Endocrine System (Final)

Front 1

There are 2 hormones produced by the thyroid gland. One is Thyroidd hormone (TH) what is the other and it's function?

Back 1

Calcitonin - Lowers serum calcium levels

Hint 1

(function) _______ serum ______ levels

Front 2

What are the 2 hormones produced by the posterior pituitary & their function.

Back 2

1. Antidiuretic hormone (ADH) - promotes H2O retention by kidneys
2. Oxytocin - promotes uterine contraction & release of milk

Hint 2

1 - think kidneys
2 - think pregnancy/infancy

Front 3

What is another name for the posterior lobe?

Back 3

neurohypophysis

Hint 3

The pituitary gland is called the hypophysis

Front 4

What is the purpose of prolactin & where is it located?

Back 4

stimulates breast milk production - in the anterior pituitary

Hint 4

think postpartum

Front 5

The primary mineralocorticoid, __________, maintains normal balance between ____&_____ in the kidneys.

Back 5

aldosterone; salt & water

Hint 5

"Al" doesn't like to rome on the beach.

Front 6

What type of cells?
A. Insulin
B. Glucagon

Back 6

Insulin = Beta Cells
Glucagon = Alpha Cells

Hint 6

think of "greek" fraternity

Front 7

A classic sign of an overactive thyroid condition in which the eyballs appear to bulge from the sockets is referred to as ______.

Back 7

exophthalmos

Hint 7

remember the picture of the "bugeyed" lady...

Front 8

What are the normal adult values for Glycosylated hemoglobin (Hb A1c)

Back 8

2.2 - 4.8%

Hint 8

this is a percentage ( % )

Front 9

If you find the Glycosylated hemoglobin (Hb A1c) levels increased in newly diagnosed or poorly controlled diabetic what type of adjustment(s) need to be made?

Back 9

Food &/or medication

Hint 9

2 things

Front 10

A 76 yr old male presents in the physicians office with chronic complaints of tiredness & constipation. The nurse realizes that this may be a sign of ________.

Back 10

imbalanced in the endocrine system

Hint 10

__________ in the _______ system

Front 11

When asked to explain what would take place during a 2-hour glucose tolerance test the nurse explains that the client must drink ___________ & not eat anything else until blood is drawn, normally _______.

Back 11

entire 75g of glucose; 2 hours

Hint 11

part of the answer is in the question.

Front 12

When sending a client for an MRI (Magnetic Resonance Imaging) the nurse must first assess for the presence of ______________.

Back 12

Metallic implants

Hint 12

this is something on the clients body...cant have MRI with it.

Front 13

Withhold all tyroid drugs or medications containing iodine for __________________ (choose one) before/after a radioactive iodine (RAI) uptake test.

Back 13

2 weeks before

Hint 13

these drugs affect the test so hold BEFORE for how long?

Front 14

What possible complication could brushing your teeth cause after a transsphenoidal hypophysectomy? why?

Back 14

hemoragge; because the surgery is performed thru an incision in the roof of the mouth

Hint 14

this surgery involves the removal of the pituitary gland

Front 15

SIADH is a condition that results from ___________.

Back 15

excess production of ADH.

Hint 15

SIADH is Symdrome of Inappropriate ADH Secretion

Front 16

SIADH is tx by correcting the ________ and by __________.

Back 16

underlying cause and limiting fluid intake

Hint 16

SIADH is Symdrome of Inappropriate ADH Secretion

Front 17

What are the main disorders caused by hyperthyroidism?

Back 17

Graves' disease & thyrotoxic crisis (thyroid storm)

Hint 17

there are 2

Front 18

Manifestations of thyroid storm include fever > _____, _________ and __________.

Back 18

fever >102F, tachycardia & hypertension

Hint 18

remember this is with HYPERthyroidism

Front 19

What drug should you not give during severe hyperthermia caused by thyroid crisis & why?

Back 19

aspirin - because it can increase thyroid hormone levels

Hint 19

this is an OTC drug

Front 20

With hyperthyroidism the T3 is ___, T4 is _____ with TSH _____.

Back 20

T3 is INCREASED, T4 is INCREASED with TSH DECREASED

Front 21

Exophthalmos is caused by the ____________ surrounding the eye.

Back 21

enlargement of muscle and fatty tissue

Hint 21

enlargement of ______ & ______ ________

Front 22

Sometimes it is necessary to all or part of the thyroid gland. Before surgery the client should be in as nearly a euthyroid state as possible. Euthyroid means _________.

Back 22

balanced thyroid

Hint 22

this is almost an oximoron

Front 23

After surgery the client is monitored for complications including _____________ damage because it is located near the thyroid gland & can be damaged during surgery.

Back 23

laryngeal nerve

Hint 23

it is a nerve

Front 24

MATCHING:
A. Antithyroid drugs
B. Beta-Adrenergic Blockers
C. Cytoxic agent
D. Corticosteroids

1. Methimazole (Tapazole)
2. Mithramycin (Mithracin)
3. Prednisone (Deltasone)
4. Propranolol (Inderal)

Back 24

(D3) Corticosteroids = Prednisone (Deltasone)

(B2) Cytoxic agent = Mithramycin (Mithracin)

(A1) Antithyroid drugs = Methimazole (Tapazole)

(B4) Beta-Adrenergic Blockers = Propranolol (Inderal)

Hint 24

NO HINTS =0)

Front 25

After a thyroidectomy the client develops the following SV s/s: hypotension, bradycardia & dysrhythmias. As the nurse you know this indicates a shift to _______.

Back 25

hypothyroidism

Hint 25

remember now the client has NO thyroid

Front 26

With hypoparathyroidism the lack of circulating PTH causes ________ & an elevated ____________ level.

Back 26

hypocalcemia & elevated blood phosphate level

Hint 26

think of the important elements in bones

Front 27

A pt DX with hypoparathyroidism may experience continuous muscle spasms known as:

Back 27

tetany

Front 28

The first priority of treating hypoparathyroidism is to increase ________ levels.

Back 28

calcium

Hint 28

think bones

Front 29

Think about hypoparathyroidism & tetany... Because the client can develop respiratory distress the nurse must ensure a patent airway. Be sure to keep oxygen, suctioning equipment & ______ @ ______.

Back 29

tracheostomoy set @ bedside

Hint 29

these items MUST be available IMMEDIATELY

Front 30

Manifestations of hypoparathyroidsm can include numbness & tingling in lips, hands, feet; irritability, depression and psychosis which indicate which system?

Back 30

Central Nervous System

Hint 30

your biggest hint is psychosis

Front 31

Addison's disease, Cushing syndrome, and pheochromomcytoma are the most common disorders of the ___________ gland.

Back 31

adrenal gland

Front 32

Women suffering from Cushing syndrome often have ______, acne & menstrual irregularities due to increased androgen levels.

Back 32

hirsutism

Hint 32

means excessive facial hair

Front 33

Diagnoisis of Cushing's Syndrome is confirmed by an increased plasma ______ level & an elevated 24-hour urine test for 17-ketosteroids & 17-hydroxycorticosteriods.

Back 33

cortisol

Hint 33

it is a glucocorticoid

Front 34

What is hypophysectomy?

Back 34

surgical removal of the pituitary gland

Hint 34

break it down - med term

Front 35

The adrenal cortex hypofunction may be primary (_______________) or secondary from lack of pituitary ACTH.

Back 35

Addison's disease

Hint 35

zip/zip

Front 36

What is the most common form of adrenal cortex insufficiency?

Back 36

Addison's disease

Hint 36

think about the 3 disorders of the adrenal glands

Front 37

With Addison's disease you should weigh yourself daily. Eating a diet high in ____ and low in ___ is important. Do what with medications?

Back 37

high in K+, low in Na+, Take your meds the rest of your life - NEVER abruptly stop

Hint 37

think vitamins/minerals.
how long should you take your meds?

Front 38

Pheochromocytoma is a __________ in the adrenal medulla. It is dx by increased _____ levels in the blood or urine, CT scan & MRI.

Back 38

benign tumor; catacholamine

Hint 38

this is a tumor; this "hormone" stimulates SNS response "fight or flight"

Front 39

Nursing care during the acute pheochromocytoma attack & prior to surgery focuses on __________.

Back 39

stabilizing the clients b/p

Hint 39

this client is in DISTRESS -- think what should be most important?

Front 40

Name the classic 3 P's of DM?

Back 40

Polyuria - ^ urine output
Polydipsia - ^ thirst
Polyphagia - ^ appetite

Hint 40

eat, drink, bathroom =0)

Front 41

DM cannot be cured but it can be controlled in order to reduce complications which most often affect the ____, kidneys, nervous & CV system.

Back 41

eyes

Hint 41

NO HINT ;-)

Front 42

A major characteristic found in insulin-dependent diabetes would include usually occurs :

Back 42

before age 30

Front 43

_______ is the #1 cause of death in Type 2 DM

Back 43

Heart disease

Hint 43

think of the other units this quarter

Front 44

What does the "onset" of drug mean?

Back 44

the time it takes for a drug to reach an effective blook level & to initiate a body response.

Hint 44

the time it takes for a drug to ________ & to _______ body response.

Front 45

If the nurse needs to decide how soon before a meal to give an insulin inection, which of the following must be considered?
onset, peak, duration, limit

Back 45

onset - because the onset determines how far in advance of meals you can safely administer.

Hint 45

it determines something...

Front 46

What color are Regular & Lantus insulin?

Back 46

clear

Front 47

Synthetically produced insulin comes either from altered pork insulin or through genetic engineering using strains of ________ to form a biosynthetic human insulin,

Back 47

Escherichia coli

Hint 47

you normally do NOT want this to "ingest this in your body.

Front 48

What does U-100 insulin mean?

Back 48

100 Units per mL

Hint 48

also can be wrote 100 U/mL

Front 49

Should you monitor for HYPOglycemia or HYPERglycemia with the following drugs:
Alcohol
Beta Blockers
Corticosteroids
Coumadin
Epinephrine
Estrogen
Ranitidine (Zantac)
Thiazide diuretics

Back 49

Alcohol = HYPO
Beta Blockers = HYPO
Corticosteroids = HYPER
Coumadin = HYPO
Epinephrine = HYPER
Estrogen = HYPER
Ranitidine (Zantac) = HYPO

Hint 49

you can do it you have a
50-50 shot =0)

Front 50

How do you tell it Regular insulin is contaminated?

Back 50

if it is cloudy

Hint 50

think appearance

Front 51

Give the steps to drawing up 10U Regular & 20U NPH insulin. The following has already been done:
1. Wash hands.
2. Inspect reg insulin for clarity.
3. Gently rotate NPH to mix well.
4. Cleanse top of vials with alcohol pad.

Back 51

Draw 20U air into syringe & WITHOUT inverting vial inject into NPH; withdraw needle; draw 10U air into syringe and WITHOUT inverting vial inject into Reg insulin vial; Invert reg insulin vial & withdraw 10U of reg; then insert the needle into the NPH vial invert & withdraw 20U (should almost draw self due to air prevoiusly injected)

Hint 51

Remember the importance is to NOT contaminate the reg insulin left in vial - we know the insulin will mix in the syringe.

Front 52

Instruct diabetic clients to use caution with exercise because although it is extremely important for them it can cause a ____________ in blood glucose levels by __________ by the muscles.

Back 52

rapide drop (in bg levels); increasing glucose use (by the muscles)

Hint 52

one goes one way the other opposite

Front 53

What is the name of the life-threatening illness that occurs in Type 1 diabetics?

Back 53

Diabetic Ketoacidosis

Hint 53

DKA

Front 54

DKA is treated with fluids, insulin and correction of electrolyte imbalances, this is first done with ____ to replace Na+ losses then switched to _____ after 2 to 3 hours to prevent hypernatremia.

Back 54

0.9% NS then 0.45% NS

Hint 54

fluid is NS

Front 55

When treating DKA after the bg levels reach 250mg/dL what is added to the NS to prevent hypoglycemia?

Back 55

dextrose

Hint 55

key word here is HYPOglycemia

Front 56

What type of insulin may be given via IV?

Back 56

regular insulin

Hint 56

there is only 1 kind

Front 57

What is the name of the serious, life-threatening medical emergency that occurs in Type 2 diabetics?

Back 57

Hyperosmolar hyperglycemic state

Hint 57

HHS

Front 58

Which diabetic medical emergency has a higher mortality rate? DKA or HHS

Back 58

HHS

Front 59

What are the manifestations of DKA?

Back 59

thirst
poor turgor
dry, mucous membranes

Front 60

A diabetic client is seated in the waiting area of your clinic. He begins to complain of nausea & hunger. You observe that he is sweating, experienceing a few chills, and has cool, pale skin. You recognize that this clients may be experiencing:

Back 60

Hypoglycemia

Hint 60

think sugar

Front 61

DEFINE: A morning rise in bg to hyperglycemic levels following an episode of nighttime hypoglycemia

Back 61

Somogyi effect

Front 62

A type of phenomenon in which the blood sugar levels rise between 5a.m. and 9a.m. is called ______.

Back 62

Dawn phenomenon

Front 63

Decreased arterial circulation can lead to lower leg ulcers and ______.

Back 63

gangrene

Hint 63

necrosis or tissue death

Front 64

What is the most common cause of nontraumatic amputations of the lower leg?

Back 64

gangrene

Hint 64

necrosis or tissue death

Front 65

____________ is the collective name for the destructive retinal changes that occur int he person with diabetes.

Back 65

Diabetic retinopathy

Front 66

Retinopathy is the leading cause of blindness in people between what ages?

Back 66

20 to 74

Hint 66

very wide range

Front 67

True or False: All diabetics have a greater risk for developing cataracts as a result of increased glucose levels within the lens.

Back 67

TRUE

Front 68

Due to the risk of retinopathy, cataracts, blindness, etc eye exams by an ophthalmologist are recommended for diabetic clients how often?

Back 68

yearly

Front 69

The first indication of diabetic nephropathy is the presence of ________ in the urine.

Back 69

albumin

Hint 69

may even be in a small amount

Front 70

Define Microalbuminuria

Back 70

small amounts of albumin in the urine

Hint 70

do med-term breakdown

Front 71

Diabetic neuropathy involves disorders of the peripheral nerves and the autonomic nervous system & can be tx with what type of drug?

Back 71

ACE inhibitors

Front 72

When planning sick-day management, the diabetic client should plan to monitor BG _______ throughout the illness.

Back 72

every 4 hours

Hint 72

remember BG can change quickly during sickness especially with n/v & diarrhea

Front 73

Before diabetics take any herbal supplements they should talk with their health care provider because complementary thereapies may _____ BG levels.

Back 73

increase

Front 74

Teach diabetic clients to buy shoes at what time of day? why?

Back 74

in the late afternoon, when feet are at their largest

Hint 74

always buy shoes that feel comfortable and do NOT need to be "broken in"

Front 75

Diabetic Foot Care: Check feet daily for? Paying special attention to?

Back 75

Check for red areas, cuts, blisters, corns, calluses, or cracks in the skin. Especially between toes for cracks or reddened areas.

Hint 75

Remember if shoes are continuously causing "pressure areas" GET RID OF THEM!!! It is NOT worth the risk with diabetics!!!

Front 76

Teach women with DM to take preventive measures against Candida albican(yeast infections) such as NOT ______, wiping from ________ after voiding, wearing _____ and avoiding ______ jeans & nylon pantyhose.

Back 76

douching, front to back, cotton underwear, avoiding

Front 77

What element is necessary for proper functioning of the thyroid?

Back 77

iodine

Hint 77

think salt

Front 78

What "organ" increase calcium blood levels?

Back 78

parathyroid

Front 79

What "organ" produces insulin?

Back 79

Islets of Langerhans

Front 80

What "organ" produces hormones known as catacholamines?

Back 80

Adrenal medulla

Front 81

A pt, DX with DI is experiencing tachycardia, poor skin turgor, & dry mouth. The nurse anticipates the development of a care plan of:

Back 81

dyhydration

Front 82

What is hypernatremia?

Back 82

^ Na+ in the blood

Front 83

What disorder results from ADH insufficiency?

Back 83

Addison's disease

Hint 83

Antidiuretic hormone

Front 84

DEFINE:Numbness or tingling in feet & hands

Back 84

Distal paresthesia

Front 85

DEFINE: Toxic accumulation of ketone bodies

Back 85

Ketosis

Front 86

DEFINE: Synthesis of glucose in the liver & kidneys

Back 86

Gluconeogenesis

Front 87

The nurse understnad that the diabetic client must be cautious when exercising because:

Back 87

blood sugar levels may drop rapidly

Front 88

The nurse explaining the action of an oral antidiabetic agent. The best statement that reflects the nurse's understanding is as follows: _______ cells are stimulated to release more _____ in response to hyperglycemia

Back 88

Beta cells; insulin

Front 89

Jacob is being evaluated for possible DM. When collecting the initial data, the nurse should ask about __________?

Back 89

urinary frequency

Front 90

The nurse is discussing hypoglycemic reactions with a family. When the spouse states "I'll make sure that we have some hard candy @ home" this indicates that she (choose one) does/does not need additional teaching?

Back 90

Does not

Front 91

A newly DX pt with diabetes is concerned about his children. He asks if they should be tested for hyperglycemia. What should be the nurse's answer & why?

Back 91

Probably; diabetes may be hereditary

Front 92

The nurse is teaching a class on the care of a diabetic pt. She states that early signs of Diabetic Ketoacidosis are:

Back 92

thirst, dry mucous membranes & poor skin turgor

Front 93

A client is admitted to the hospital, DX with Type 2 DM & scheduled for d/c the following day. The nurse relizes that the short hsp stay is NOT sufficient for adequate diabetic teaching; therefore the client's education should include:

Back 93

specific, realistic goals

Front 94

Mr. Jackson, DX with Type 2 DM, is prescribed an 1800-cal diet with daily exercise. The client's assessment date included: T-98.6, P-90, R-20, BP-160/98, height-5.5", weight-185 lbs. A dietary counseling referal was requested. The primary goal of nutritional TX is:

Back 94

reduction in dietary calories to maintain normal BP

Front 95

A client has been seen by the diabetic nurse. When the clients says "I can eat as much as I want to as long as I cover it with additional insulin" You determine that:

Back 95

add't teaching is necessary.

Front 96

A 16-yr-old male client has been using self-capillary blood glucose monitoring as part of his diabetic management. After evaluating his technique, the nurse identifies a need for additional teaching when the client choses a puncture site:

Back 96

in the center of the finger pad.