endocrine adult health

hypothyroidism

Underproduction of thyroid hormones (T3, T4), causes slowed metabolism

hypothyroidism sxs

low T3/T4, high TSH, fatigue, lethargy, weight gain, cold intolerance, bradycardia, hypotension, constipation, dry skin, amenorrhea, goiter

meds hypothyroidism

Levothyroxine (Synthroid)

hypothyroidism interventions

give levo on empty stomach, monitor tsh levels, hr and bp, low calorie/high fiber diet, warm environment

myxedema coma

life-threatening severe hypothyroidism

myxedema coma sxs

coma, extreme bradycardia, shock, hypoventilation, hypothermia, respiratory failure

myxedema coma meds

IV thyroid hormone

myxedema coma nursing interventions

VS monitoring, maintain airway, mechanical ventilation as needed, IV fluids, warm blanket

hyperthyroidism

overproduction of thyroid hormones, increased metabolism

hyperthyroidism sxs

high T3/T4, low TSH, weight loss, heat intolerance, tachycardia, HTN, restless, anxiety, insomnia, diarrhea, goiter, exopthalmos

hyperthyroidism meds

methimazole, propylthiouracil (PTU), potassium iodide

hyperthyroidism interventions

high calorie diet, cool environment, reduce stim, rest, cardiac rhythm monitoring, DO NOT palpate goiter, eye care for exophthalmos

radioactive therapy (RAI)

oral treatment that destroys thyroid tissue used for hyperthyroidism, complication is hypothyroidism, pregnancy test before, avoid close contact with children or pregnant women for 1 week, flush toilet 2-3 times, use seperate utensils, wash clothes separately

thyroid storm

life threatening hyperthyroidism caused by thyroid surgery, palpation of goiter, or untreated hyperthyroidism

thyroid storm sxs

high fever, severe tachycardia, agitation, seizures, hypertension

thyroid storm interventions and meds

monitor bp, hr, and rhythm, cooling blankets, IV fluids, seizure precautions, administer antithyroid meds (methimazole, PTU)

thyroidectomy what is it and complications?

surgical removal of thyroid gland, airway obstruction, bleeding, thyroid storm, hypocalcemia

thyroidectomy meds and interventions

levo after surgery, semi fowler, avoid neck flexion, trach kit at bedside, suction, monitor for frequent swallowing and stridor

hyperparathyroidism what is it and what meds are used to treat it?

excess PTH which causes high calcium usually caused by parathyroid tumor, treated with cinacalcet and bisphosphonates

hyperparathyroidism sxs

hypercalcemia, HTN, muscle weakness, fracture risk, low phosphate

hypoparathyroidism what is it and what meds are given?

low PTH which results in low calcium usually caused by thyroidectomy damage

hypoparathyroidism sxs and nursing interventions

hypocalcemia, tetany, tingling around mouth, numb finger, positive chvostek/trousseau, seizures, seizure precautions, monitor calcium, trach kit and suction

what is addison’s disease and the causes?

adrenal insufficiency, low cortisol and aldosterone, caused by autoimmune destruction and adrenal tumors/ low ACTH

sxs for addison’s disease

hypotension, hyponatremia, hypoglycemia, hyperkalemia, fatigue, weight loss, muscle weakness, bronze skin

meds for addison’s disease

hydrocortisone, prednisone (steroid replacement)

what is addisonian crisis and what is it caused by?

acute adrenal insufficiency, MEDICAL EMERGENCY, caused by abrupt steroid withdrawal, illness, and stress

addisonian crisis sxs

severe hypotension, hypoglycemia, hyperkalemia, confusion, vomiting, diarrhea

meds given for addisonian crisis?

IV corticosteroids, IV dextrose, insulin and D5 for hyperkalemia

what is cushings and what is it caused by?

excess cortisol and aldosterone, caused by long term steroid use, pituitary/adrenal tumor

cushings sxs

HTN, hyperglycemia, hypernatremia, hypokalemia, weight gain, moon face, buffalo hump, truncal obesity, thin skin, poor wound healing

cushings medications

ketoconazole (to block cortisol production), mitotane (for adrenal cancer)

pheochromocytoma what is it?

tumor of the adrenal medulla, releases excess catecholamines

pheochromocytoma sxs, meds, and nursing interventions

severe HTN, tachycardia, palpitations, beta blocker, monitor BP, DO NOT PALPATE ABDOMEN, prepare for adrenalectomy

SIADH what is it? what meds help?

too much ADH causing water retention, meds are conivaptan, tolvaptan, furosemide, hypertonic saline (3%)

SIADH sxs

high urine osmo, low urine output, hyponatremia, weight gain, headache, concentrated urine, confusion, seziures

DI what is it and what meds are given?

too little ADH or kidneys don’t respond to the ADH, massive water loss, administer desmopressin (DDAVP for central DI), or thiazide diuretic (for nephrogenic DI)

DI sxs

polyuria, polydipsia, hypernatremia, hypotension, tachycardia, dry mucus membranes, dilute urine, low urine osmo