfonylurea Drug? (P.655)
- Insulin Stimulators
- 1st Generation: Tolbutamide; Chlorpropamide
- 2nd Generation: Glipizide; Glimepiride; Meglitinides; Repaglinide
Implications of Low C-Peptide Test Results? (David)
- Connecting Peptide – Released by Pancrease in Equal Levels with Insulin
- Test Shows How Much Insulin Body is Making
Nursing Care Guidelines for a Patient Post Subtotal Thyroidectomy? (P.636)
- Monitor V.S., Surgical Site, Monitor Excessive Bleeding
- Keep Tracheostomy Set; Keep Pt. in Semi-Fowler Position
- Gentle ROM, Avoid Hyperextension; Use Incentive Sphirometer
- Teach Signs of Thyrotoxic Crisis, Irritability, Fever, or Palpitations
Purpose and Side Effects of Propylthiouracil? (P.635, P.1180 Davis Drug)
- Treats Hyperthyroidism
- Nausea, Vomiting, Diarrhea, Rash
- Agranulocytosis (Decrease WBC), Thrombocytopenia (Decrease Platelets)
Teaching Points for a Patient Beginning Thyroid Replacement Therapy? (P.633)
- Monitor and Record Bowel Movements
- Increase Fluids; Encourage Fiber; Use Stool Softener
Define Hashimoto’s Disease? (P.1005-1006)
- Autoantibodies and TSH Form
- Thyroid Gland Over Stimulates Causing Hyperthyroidism
- Becomes Enlarged with Lymphocytes and Phagocytes
- Autoantibodies Destroy Thyroid Cells causing Hypothyroidism
Diagnostic Tests for Hypoparathyroidism? (P.638)
- Lab Tests Show Decreased Serum Calcium and PTH Levels
- Increased Serum Phosphate, Magnesium Levels Maybe Low
- Radiograph Shows Bone Changes
- Chvosteks’s and Trousseau’s Signs
Nursing Diagnoses and Interventions for a Patient with Cushings Syndrome? (P.641-642)
- Excess Fluid Volume Related to Sodium and Water Retention
- Risk for Impaired Skin Integrity; Risk for Injury R/T Impaired Glucose Tolerance
- Disturbed Body Image
Manifestations of Addisons Disease? (P.640-641)
- Insufficient Production of Hormones of Adrenal Cortex
- Hypotension R/T Lack of Aldosterone
- Caused by Low Production of ACTH
Special Nutritional Considerations for a Client with Addisons and Cushings? (P.640-642)
- Addisons: High Sodium Diet
- Cushing: High Potassium, Low Sodium
S/S of SIADH. Including Diagnostic Tests? (P.627)
- Fluid Overload; Muscle Cramps; Weakness
- Serum Urine and Sodium Levels
Possible Causes of Hypoglycemia in a Patient with Diabetes Mellitus? (P.657)
- Not Enough Calories Available in Relation to Circulating Insulin
- Typically Blood Glucose Levels Below 50 mg/dl
- Caused by Skipping Meal, Vigorous Exercise, Insulin Overdose
Long Term Complications of Diabetes Mellitus? (P.659-660)
- Circulatory System – Atherosclerosis and Areteriosclerosis leads to Hypertension

- Eyes – Blood Vessels Diseased Retinopathy, Cataracts
- Kidneys – Damage Blood Vessels of Kidney Leads to Nephropathy
- Neuropathy – Damage to Nerves
- Infection – More Prone to Infection
- Foot Complication – Due to Poor Blood Flow to Lower Extremeties
Cornerstone of Treatment for a Pt with Type II Diabetes? (P.649)
- Treatment Begins with Diet and Exercise
- Variety of Meal Plans are Available
- Fat and Sodium Intake is Limited
- Complex Carbohydrates are Encouraged
- Use Less of Simple Sugars as Possible
Goals of Nutrition Therapy in a Client with Diabetes? (P.649)
- Maintain Fasting Plasma Glucose Level Below 120 mg/dl
- Glycohemoglobin Level Less than 7 percent
- Maintain Blood Glucose and Lipid Levels as Normal as Possible
Review the Process of Mixing Insulins? (P.654)
- Too Much to List (Common Sense)
- Basically Draw Clear then Draw Cloudy
- If Too Much Cloudy is Drawn Accidentally, Discard Syringe (Or Squirt in Air J)
Describe Situations where a Patient with Type II Diabetes May Need Insulin? (P.654)
- Blood Glucose Not Controlled with Oral Hypoglycemics
- Not Necessary to Sustain Life as in Type I
Describe the Subcutaneous Site that Absorbs Quicker than Others? (P.652)
- Most Experts Recommend Abdomen and Buttocks
Describe the Somogyi Phenomenon? (P.654)
- Blood Glucose Rises Inspite of Insulin
- Occurs in Night Causing Sweat and Headaches
Interventions to Minimize Clients Risk of Developing Lipodystrophies Related to Insulin Injections? (P.652)
- Absence Of or Abnormal Distribution of Fat in the Body
- Injections Should be Given at Different Site Each Time
- Use One Area Per Week, Space Injections 1in Apart
Advantages and Side Effects of Metformin Over Other Anti-Diabetic Meds? (P.655)
- Increases Glucose Transport in Skeletal Muscle
- Causes GI Side Effects and Weight Loss
Discuss Sick Day Management of a Client with Diabetes?
- Unable to Find
Management of Hypoglycemic Reaction? (P.658)
- Administer “Fast Sugar” such as Orange Juice or Glucose Tablets
- If Pt. has Dysphagia Give IV Solution
- Do Not Treat with too much Sugar
Describe the Etiology and Manifestation of Diabetic Neuropathies?
- Not Yet Complete
Signs and Symptoms and Management of DKA? (P.658)
- Kussmaul’s Respiration
- Careful Monitoring of Blood Glucose at Home
Describe Kussmaul’s Respirations? (P.658)
- Deep, Sighing Respiratory Pattern
- Expired Air has Fruity Odor Mistaken for Alcohol
- Similar to Juicy Fruit Gum
Critical Teaching Points Surrounding Corticosteroid Use, Especially Importance of Not Abruptly Stopping Medications. Why? What Will Happen?
- Unable to Find
- Andreal Glands will Not Adjust Quickly Enough to Provide the Necessary Hormones
Signs/Symptoms/Management of a Thyrotoxic Storm? Who is at Risk? (P.634)
- Sever Hyperthyroid State from Illness or Stressor
- Pt. Inadequately Prepared Before Thyroid Surgery with Antithyroid Meds
- Tachycardia, Fever, Hypertension, Dehydration, Restlessness
Etiology of DI? (P.626)
- Diabetes Insipidus
- Tumors or Trauma to Pituitary Gland
- Surgery Near Pituitary Gland; Glucocorticoids; Alcohol
Nutritional Needs for a Patient with Hyperthyroidism?
- High Calorie Diet Maybe Required to Meet Caloric Requirements
- Diarrhea Lessened with Low Fiber Diet
Key Differences Between Type I and Type II Diabetes? (P.647)
- Type I – Rapid Onset; Age < 40; Virus or Autoimmune; Lean Body; Ketoacidosis; Insulin to Survive; Trauma to Pituitary Gland
- Type II- - Slow Onset; Age >40; Heredity, Obesity; Hyperglycemia; Diet, Exercise, Oral Hypoglycemics, or Insulin

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