endocrine + ekg interpretation

what does aldosterone do to the body?

• mineralocorticoid

• retention of sodium and water

• excretion of potassium

what does norepinephrine do?

vasoconstrict while increasing bp, pupil dilation, increased contractility, inhibits GI system activity

what does epinephrine do to the body?

• increases the body’s metabolism

• increase glucose levels in blood

• inhibits secretion of insulin

antidiuretic hormone

• secreted by the pituitary gland

• holds onto water increases blood volume, reduces urine output. does not hold onto sodium

• vasopressin

parathyroid hormone

• causes calcium to be pulled out of bones>ca in blood increases

calcitonin

• produced by thyroid gland

• released when ca increase

• stops bones from releasing more ca into blood

how do we store insulin?

• keep away from heat and direct sunlight

• never freeze insulin

• store in refrigerator until ready for use

• when actively using, keep at room temp

• in a cool, dry place for up to 28 days after opening

Methylprednisolone

• monitor for too much steroids

• monitor for hyperglycemia, osteoporosis and delayed wound healing

what are two types of antidiuretic hormone?

vasopressin and desmopressin

levothyroxine

• must be taken on empty stomach

• take at the same time everyday

• lifelong therapy

what are symptoms and treatment of adrenal crisis?

• results from addison’s disease

• extreme fatigue, dehydration, fever, hypotension, renal shut down, increase in serum K and decrease in serum Na

• tx; think SHOCK!! so fluid resus and administration of glucocorticoids

Cushing’s disease tx

• adrenalectomy

• avoid infection since pt is immunosuppressed

Conn’s disease

A condition caused by overproduction of aldosterone, leading to hypertension, hypokalemia, and metabolic alkalosis. Treatment often includes surgical removal of adrenal tumors or aldosterone antagonists.

Pheochromocytoma

A rare tumor of the adrenal glands that produces excess catecholamines, leading to symptoms such as hypertension, palpitations, and diaphoresis. Treatment typically involves surgical removal of the tumor and management of hypertension.

DI tx

• monitor neuro status bc of hypernatremia

• replaced fluids b/c of dehydration

• vasopressin/desmopressin to maintain water balance and manage symptoms.

SIADH tx

• fluid restriction to prevent overload

• administered demeclocycline or vasopressin receptor antagonists

• hypertonic saline

• electrolyte monitoring to manage hyponatremia.

hyperthyroid disease

• grave’s disease - autoimmune disease with antibodies attacking the thyroid

• treatment; often includes antithyroid medications, radioactive iodine therapy, or surgery to remove part or all of the thyroid gland.

hypothyroid tx

levothyroxine

thyroid storm

A severe and potentially life-threatening exacerbation of hyperthyroidism. It can cause symptoms like fever, tachycardia, and altered mental status, often requiring urgent treatment to stabilize the patient.

• caused by untreated grave’s or recent surgery or trauma to thyroid

• tx;

  • antithyroid - methimazole

  • iodine compounds

  • radioactive iodine tx

hypoparathyroidism

A condition characterized by inadequate secretion of parathyroid hormone, leading to low calcium levels in the blood (and high phohsphate). Symptoms may include muscle cramps, tingling in extremities, and seizures.

tx;

• fix electrolyte imbalance (calcium replacement and phosphorus binders)

hyperparathyroidism

on assessment; loss of appetite, nausea, vomiting, and abdominal pain. It is characterized by excessive secretion of parathyroid hormone, leading to elevated calcium levels in the blood and potential kidney stones or osteoporosis.

treatment; partial parathyroidectomy

hypoglycemia treatment

15, 15, 15

• 15g of carbs then wait 15 mins check bg again then eat another g of carbs if still low bg

• after bg rises eat a snack with complex carb/protein to help keep BG up

if unconscious

• IV access? push D5W

• If no IV? IM glucagon

sinus bradycardia causes and tx

• caused by sleep, inactivity, very athletic, drugs and MI

• tx; atropine

sinus tachycardia cause and tx

• caused by stress, anxiety, fever, hypotension

• tx; beta-blockers or treating the underlying cause

first-degree heart block cause and tx

cause;

• often an incidental finding

• peds; infection

• myocarditis

• congenital heart disease

tx:

• treatment is not generally required

• if extreme then pacing

second degree heart block type 1

cause:

• ischemia

• myocarditis

• status post-cardiac surgery

tx:

• asymptomatic: no tx

• symptomatic: pacing

second degree heart block type 2 cause and tx

cause:

• MI and ischemia

tx:

• pacing

third degree heart block cause and tx

cause:

• damage to heart

interventions

• pacing

pacemaker education

• keep a pacemaker identification in wallet

• taking a bath and shower is not restricted for permanent pacemakers

• no pressure or tight clothing over generator

• operating household appliances would be safe

• notify airport security of pacemaker

• contraindication for MRI

• for temporary pacemakers, don’t get wires wet

atrial flutter cause and tx

cause:

• heart disease

• MI

• CHF

• Pericarditis

tx:

• cardioversion

• pacing

• antiarrhtymics: amiodarone

• bb: metoprolol

• ccb: diltiazem

afib cause and tx

cause

• heart disease

• pulmonary disease

• stress

• alcohol

• caffeine

tx:

• fix the cause

• cardioversion

• aa: amiodarone

• bb: metoprolol

• ccb: diltiazem

supreventicular tachycardia cause and tx

cause:

• caffeine

• CHF

• fatigue

• hypoxia

• altered pacemaker in heart

tx:

• cardioversion, adenosine

asystole tx

cpr and epinephrine

after cardioversion we need to check

vitals and EKG to ensure sinus rhythm is restored.