Endocrine

Front 1

Following a thyroidectomy it is most important to ask the patient:

Back 1

If they have a feeling of 'fullness' at their incision site...may indicate bleeding

Front 2

What should be monitored if a patient is taking propranolol (Inderal) to treat hyperthyroidism?

Back 2

BP and HR prior to administration and periodically during therapy

Front 3

To improve the nutritional status of a patient w/ Grave's disease, what should the nurse do?

Back 3

Provide a quiet atmosphere during meals

Front 4

What are the s/s of hyperthyroidism?

Back 4

increased appetite, weight loss, diarrhea, diaphoresis, wet and moist skin, nervousness, insomnia, heat intolerance, tachycardia, palpitations, HTN, decreased TSH, elevated T4

Front 5

What are the s/s of hypothyroidism?

Back 5

bradycardia, hypotension, cold intolerance, constipation, fatigue, lethargy, weakness, weight gain, goiter, brittle nails, dry and coarse hair

Front 6

Post-op thyroidectomy what method should the nurse use to assess for bleeding?

Back 6

Palpate the back of the neck and shoulders...the tendency is for blood to follow gravity and flow down at the sides and posteriorly if hemorrhage occurs in the area of the neck

Front 7

Following a thyroidectomy, what is the purpose of voice checks and assessing for numbness or tingling?

Back 7

Possible post-op complications include laryngeal nerve damage manifested by stridor, and numbness or tingling in the extremities, lips, or mouth is a sign of hypocalcemia which can lead to respiratory distress due to tetany

Front 8

What are the characteristics of myxedema coma (a life-threatening condition)?

Back 8

Severely decreased cardiac output, fluid and lyte imbalance, acidosis, decreased respiratory function, tongue edema, and hypothermia

Front 9

What lab results should be expected for a client w/ Hashimoto's thyroiditis?

Back 9

Elevated TSH

Front 10

Nursing care for a client w/ hyperthyroidism would include:

Back 10

1. Private room, restricted visitors, quiet environment
2. Cool, well ventilated room
3. Eye care: sunglassess, eyedrops
4. Diet: high-cal, protein, and B6; 6 small meals/day; avoid stimulants (caffeine, tobacco)
5. Meds

Front 11

What are the s/s of a thyroid storm (crisis)?
What is the primary nursing intervention?

Back 11

1. Apprehension, restlessness, fever, hypotension, extreme tachycardia, RESPIRATORY DISTRESS, pulmonary edema, weakness, delirium
2. Maintain airway and adequate aeration

Front 12

Nursing care post-thyroidectomy:

Back 12

1. Semi-Fowler's
2. Immobilize head during position changes
3. Prevent hypocalcemia and tetany...ANTIDOTE: Calcium Gluconate

Front 13

Patient teaching for levothyroxine (Synthroid)?

Back 13

1. It increases basal metabolism and thus wakefullness, so it should be taken in the AM
2. Do not double-up on dose if missed
3. Do not stop taking abruptly
4. It may take up to 4wks for therapeutic results
5. s/s of hyperthyroidism

Front 14

Patient teaching for Lugol's solution?

Back 14

1. Avoid foods high in iodine (seafood, iodized salt, cabbage, kale, turnips)
2. Avoid foods high in potassium (avocado, raisins, meat, fish, milk, spinach, canteloupe, bananas)
3. Consult MD before taking OTC cold remedies...many contain iodine as an expectorant

Front 15

Why is a patient w/ hyperparathyroidism AKA hypercalcemia prescribed NS along w/ Lasix?

Back 15

To promote the excretion of calcium...large doses of saline infusions concurrently w/ Lasix will stimulate a decrease in serum calcium through renal exretion

Front 16

Critical patient teaching regarding hypoparathyroidism AKA hypocalcemia:

Back 16

1. Strategies to prevent falls...they have paresthesias, mood disorders, muscle spasms, and hyperactive DTRs, placing them at risk for falls
2. Increase their intake of Ca++ and VitD
3. Take prescribed meds