(Summary) MDC II - Final Exam - Rasmussen, With Complete Solution 2024/2025.

(Summary) MDC II - Final Exam - Rasmussen, With Complete Solution 2024/2025. PT PAP HOT ▪ Pituitary ▪ Thyroid ▪ Pancreas ▪ Adrenals ▪ Parathyroid ▪ Hypothalamus ▪ Ovaries ▪ Testes What are the glands of the endocrine system? (SATA Q?) Grave's disease an autoimmune disorder that is caused by hyperthyroidism and is characterized by goiter and/or exophthalmos Treatments ▪ Rx: methimazole, atenolol, and iodine-131 ▪ radiation therapy Nursing Interventions ▪ provide a calm environment ▪ keep patients room cool ▪ assess pain ▪ prepare patient for surgery ▪ post-operative care ▪ maintain a patent airway -------- same as hypothyroidism --------- ▪ provide periods of rest ▪ continuous cardiac monitoring ▪ monitor vital signs ▪ daily weight ▪ monitor I&O ▪ monitor laboratory tests ▪ apply antiembolism stockings to prevent DVT ▪ provide skin care HYPERthyroidism aka Grave's disease ▪ Treatments pituitary gland _________ is considered to be the "master gland" as it secretes hormones that control other parts of the endocrine system. ▪ ACTH ▪ TSH ▪ are the most life threatening because they cause a decrease in the secretion of vital hormones from the adrenal and thyroid glands. Anterior HYPOpituitarism ▪ Deficiencies of which two hormones are the most life threatening? Bloodwork (all are DECREASED) ▪ T3 ▪ T4 ▪ Prolactin ▪ Testosterone ▪ Estradiol Scans (you'll always draw blood work first for diagnostics though) ▪ CT/MRI - detect bone or soft tissue lesions ▪ Skull X-ray - detect enlargement, erosions, and calcification of the sella turcica Anterior HYPOpituitarism ▪ Laboratory & Diagnostic Tests TRUE! We have very small amounts of testosterone or estradiol no matter if we are men or women. T/F: do both men and women have testosterone and estradiol? INCREASED: ▪ Prolactin - this might be the answer to the Q ▪ Cortisol ▪ TSH ▪ LH (men) ▪ FSH (men) ▪ Glucose DECREASED: ▪ Gonadotropin Anterior HYPERpituitarism (SATA Q?) ▪ Laboratory Tests ▪ Prevent infection because they are immunosuppressed ▪ handwashing HYPERcortisolism (aka Cushing's Disease) Priority Intervention diabetes insipidus ▪ Deficiency of ADH resulting in large volumes of dilute urine ▪ A disorder of the posterior pituitary gland They are losing a lot of water: • polyuria • polydipsia • dehydration • fluid/electrolyte imbalance • dilute, low urine specific gravity (1.005) • high plasma osmolarity • output does not decrease when fluid intake decreases remember! your s/s are going to look like dehydration • tachycardia • hypotension • poor turgor • dry mucous membranes • decreased cognition • ataxia • irritability Posterior Pituitary Gland: Diabetes Insipidus: ▪ What will the patient present with?/Key Symptoms ▪ desmopressin acetate (a synthetic form of vasopressin) ▪ can be PO, SL, or intranasal Posterior Pituitary Gland: Diabetes Insipidus: ▪ Drug Therapy Addison's disease What is adrenal gland hypofunction? ▪ If the patient remains alert and oriented x 3 Addison's Disease ▪ How do you know the therapy is working? ▪ Glucocorticoid drugs MUST be withdrawn slowly so you don't wind up with Addison's or adrenal insufficiency ▪ This allows for pituitary protection of ACTH and activation of the adrenal cortex to produce cortisol Addison's Disease ▪ How do you discontinue glucocorticoid therapy to avoid secondary adrenal insufficiency? ▪ Muscle weakness ▪ Muscle/joint pain ▪ Fatigue Addison's Disease ▪ Neuromuscular S/S ▪ Hypertension ▪ Dependent edema ▪ Bruising ▪ Petechiae Cushing's Disease aka hypercortisolism ▪ Cardiovascular S/S INCREASED • blood glucose level • sodium level • late-night salivary cortisol *• urine cortisol* DECREASED • lymphocyte count • calcium level Cushing's Disease aka hypercortisolism ▪ Laboratory Tests INCREASED ▪ potassium (K) ▪ calcium (Ca) ▪ BUN DECREASED ▪ serum cortisol ▪ salivary cortisol ▪ fasting blood glucose ▪ sodium (Na) Addison's Disease ▪ Laboratory Tests Sodium increases Potassium decreases In hyperaldosteronism what happens with potassium and sodium? (Remember...it's the opposite of Addison's disease) Heat intolerance - they are sweaty! Hyperthyroidism aka Grave's disease ▪ Hallmark assessment Pheochromocytoma a benign tumor of the adrenal medulla that causes the gland to produce excess epinephrine, so you are in a constant fight/flight state. ▪ Do not smoke ▪ Do not drink caffeine ▪ Do not change position suddenly ▪ Eat a diet rich in calories, vitamins, and minerals (avoid tyramine foods) Any of the above can cause a hypertensive crisis (closely monitor their BP!) never palpate or can give pt a massive rush of catecholamines (epinephrine) Pheochromocytoma ▪ Patient Education Cold intolerance Other S/S: ▪ think dehydration: fatigue, weakness, lethargy, constipation, dry skin ▪ poor memory ▪ fatigue ▪ lack of energy - sleeping more frequently ▪ muscle aches ▪ stiff muscles Hypothyroidism ▪ Hallmark assessment Improvement usually occurs within 2 weeks Thyroid Therapy ▪ When will a patient feel therapeutic effects? iatrogenic hypoparathyroidism What does a thyroidectomy cause? Thyroid surgery can cause parathyroid gland injury which results in tetany and hypocalcemia Assess for: ▪ muscle twitching ▪ muscle spasms ▪ tingling around the mouth ▪ tingling of the toes and fingers ▪ hoarseness ▪ stridor ▪ suture line pressure ▪ thyroid storm