Key Points

Front 1

Acromegaly

Back 1

is a rare condition resulting from excess secretion of growth hormone (GH).

Front 2

In adults, bones increase in thickness and width but not length (T/F)

Back 2

True

Front 3

Manifestations of acromegaly

Back 3

enlargement of hands and feet, thickening and enlargement of face and head bony and soft tissue, sleep apnea, signs of diabetes mellitus, cardiomegaly, and hypertension.

Front 4

Treatment of acromegaly

Back 4

treatment focuses on returning GH levels to normal through surgery, radiation, and drug therapy. Prognosis is dependent on age at onset, when treatment is initiated, and tumor size.

Front 5

Postop surgical care for acomegaly

Back 5

Nursing care for surgical patient postoperatively includes avoidance of vigorous coughing, sneezing, and straining at stool to prevent cerebrospinal fluid leakage from where sella turcica was entered.

After surgery with a transsphenoidal approach, head of bed is elevated to a 30-degree angle at all times and neurologic status is monitored. Mild analgesia is used for headaches. Teeth brushing is avoided for at least 10 days.

Front 6

Patient info

Back 6

If hypophysectomy is done or pituitary is damaged, antidiuretic hormone (ADH), cortisol, and thyroid hormone replacement are needed for life. Patient teaching is essential with hormone replacement therapy.

Front 7

Hypopituitarism

Back 7

is rare and involves a decrease in one or more of the pituitary hormones.

Front 8

Most deficiencies with hypopituitarism are due to a______?

Back 8

pituitary tumor

Front 9

Treatment of hypopituitary

Back 9

The treatment consists of surgery or radiation for tumor removal, followed by lifelong hormone replacement.

Front 10

Syndrome of inappropriate antidiuretic hormone (SIADH)

Back 10

results from abnormal production or sustained secretion of ADH and is characterized by fluid retention, serum hypoosmolality, dilutional hyponatremia, hypochloremia, concentrated urine in presence of normal or increased intravascular volume, and normal renal function.

Front 11

The most common cause of SIADH is ________.

Back 11

lung cancer.

Front 12

Treatment of SIADH

Back 12

Treatment is directed at underlying cause with a goal to restore normal fluid volume and osmolality. Fluid restriction results in gradual, daily weight reductions, progressive rise in serum sodium concentration and osmolality, and symptomatic improvement. With chronic SIADH, patient must learn self-management.

Front 13

Diabetes insipidus (DI)

Back 13

associated with deficiency of production or secretion of ADH or decreased renal response to ADH. Depending on cause, DI may be transient or chronic lifelong condition.

Front 14

List the 3 types of DI

Back 14

central, nephrogenic, and primary

Front 15

Characteristics of DI

Back 15

• DI is characterized by polydipsia and polyuria. If oral fluid intake cannot keep up with urinary losses, severe fluid volume deficit results as manifested by weight loss, constipation, poor tissue turgor, hypotension, and shock. The increased urinary output and plasma osmolality can cause severe fluid and electrolyte imbalances.

Front 16

Treatment of DI

Back 16

Treating the primary cause is central to management. Therapeutic goal is maintenance of fluid and electrolyte balance

Front 17

Nursing Care for DI

Back 17

Nursing care includes early detection, maintenance of adequate hydration, and patient teaching for long-term management.

Front 18

A goiter is an enlarged _______ gland.

Back 18

enlarged thyroid gland

Front 19

In a person with a goiter the thyroid cells are stimulated to grow, which may result in an overactive thyroid (hyperthyroidism) or an underactive one (hypothyroidism). (T/F)

Back 19

True

Front 20

________ and ________ levels are measured to determine the level of thyroid function associated with the goiter.

Back 20

Thyroid-stimulating hormone (TSH) and T4

Front 21

Treatment of the Goiter with thyroid hormone may prevent further thyroid enlargement.

Back 21

True

Front 22

Surgery to remove large goiters may be performed.

Back 22

True

Front 23

Thyrotoxic crisis, or thyroid storm,

Back 23

an acute, rare condition in which all hyperthyroid manifestations are heightened. Although a life-threatening emergency, death is rare when treatment is vigorous and initiated early.

Front 24

Manifestations of a thyroid storm/Thyrotoxic crisis

Back 24

Manifestations include severe tachycardia, shock, hyperthermia, seizures, abdominal pain, diarrhea, delirium, and coma.

Front 25

Treatment of a thyroid storm.

Back 25

Treatment focuses on reducing circulating thyroid hormone levels by drug therapy.

Front 26

Hyperthyroidism

Back 26

Hyperthyroidism is thyroid gland hyperactivity with sustained increase in synthesis and release of thyroid hormones

Front 27

Most cases of hyperthyroidism result in ________.

Back 27

Graves’ disease

Front 28

exophthalmos

Back 28

results from hyperthyroidism, protrusion of eyeballs from the orbits.

Front 29

The two primary laboratory findings used to confirm the diagnosis of hyperthyroidism are ___________ and __________.

Back 29

decreased TSH levels and elevated free thyroxine (free T4) levels

Front 30

The primary treatment options for hyperthyroidism are

Back 30

antithyroid medications, radioactive iodine therapy, and subtotal thyroidectomy.

Front 31

Thyroiditis is an inflammatory process in the _________.

Back 31

thyroid gland

Front 32

Hashimoto’s thyroiditis

Back 32

is a chronic autoimmune disease in which thyroid tissue is replaced by lymphocytes and fibrous tissue. It is the most common cause of goiterous hypothyroidism.

Front 33

The common cause of Hypothyroidism

Back 33

Iodine deficiency

Front 34

Characteristics of Hypothyroidism

Back 34

Hypothyroidism has systemic effects characterized by a slowing of body processes. Manifestations include fatigue, lethargy, personality and mental changes, decreased cardiac output, anemia, and constipation.

Front 35

myxedema

Back 35

an accumulation of hydrophilic mucopolysaccharides in dermis and other tissues. This mucinous edema causes characteristic facies of hypothyroidism (e.g., puffiness, periorbital edema, and masklike affect).

Front 36

Characteristics of Myxedema coma

Back 36

Myxedema coma is characterized by subnormal temperature, hypotension, and hypoventilation. To survive, vital functions are supported and IV thyroid hormone replacement administered

Front 37

Treatment of Hypothyroidism

Back 37

hormone replacement therapy. Levothyroxine (Synthroid) is the drug of choice.

Patient teaching is imperative and need for lifelong drug therapy is stressed