MedSurg II Endocrine Exam 4 Review(Az college of nursing)2023/2024 Hormone secretion does what when circulating levels drop? - Correct Answer increase Elevation of T3 T4 levels being released means - Correct Answer TSH levels drop How would you palpate and assess a tumor on the thyroid? - Correct Answer ISTHMUS. Stand behind the pt (posterior approach) and palpate anterior neck below chricoid cartilage and have the patient swallow.What is the best indication to determine if someone has hypothyroidism - Correct Answer TSH level (high) What would be the difference between thyroid storm and hyperthyroidism - Correct Answer thyroid storm will appear with fever, tremors, severe htn, tachycardia, CHANGE
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What clinical manifestations would we see with hyperthyroidism? - Correct Answer tachycardia, weight loss, thyroid bruits, hairloss, bulging eyes (exopthalmus), goiter, anxiety, insomnia, increased appetite Not all hormones need to be imbalanced to - Correct Answer diagnose Anytime we have a subtotal or total thyroidectomy pts are at risk for - Correct Answer hypoparathyroidism and hypothyroidism Postop complications for total or subtotal thyroidectomies - Correct Answer airway (swelling), laryngeal nerve damage (change in voice or tone, stridor), hypocalcemia (hypoparathyroidism), hyperthyroid symptoms (thyroid storms), hyperthermic For hypoparathyroidism we wanna check what type of calcium level - Correct Answer ionized calcium level A1C levels should be less than what for diabetics? - Correct Answer 7 In A1C lower levels are always - Correct Answer better Grave's disease is asscoiated with - Correct Answer hyperthyroidism What is hashimotos associated with - Correct Answer hypothyroidism Pt education for transsphenoidal hypophysectomy - Correct Answer keep low ICP 1 / 2
Interventions to lower ICP - Correct Answer elevate head of bed, no lifting heavy objects, do not use IS, no straws, monitor CSF leakage (monitor with halo test), no blowing nose or coughing sneezing.If we suspect CSF leakage what is our first priority? - Correct Answer notify the surgeon Main cause of hyperpituitarism is - Correct Answer tumors What is our go to intervention for hyperpituitarism - Correct Answer surgery to remove tumor or even part of the gland Hypothyroidism discharge teaching - Correct Answer PT and pharmacy is recommended as a care plan (lifelong medication, and weakness and muscle aches for PT).Pt education for hypothyroidism - Correct Answer take meds in the am with no food, report weight loss, report chest pain For severe hypothyroidism our priority will be - Correct Answer get VS Hyperparathyroidism priority nursing assessments - Correct Answer cardiac monitoring (shortened QT), bowel function (diarrhea is common), pain management, and calcium levels, NOT I&Os Hyperthyroidism will cause in increase in - Correct Answer corticosteroid elevation therefore increased glucose and higher risk for seizures Which risk would we address first between seizures and hyperglycemia? - Correct Answer seizures What is worse acutely in Diabetes? - Correct Answer hypoglycemia Normal blood sugar is - Correct Answer 65-99 Insulin is released from - Correct Answer beta cells of the pancreas Glucagon is released from - Correct Answer alpha cells of the pancreas Insulins job is to - Correct Answer "unlock" the cell so it allows glucose to enter, therefore lowering the sugar in the blood Type I diabetes is most commonly diagnosed before - Correct Answer 30 DM type I is frelated to - Correct Answer beta cells (not able to make insulin) Insulin deficiency is which diabetes - Correct Answer type I
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