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47 Cards in this Set
- Front
- Back
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what is giantism |
growth beyond 2 standard deviation and genetic range |
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what causes giantism |
excessive IGFI and GH only pre-puebal when growth plate still open |
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what are the managment of gigantism |
-treat underlying cause -Transsphenoidal surgery - |
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what is the medication for gigantism |
somatsatin analogue (Oct dopamine agonist pegvisomat |
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what are some major complication with pituary tumor |
blindness with tumor hormone imbalance |
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what is the surgical approach for pituitary tumor |
transsphnodial approach |
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what are the pre op for transsphnodial approach |
assessment- baseline , teaching , pain management, bowel and oral preparation , IV cortisisal to prevent adrenal defiency |
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what are the post op abc for transophnodial surgery |
Airway - packing insite, avoid straining brething - o2 as need be and advise using mouth Cirrculation- assess vital sign , assess urinary output , |
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what are some of the neurological care for post op transohnodial surgery |
prop up 30-45 to promote drainage monitor ICP monitor for meningitis monitor for CSF drainage monitor for visual monitor for motor functioning |
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what are some wound care that should be giving |
clean the moustche dressing as need be do not remove packing \ monitor for bleeding , CSF leakage or infection |
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what are some medication that should be adminster for post op transsphenoidal surgery |
IV mannitol to reduce ICP IV dexamethasone then later oral A/b pain med PRN |
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what are some other important post op care for transsphenoidal surgery |
monitor for DI , hormoneal inffenicy . avoid straining to the site , courghing and bending over etc |
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what are some of the SS of cushing syndrome |
General apperence - moon and puffy face interaugmentery- skin is easily bruised , thinning , red striae , osterporisis . metabolism- hyperglyemia and HT and increased appetite and weight gain immune - delayed immune response + wound heal Hormonal activity - menstrual disorder , hair growth GI - gastric ulcer and increased gastic juice prodution Emotional unstablity |
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what are the treatment for Cushing/ Hyper |
Surgery - underlying cause Radiation -radiactive isotope (for targeted p/t) Pharmcological treatment ( inoperatable case) -somatostatin -> decrease ACTH secretion ketocongazle (nizoral) and cytadren to inhibit cortical production |
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what are some nursing diagnosis for Cushing |
excessive fluid volumne related to sodium retenstion Risk of infection -protein, vitamin A and C disturbed body image risk of injury |
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what are the treatment for addision diseases |
lifeong replacement therapy increase sodium in diet |
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what are some of the education that should be given |
Drug compliance -information on dosage etc -Teach importance of drug, side effect (e.g. weight gain and puffy face ) and -Consume food with medication to avoid gastic irriatation -reinforce the life time taking of drugs and life threatening Self -Monitoing -Body weight for water retention - observe for adrenal insuffiency life style changes -adjust dosage in time of great stress -inform doctor of the need of dosage change -wear medical bracelet -carry emergency kit |
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what are the managment for addisoian crisis |
0.9% NaCl correct electrolyte imbalance D5 to corect hypogly high hydrocotisone treat infection shock managment to ensure airway |
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what are the nursing diagnosis for Addison diseases |
activity intolerence fluid volumne defcieit ineffective treatment regieme risk of injury |
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what are the nursing mangagement for Pheochromocytoma |
risk for injury -avoid caffine -give med -vital sign -quiet envroment |
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what are the nursing care of hypothyroidism |
- imbalanced nutrition; decreased metabolism , less cal needed .-> low cal diet until body stablize -> increase activity to compensate lower metabolic rate -actviity intolerence monitor vital sign , schedule rest and activity in between , drug compliance hypothermia - constipation -stool softener , fiber , water , excercise , habitude bowel opening |
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what is the pharmcological treatment for hyperthryodism |
Cabizole PTU( inhbit t3 t 4 conversion ) methimzaole (disrupt TH synthesis) betablocker |
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what are the other option for hyperthyrodism |
Surgery and radioactive iodine salt |
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what are some of the patient education that should be given after RIS treatment |
avoid pregency for 6 months avoid young children for 1 week sleep alone for 1 week avoid pregent women avoid sharing utensil report abnormaility esp S/S of hypo or hyper |
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what are the post op care that should be given to pt with thyroidsectomy |
assess for largyenyal damage assess of latent tetany assess for wound condition prevent haemogragge respitary support comfort |
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what are some clinical precaution of HbA1c |
normal pt should be lower than 7% -anemia false low count -polycynthemia false high count - inaccuracy due to high turn over |
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what are some care toward metformin ?
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first line of drug for t2 -avoid alchol |
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what are some drug that affect BG |
raise bg -diuretic -steroid lower BG -alcohol -indereal -isonazid (TB) |
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what is GI |
how fast it takes to affect BG |
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what are some benifit of excercise |
- need to break up sedemntary lifestyle more than 90 mins -improve BP -improve insulin resistence -improve glucose uptake in muscle group and reliance on carbohydrate |
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how to prevent hypoglyemcia before excercise |
keep simple and complex CHO during excercise avoid injection in excercise limb discuss need for medication adjustment for excercise day small snack before bed if CBP is below 5.6 |
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what is the treatment of hypoglyecmia |
10-15g of simple CHO recheck after 15 mins if noprimove , repeat step1 complex 10-15 g of CHO |
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why is pancretic CA hard to detect |
no specfic symptoms and too similar to other disease hidden behind other organ |
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what are some SS of panretic CA |
dark clary urine , upper abdominal pain that radiate to back \ loss of appetite weight loss juandice and white eyes |
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what is the more common form of pancreas CA |
exocrine - in the duct |
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what are the different surgery for pancreas CA |
whipple surgery -head of pancrease , small intestenine , smoach , gall blader distal - body and tail of pancrease , and spleen |
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what is a important drug for pancreas |
FOLFIRINOX Folfirinox |
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what are the medication for severe DI
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DDAVP effective short term medi nasal spray vs injection presstin (tannate) long term |
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what are the medication for mild DI |
indapamide chlorpropamide-for |
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what should be considered for chlorpropamide |
it could induce hypoglyemcia |
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what medication should be used for nephrogenic |
diuretic -thizdime for sodium excerection NSAID amilorde - reduce lithium |
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what are the nursing intervention for DI ? |
fluid volumne deficit - monitor BW -monitor IO - assess sign of dehyration - skin turgor , BP , rhytham , sunken eyes -warn of excessive drinking - LOC and thirst level , vital sign -IV therapy , 0.5 mmol/m of serum sodium , IV care -monitor Urine and serum electrolyte Actvity intolerence Constipation - medication care -DDVAP-> URI , allergic rhitits , nasal congestion -Vessopressin - GI persistatsi , care when injection , cardiac status Patient education -fluid level -self monitor -medication -FU and medical alert bracelet |
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what are bromocriptine (parlodel) for ? |
supress protactin |
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what should be considered for when giving ocetoride (somatostatin) |
reduce the dosage of insulin for DM patient |
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how do you manage MYXEDEMA COMA |
IV thyroxine glucosteroid supportive measure support hypothermia treat infeciton cardio& respiratory support |
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what are the nursing managment for addision disease |
fluid balance -encourage intake -i&O -monitor dehyration -orthostatic hypertension -serum electrolyte Activity intolerence -rest and activity scheudle -reintroduce activity as tolereated - risk of ineffective therupatic -same as education |
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what is the definate managment for PHPT |
parathyroidectomy. and for aspytomatic then its monitoring |
