Nursing Review: Endocrine and Gastrointestinal Disorders Flashcards

Comprehensive vocabulary flashcards covering endocrine and gastrointestinal disorders based on nursing review lecture notes.

Acromegaly

Hypersecretion of growth hormone in adults after closure of epiphyseal plates, characterized by protruding jaw, large palms, soles of feet, dense bones, and organomegaly.

Gigantism

Hypersecretion of growth hormone occurring in children (bata) with open epiphyseal plates.

Octreotide (Sandostatin)

Antihormone medication used to decrease growth hormone levels in acromegaly, taken in the morning on a full stomach.

Transsphenoidal Hypophysectomy

Surgical removal of the pituitary gland performed through an incision in the upper gingival mucosa in the space between the upper gums and lip.

Increased Intracranial Pressure (ICP) Post-Hypophysectomy

Priority post-op complication indicated early by altered level of consciousness (ALOC); managed by elevating head of bed (EHOB) and avoiding coughing, sneezing, valsalva, bending, or heavy lifting.

CSF Leak Glucose Testing

Gold standard confirmation method for cerebrospinal fluid (CSF) leaks, such as clear nasal drainage (rhinorrhea) post-hypophysectomy.

Hormonal / Pituitary Dwarfism

Hyposecretion of growth hormone resulting in a proportionally small body-to-limb ratio, toddler-like appearance, and inability to reproduce.

Achondroplasia

Genetic form of dwarfism characterized by a disproportional body-to-limb ratio, distinct from hormonal pituitary dwarfism.

Somatropin / Somatotropin

Growth hormone replacement therapy used to treat pituitary dwarfism, administered in the evening on a full stomach.

Grave's Disease

Primary hyperthyroidism characterized by elevated $T_3$/$T_4$ levels and decreased TSH due to negative feedback, presenting with increased vital signs, restlessness, diarrhea, increased appetite, and weight loss.

Exophthalmos

Hallmark sign of Grave's Disease involving protruding eyes; managed with sunglasses and eye drops during the day and taping eyelids shut at night.

Propylthiouracil (PTU)

Antithyroid medication used in Grave's Disease to lower thyroid hormone levels, taken in the morning with a full stomach.

Agranulocytosis / Neutropenia

Adverse effect of antithyroid medications (Methimazole and PTU) characterized by sore throat, fever, and flu-like symptoms requiring holding the dose and calling the physician immediately.

Radioactive Iodine (131-I)

Treatment that destroys hyperactive thyroid tissue (medical thyroidectomy) to reduce hormone production, requiring lifetime Levothyroxine replacement afterward.

Saturated Solution of Potassium Iodide (SSKI)

Preoperative medication for thyroidectomy used to decrease the size and vascularity of the thyroid gland, administered mixed with juice or milk through a straw to prevent tooth staining.

Audible Stridor

Priority post-thyroidectomy sign indicating airway obstruction from tracheal edema or spasm; requires immediate physician notification and emergency tracheostomy set at the bedside.

Laryngeal Nerve Damage Assessment

Evaluated post-thyroidectomy by asking the patient to speak and checking for persistent hoarseness.

Hashimoto's Thyroiditis

Primary hypothyroidism characterized by decreased $T_3$/$T_4$ levels and elevated TSH, leading to decreased vital signs, lethargy, constipation, weight gain, and facial/periorbital edema.

Myxedema Coma

Life-threatening complication of severe hypothyroidism triggered by ISIS (injury, stress, infection, surgery) or sedatives, presenting with coma, edema, and poor cardiac output.

Thyroid Storm / Thyrotoxicosis

Life-threatening complication of Grave's Disease triggered by ISIS, presenting with severe hypertensive crisis and risk for cardiac arrest; managed with beta-blockers, diazepam, and IV Methimazole.

Parathyroid Hormone (PTH)

Hormone responsible for bone resorption (bone breakdown), transferring calcium from the bones into the blood.

Hyperparathyroidism

Condition of excessive PTH resulting in hypercalcemia, hypophosphatemia, bone demineralization, pathological fractures, and kidney stones.

Alendronate (Fosamax)

Bisphosphonate used in hyperparathyroidism taken in the morning on an empty stomach with a full glass of water, requiring the patient to remain upright for $30\,\text{mins}$ to prevent esophagitis.

Calcitonin

Hormone that opposes PTH by promoting bone reabsorption, locking calcium back into the bones and lowering blood calcium levels.

Hypoparathyroidism

Deficiency of PTH, most commonly caused by accidental removal of parathyroid glands during thyroidectomy, resulting in hypocalcemia and hyperphosphatemia.

Trousseau's Sign

Carpopedal spasm induced by inflating a blood pressure cuff, indicating hypocalcemia and tetany.

Chvostek's Sign

Facial muscle twitching elicited by tapping over the facial nerve, indicating hypocalcemia and tetany.

Calcium Gluconate

Emergency intravenous medication administered for acute severe hypocalcemia and tetany.

Cushing's Disease

Hypercortisolism caused by an endogenous pituitary or adrenal gland tumor, resulting in excess sugar (cortisol), salt (aldosterone), and sex (testosterone) hormones.

Cushing's Syndrome

Exogenous hypercortisolism caused by long-term administration of steroid medications.

Ketoconazole

Antihormone medication used in Cushing's condition to decrease adrenal steroid hormone synthesis.

Mitotane

Chemotherapeutic agent used for adrenal cortex tumor suppression, causing a medical adrenalectomy.

Bilateral Adrenalectomy Care

Surgical removal of both adrenal glands requiring lifetime steroid replacement therapy, which must never be skipped or stopped abruptly.

Addison's Disease

Primary adrenal insufficiency caused by autoimmune destruction of the adrenal cortex, presenting with low SSS (sugar, salt, sex), bronze skin discoloration, hypoglycemia, hyponatremia, and hyperkalemia.

Addisonian Crisis

Life-threatening complication of adrenal insufficiency triggered by stress/ISIS, causing severe hypotension and hypovolemic shock; treated immediately with IV steroids.

Pheochromocytoma

Catecholamine-secreting tumor of the adrenal medulla causing severe fight-or-flight symptoms, hypertensive crisis, and risk for cardiac dysrhythmias.

Pre-Op Alpha Blockers in Pheochromocytoma

Medications like Doxazosin and Phenoxybenzamine given FIRST prior to surgery to control hypertension, followed by beta-blockers.

Abdominal Palpation Contraindication

Absolute prohibition in pheochromocytoma patients because compressing the abdomen squeezes the tumor and releases massive catecholamines into circulation.

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Condition of excessive ADH causing fluid volume overload, dilutional hyponatremia, oliguria ($< 30\,\text{mL/hr}$), and high urine specific gravity.

3% Hypertonic Saline

Intravenous fluid administered with extreme caution via an infusion pump to correct severe hyponatremia in SIADH.

Furosemide (Lasix)

Loop diuretic used in SIADH to manage pulmonary edema; requires monitoring for ototoxicity and tinnitus.

Demeclocycline

Tetracycline antibiotic used off-label in SIADH to block/antagonize the renal action of antidiuretic hormone.

Diabetes Insipidus (DI)

Deficiency of ADH causing fluid volume deficit, extreme polyuria ($> 60\,\text{mL/hr}$), polydipsia, hypernatremia, and dilute urine with low specific gravity.

Desmopressin Acetate (DDAVP)

Synthetic ADH analog administered via the intranasal route as maintenance therapy for Diabetes Insipidus, alternating nares daily.

Vasopressin

Emergency intravenous medication given for acute Diabetes Insipidus and severe hypovolemic shock.

Fasting Blood Glucose (FBG)

Diagnostic test for diabetes mellitus performed after an $8\,\text{hour}$ NPO status, where a result greater than $126\,\text{mg/dL}$ confirms diabetes.

Glycosylated Hemoglobin (HbA1c)

Diagnostic test reflecting average blood glucose control over the preceding 3 months; a value greater than $6.5\%$ indicates diabetes.

Oral Glucose Tolerance Test (OGTT)

Diagnostic test involving an $8\,\text{hour}$ fast followed by drinking a $75\,\text{g}$ glucose solution; a 2-hour blood sugar greater than $200\,\text{mg/dL}$ diagnoses diabetes.

Type 1 Diabetes Mellitus

Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency, typically presenting in young patients ($< 30\,\text{years}$) who are thin and prone to DKA.

Type 2 Diabetes Mellitus

Condition characterized by insulin resistance in target tissues, typically occurring in adults ($> 30\,\text{years}$) associated with obesity and managed initially with oral hypoglycemic agents.

Rapid-Acting Insulin

Insulin preparations (Lispro, Aspart, Glulisine) with an onset of $15\text{--}30\,\text{mins}$, peak of $1\text{--}2\,\text{hours}$, and duration of $3\text{--}6\,\text{hours}$.

Regular Insulin (Short-Acting)

Clear insulin with an onset of $30\text{--}60\,\text{mins}$, peak of $2\text{--}4\,\text{hours}$, duration of $5\text{--}8\,\text{hours}$, and the ONLY type safe for IV administration.

NPH Insulin (Intermediate-Acting)

Cloudy insulin suspension with an onset of $1\text{--}2\,\text{hours}$, peak of $4\text{--}12\,\text{hours}$, and duration of $12\text{--}24\,\text{hours}$.

Long-Acting Insulin

Insulin glargine (Lantus) or detemir with an onset of $1\text{--}2\,\text{hours}$, no pronounced peak, duration of $24\,\text{hours}$, and low risk for hypoglycemia.

Insulin Mixing Sequence

Order of drawing combined insulins: inject air into NPH (cloudy), inject air into Regular (clear), aspirate Regular (clear) dose, and lastly aspirate NPH (cloudy) dose.

Somogyi Effect

Nighttime overdose of insulin causing nocturnal hypoglycemia followed by rebound morning hyperglycemia; managed by reducing evening insulin or adding a bedtime snack.

Dawn Phenomenon

Early morning hyperglycemia caused by natural surge in growth hormone/cortisol; managed by increasing the evening insulin dose or holding bedtime snacks.

Metformin (Glucophage)

Biguanide oral hypoglycemic agent that must be held $24\,\text{hours}$ before and $48\,\text{hours}$ after contrast dye procedures to prevent acute kidney injury and lactic acidosis.

Sulfonylureas

Oral antidiabetic medications (e.g., Gliclazide) that lower blood sugar by stimulating the pancreas to increase insulin secretion.

Diabetic Ketoacidosis (DKA)

Complication of Type 1 DM characterized by blood glucose $> 300\,\text{mg/dL}$, metabolic acidosis with ketone production, and Kussmaul respirations.

Hyperosmolar Hyperglycemic State (HHS)

Complication of Type 2 DM characterized by extreme hyperglycemia ($> 800\,\text{mg/dL}$), severe dehydration, and absence of significant ketoacidosis.

Diabetic Retinopathy

Microvascular complication of chronic hyperglycemia causing damage to retinal blood vessels and potential vision loss.

Diabetic Nephropathy

Kidney damage resulting from prolonged hyperglycemia, assessed by elevated BUN/creatinine, microalbuminuria, and declining urine output.

Diabetic Peripheral Neuropathy

Nerve damage leading to sensory loss, numbness, and tingling in the extremities, increasing the risk for undetected injuries and diabetic foot ulcers.

Diabetic Foot Care Rules

Daily foot inspections, buying shoes in the late afternoon, cutting nails straight across, keeping feet dry without lotion between toes, and NEVER walking barefoot.

Achalasia

Esophageal motility disorder characterized by absent/ineffective peristalsis and failure of the lower esophageal sphincter (LES) to relax during swallowing.

Hiatal Hernia

Condition where a portion of the stomach herniates upward through a weakened diaphragm into the thoracic cavity, causing heartburn and regurgitation.

Diverticulosis

Asymptomatic outpouchings (diverticula) in the intestinal wall, most commonly occurring in the sigmoid colon due to high intraluminal pressure from chronic constipation.

Diverticulitis

Inflammation of intestinal diverticula due to obstruction by fecaliths or seeds, causing severe left lower quadrant (LLQ) pain; requires a low-fiber diet during active inflammation.

Zenker's Diverticulum

Outpouching of the posterior pharyngeal wall above the upper esophageal sphincter, causing dysphagia, regurgitation of undigested food, and halitosis.

Hemorrhoids

Dilated, swollen varicose veins in the anal and rectal canal resulting from elevated pressure, straining, and chronic constipation.

Hemorrhoidectomy Post-Op Care

Position patient side-lying, provide pain medication prior to the first bowel movement, apply cold packs, and restrict sitz baths until AFTER $12\,\text{hours}$ post-op to prevent severe hemorrhage.

Gastroesophageal Reflux Disease (GERD)

Incompetence of the lower esophageal sphincter (LES) allowing gastric contents to flow back into the esophagus, primarily caused by obesity.

Pyrosis

Burning sensation in the chest behind the sternum (heartburn), representing the primary clinical symptom of GERD.

Barrett's Esophagus

Precancerous lesion resulting from chronic GERD, where normal squamous esophageal epithelium is replaced by columnar gastric mucosal cells.

Antacids

Neutralizing agents for gastric hydrochloric acid that should be taken $1\text{--}2\,\text{hours}$ before or after meals and other oral medications to prevent drug interactions.

Proton Pump Inhibitors (PPIs)

Potent acid-suppressing medications (Omeprazole, Pantoprazole) that block gastric acid production, best taken in the morning $30\,\text{mins}$ before meals on an empty stomach.

Histamine-2 (H2) Blockers

Medications (Famotidine, Cimetidine) that decrease stomach acid production by blocking H2 receptors on parietal cells, often combined with PPIs for ulcer management.

Peptic Ulcer Disease (PUD)

Mucosal erosion in the stomach, duodenum, or esophagus, most commonly caused by Helicobacter pylori infection and chronic NSAID use.

Gastric Ulcer

Ulceration in the stomach presenting with epigastric pain occurring during or immediately after meals, leading to anorexia, weight loss, and coffee-ground hematemesis.

Duodenal Ulcer

Most common ulcer type, presenting with right upper quadrant/epigastric pain occurring $2\text{--}3\,\text{hours}$ after meals (or waking at night), relieved by food intake, and associated with melena.

Esophagogastroduodenoscopy (EGD)

Gold standard diagnostic procedure for peptic ulcers requiring $6\text{--}8\,\text{hours}$ pre-procedure NPO status and post-op gag reflex verification before oral intake.

Sucralfate (Carafate)

Cytoprotective mucosal barrier agent that binds to ulcer beds, taken $1\,\text{hour}$ before meals and at bedtime on an empty stomach.

Misoprostol (Cytotec)

Synthetic prostaglandin E1 analog that protects gastric mucosa against NSAID toxicity; strictly contraindicated in pregnancy due to abortifacient effects.

Billroth I (Gastroduodenostomy)

Surgical removal of the distal stomach with anastomosis of the remaining stomach directly to the duodenum.

Billroth II (Gastrojejunostomy)

Surgical removal of the distal stomach with anastomosis of the stomach directly to the jejunum.

Dumping Syndrome

Rapid gastric emptying into the small intestine post-gastrectomy causing postprandial hypoglycemia, abdominal cramps, and diarrhea; managed by small frequent meals, low carbs, and taking fluids BETWEEN meals.

Pernicious Anemia

Vitamin $B_{12}$ deficiency resulting from gastrectomy due to loss of parietal cells and intrinsic factor, requiring lifetime monthly intramuscular $B_{12}$ injections.

Appendicitis

Inflammation of the appendix caused by fecalith obstruction; presents with initial periumbilical pain migrating to the right lower quadrant (RLQ), accompanied by Blumberg's and McBurney's signs.

McBurney's Point

Site of localized tenderness in acute appendicitis located one-third of the distance from the anterior superior iliac spine to the umbilicus in the RLQ.

Cholelithiasis

Formation of gallstones in the gallbladder, commonly associated with the 6 Fs (Female, Fat, Forty, Fertile, Fair, Fatty food lover) and presenting with severe RUQ pain after fatty meals.

Choledocholithiasis

Presence of gallstones obstructing the common bile duct, leading to jaundice, steatorrhea, dark tea-colored urine, and pruritus.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic diagnostic and therapeutic procedure used to visualize and remove gallstones lodged in the biliary tract.

T-Tube

Biliary drainage tube inserted into the common bile duct post-open cholecystectomy to maintain duct patency and drain bile ($500\text{--}1000\,\text{mL}$ expected green-brown output in the first $24\,\text{hours}$).

Acute Pancreatitis

Autodigestion of the pancreas by activated digestive enzymes (lipase, amylase, trypsin) secondary to gallstones or alcohol abuse, causing severe mid-epigastric/LUQ pain radiating to the back.

Cullen's Sign and Grey-Turner's Sign

Physical signs of severe acute pancreatitis with intra-abdominal or retroperitoneal bleeding, showing periumbilical bluish discoloration (Cullen's) or flank ecchymosis (Grey-Turner's).

Pancreatic Enzyme Replacement Therapy

Exogenous digestive enzymes (pancrelipase) administered with EVERY meal and snack in chronic pancreatitis to allow nutrient absorption and reduce steatorrhea.

Liver Cirrhosis

Permanent scarring and fibrosis of liver tissue leading to loss of protein synthesis (hypoalbuminemia/edema), impaired coagulation, jaundice, portal hypertension, and hepatic encephalopathy.

Liver Biopsy Procedure

Diagnostic procedure requiring the client to exhale and hold their breath during needle insertion between the 6th and 7th intercostal spaces, and lie on their RIGHT side post-procedure to prevent bleeding.

Sengstaken-Blakemore Tube

Triple-lumen nasogastric tube with esophageal and gastric balloons used to exert direct pressure (tamponade) on bleeding esophageal varices; scissors must be kept at the bedside for emergency airway compression.