Effects of epinephrine (SATA)
increases HR, force of contraction and therefore
stimulates vasoconstriction in skin and most viscera,
stimulates vasodilation in skeletal muscles, dilates the bronchioles, decreases peristalsis, stimulates the liver convert glycogen to glucose, increases
Release of Calcitonin, stimulates release
Produced by the parafollicular cells in the thyroid gland, Calcitonin inhibits the resorption of calcium and phosphate by osteoclasts, lowering the blood levels of these minerals and retaining them in bones
The stimulus for secretion of calcitonin is, hyp
Patient AIDS/HIV positive, most appropriate prevention
Gloves, PPE
What to monitor for in patient with Diabetes Insipidus?
Monitor weight
urine specific gravity daily
I & O
Symptoms of Hyperthyroidism
Tachycardia, increased cardiac output, warm skin, heat intolerance.
Fatigue, restlessness, hyperactive reflexes, tremor, insomnia, emotional instability.
Dyspnea.
Diaphoresis; warm, moist skin, fine, soft hair.
Increased appetite, weight loss, frequent st
What 2 hormones change glycogen to glucose
epinephrine
glucagon
HIV positive patient, test to determine presence of virus
Western Blot Test.
Hyperthyroid, on Synthroid, nursing care-when, side effect, how long to take effect and what else
Dosage may need to be adjusted occasionally
Hormones in anterior pituitary are secreted in response to what
Hypothalamus
Thyroid Stimulation test after TRH, what happens after injection?
Rises
Cushings syndrome, steroid use is discontinued what do you do?
Question order, needs to be tapered of steroids
How is HIV transmitted?
Sexual secretions
Infected blood
Breast milk, fetal transmission, infected blood
Needs portal of entry, tear in mucous membrane, or nonintact skin
Thyrotoxic Crisis
Monitor vital signs for symptoms
Post prophylactic HIV exposure should be continued for how long
4 weeks
Hypophysectomy, Most important tool bedside
Trach set
Treatment DKA
I/V Insulin
I/V Fluid
Most common opportunistic infection HIV
PCP
Thyrotoxic Crisis treatment
Relieve life-threatening symptoms
Give acetaminophen for fever
I/V fluids and cooling blanket
Beta blocker and 02
What gland produces ADA and oxytocin?
Posterior Pituitary Gland
Relatively common opportunistic infection with HIV
Candidiasis Albinis
PCP
Hyperglycemia symptoms
Polyuria
Polydipsia
Blurred vision
Headache
Lethargy
Abdominal pain
Ketonuria
Coma
Negative feedback mechanism does what?
The hormone itself controls further secretions.
When target tissue becomes too active, there is a negative effect on the endocrine gland, decreasing its secretory activity.
How is HIV transmission spread?
Portal of entry, broken skin, mucous membrane
What hormone increases calcium absorption by kidneys?
PTH (parathyroid hormone)
Long term complications of diabetes effect what part of body?
Circulatory system
Kidneys
Eyes
Nerves/skin
Patient on HIV meds, why, what do they do?
Prohibit the reproduction of the virus to in healthy cells
Hypoglycemic reaction going to administer OJ how do I know it is safe to give?
Patient is able to swallow, gag reflex present
Goal and recommendations of ADA
Preprandial glucose level of 70-130 mg/dl
Postprandial glucose less than 180 mg/dl
Glycohemoglobin (HbA1c) less than 7%
B/P less than 130/80 mm/HG
Surgery and shows symptoms of Tetany what happened?
Accidently removed part of parathyroid
When are plasma levels of androgynous adrenal corticoids the highest?
In the morning, early AM
Hormone secreted by anterior pituitary gland?
Thyroid-stimulating hormone (thyrotropin),
ACTH, PRL,
Growth Hormone (somatotropin),
FSH, and LH
Treatment goal for HIV
Prevent virus from replicating
S&S of hypoglycemia
Hunger, Sweating, Tremor, Blurred vision, Headache, Irritability, Confusion, Seizures and Coma
Why give patient antithyroid drug before surgery (thyroidectomy)?
before undergoing a thyroidectomy, the patient should be in a euthyroid state. This is accomplished by using antithyroid medications. They help slow heart rate and reduce other symptoms, making surgery safer. Iodine reduces vascularity of thyroid gland, d
Immunosuppressed on reversed isolation, why?
To protect them from us
Hypovesectomy teaching
If patient is having a hypophysectomy, let them know symptoms will be relieved but that bone growth and visual changes may not reverse. They will need lifelong hormone replacement post surgery
Diabetic patient comes into ER with a fruity order
DKA-Type 1 Diabetes, fat being broken down into ketones
Acromegaly teaching
Lifelong replacement of thyroid hormone, corticosteroids and sex hormones will be needed.
some symptoms are relieved but bone growth/visual changes may not reverse
teach the importance of follow-up care to avoid complication.
how to administer replacement
Hypovesectomy teaching
If pateint is having a hypophysectomy, let them know symptoms will be relieved but that bone growth and visual changes may not reverse. They will need lifelong hormone replacement post surgery
What kind of respiration would you expect to see in DKA patient?
Kussmaul's Respirations
Patient Diagnosed with acromegaly what kind of treatment would Dr recommend?
Removal of pituitary
On glucosteroids for long time, what is the risk for them?
hyperglycemia
Patient has AIDS, develops fever, what should be done?
Report to physician immediately
Patient Reg insulin and NPH in 1 syringe, which do you draw 1st
Clear to Cloudy-Draw regular first, air into cloudy (NPH) first
Complication of hypothyroidism
Myxedema coma
Specific cells of immune system is monitored in HIV/AIDS
CD4
Hypoglycemic what should I do?
Take action, recognize and treat immediately juice, hard candy/honey, glucagon, iv dextrose
Patient presses call light, diaphoretic and jittery what do you do?
Check blood sugar
Addison's disease being released, what patient teaching to reinforce?
Avoid stressful situations
Symptoms hypothyroidism
Bradycardia, Decreased cardiac output, Cool skin, Cold intolerance.
Lethargy, Slowed movements, Memory loss, Confusion.
Dyspnea, hypoventilation.
Cool, dry skin; Brittle, dry hair.
Decreased appetite, Weight gain, Constipation, Increased serum lipid level
Dinner tray with rice, what can I substitute?
Bread
Diabetic patient needs to know what can lead to hyperglycemia
Stress
Over eating
Admin insulin, what do I need to know to prevent lypodistrophy?
Rotate injection sites
Metformin, what do you assess and monitor for?
liver/kidney enzymes
DI, what test tells me things are returning to normal
Urine Specific gravity, know range 1.001-1.029
Most common cause of hyperthyroidism
Graves' disease
Meds to treat DI
Vasopressin
On thyroid hormone therapy, how do I know its effective, what do I look for
...
Most effective method to control spread of HIV
Education and prevention
What hormones work in opposition to control blood glucose levels?
Insulin, glucagon
Initial symptoms in patient with HIV
Joint pain, fever, rash
Diabetic, HA1C at 14/15% what is it telling me? How long have they been out of control?
2-3 months
Characteristics of Lantus insulin-
No peak, 1-2hr onset, 24hr duration, do not mix
Cat HIV patient
Immunizations up to date and careful with feces
What to monitor for in patients with SIADH?
...
HIV diagnosed, thinking about death what should I tell them?
It is now a chronic treatable disease
Things might notice of patient has Addison's disease
Hypotension Weakness
Fatigue Weight loss
Confusion Psychosis
Dehydration Tachycardia
Excessive urination and sodium loss
Patient NPH insulin, what might they have hypoglycemic action, peak?
6-12hrs
How does insulin pump work, what should I tell patient?
Pump delivers sub q insulin via tiny catheter continuously in small (basal) amounts.
Client can add bolus of insulin with the push of a button before meals or snacks
Life threatening complication for patient with thyroidectomy
airway
Levothyroxine, with side effects, what might do? Symptoms of what?
...
Major symptom associated with pheochromocytoma?
Addisons disease
Cold spot on thyroid scan means
malignant
Read Graves' disease
Autoimmune disorder in which thyroid-stimulating antibodies cause the thyroid gland to make too much thyroid hormone
What type diabetes do I have if it can be controlled by diet/exercise?
Type 2
Somatrem/Protropin, what is the expected therapeutic effect of med
increased skeletal growth in children with a GH deficiency
replacement of somatropin in deficient adults
increased bone density in adult GH-deficient patients
Thyroid med how long do they need to take it for?
1-2 months/several weeks