Endocrine System

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Author:
pachie_18
ID:
234668
Filename:
Endocrine System
Updated:
2013-09-13 15:37:41
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nclex RN
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review
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  1. Thyroid Gland
    • produces T3,T4, Calcitonin
    • *calcitonin dec Ca levels by taking the Ca out of the blood & pushing it back into the bone
    • you need iodine to make hormones (this is dietary iodine)
    • thyroid hormone give us energy
  2. Hyperthroid: too much energy=GRAVES DISEASE s/s
    • nervous
    • weight dec
    • sweaty/hot
    • exophthalmos=bulging eyes
    • attention span dec
    • appetite inc
    • irritable
    • GI inc
    • BP inc
    • thyroid big
  3. Graves Disease dx
    • if you drew a T4(thyroxine) or T3(triiodothyronine) level on this client it will be both inc
    • thyroid scan
    • d/c any iodine medication one week prior to thyroid scan
  4. Graves Disease Tx
    • 1. ANTI-THROIDS: PTU, Methimazole(Tapazole)
    • **stops the thyroid from making thyroid hormones
    • **its used pre-op to stun the thyroid (dec bleeding)
    • **want this client to be euthyroid

    • 2. IODINE COMPOUNDS: Potassium Iodine (SSKI), Strong Iodine Solution (Lugol's solution)
    • **dec the size & vascularity of the galnd
    • **give in milk, juice, and use straw

    • 3. BETA-BLOCKERS: propanolol (Inderal)
    • **dec myocardial contractility,CO, HR, BP, anxiety

    • 4. RADIOACTIVE IODINE (1 dose)
    • **given PO (r/o pregnancy first)
    • **destroys thyroid cells-->hypothyroid
    • **precautions: staw away from babies for 24hrs, dont kiss anyone for 24 hours
    • **watch for thyroid storm (could be rebound effect post-radioactive iodine
  5. Graves Disease Surgery: thyroidectomy (partial/complete)
    postop: support neck & pu personal items close to them

    • positioning: HOB elevate (dec edema)
    • check for behind the neck bleeding
    • nutrition: need more calories
    • assess for recurrent laryngeal nerve damage by listening for horseness/weak voice
    • could l/t vocal cord paralysis, if there's paralysis of both cords airway obstruction wil occur requiring ┬áSTAT trach
    • teach to report any pressure
    • trachs set at bedside=swelling, recurrent laryngeal nerve damage, hypocalcemia

    **eye care=if client cant close eyelids, hypoallergenic tape may be applied to close lid (help prevent injury or irritation). Dark glasses + artificial tears.
  6. HYPOTHYROID=MYXEDEMA s/s
    • no energy
    • when this is present at birth, its called CRETINISM--> very dangerous, can l/t slowed mental & physical development if undetected
    • fatigue
    • GI dec
    • weight inc
    • cold
    • slower slurred speech
    • no expression (in psych r/o thyroid problem=depression vs. manic)
    • **you maybe taking care of a totally immobile client
  7. Myxedema Tx
    • Synthroid, Proloid, Cytomel=meds for life
    • energy inc with these meds
    • people with hypothyroidism tend to have CAD
  8. Parathyroid Problems=Ca problems
    • Parathyroids secrete PTH which makes you pull Ca from the bones & place it in the blood. Therefore, the serum Ca level goes up.
    • too much PTH=high Ca
    • low PTH=low Ca

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