Adult Health Exam Two.txt

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BSNwannabe
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249742
Filename:
Adult Health Exam Two.txt
Updated:
2013-11-30 00:49:38
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endocrine adult health autoimune
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med,surg
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endocrine adult health autoimune
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  1. Hyper Pituitarism
    • Usually affects target organs
    • Often Excess GH
    • - Giantism (Childhood)
    • - Acromegally (Adulthood)
  2. Giantism
    Caused by Hyperpituitarism and excess GH in early childhood
  3. Acromegally
    • Hyperpituitarism and excess GH in Adulthood (usually between 30-40 y.o.)
    • Sx: Spade-Shaped hands and feet, prominant supraorbital ridge, large nose/jaw, separated or lacking teeth, sexual dysfunction, HTN, visual feild deffects, peripheral neuropathy, abnormal glucose
  4. Hypopituitarism
    • Rare, usually from tumor/trauma
    • Usually non-specific but can be target organs
    • Tx c sergery, radiation therapy, hormone therapy
    • Can be ACTH, TSH, GH, Gonadotrophin
  5. ACTH Deficiency
    • Anterior Pituitary Problem
    • Acute: Fatigue, N/V, Dizziness, Circulatory Collapse
    • Chronic: Tiredness, Pallor, Wt.Loss, Anorexia, Hypoglycemia
  6. TSH Deficiency
    • Anterior Pituitary Problem
    • bradycardia, constipation, slow mentation, hair loss, hoarsness, wt. gain, cold intoleerance
  7. Gonadotroohin Deficiency
    • ANterior Pituitary Problem
    • loss of libido, infertility, amenorrhea, osteoporosis
  8. GH Deficiency
    • Anterior Pituitary Problem
    • Decreased muscle mass and strength, decreased quality of life, increased central obesity, premature artherosclerosis
  9. SIADH
    Disfunction in the POSTERIOR pituitary causes an excess of ADH leading to the kidneys retaining water. This retention of water leads to a decrease in urine output.
  10. Diabetes Insipidus
    A dysfunction in the POSTERIOR pituitary leads to deficient ADH production which causes an increase in dilute urine output. Due to the increased dilute urine output there is hyponatremia causing uncontrolable thirst. There is poor skin turgor, hyerthermia, tachycardia, dry mucosa, hypotension, coma, yearning for ice water.
  11. Hyperthyroidism
    • Sx: goiter, exophthalamos, warm/moist/flushed skin, hair loss, weight loss with increased apetite
    • -Graves Dz
    • Tx: Block the effects, stop the over secreation with medications or sergery, RAI
    • Nrs: Teach about RAI, artificial tears, dark glasses, increased caloric intake, decrease caffeine intake, limit activity
  12. Hypothyroidism
    • Sx: Cold intolerance, weight gain, cold/dry/course skin, decreased pulse below 75 bpm, hoarsness, deafness, myxedema.
    • Tx: Thyroid hormone replacement, NO sedatives, OTC meds MUST be checked with Dr.
    • Nrs: Low cal diet, temp control environment, prevent constipation.
  13. Hyperparathyroidism
    • Cause: Adenoma, Carcinoma, Trauma, Chronic Kidney Dz
    • Sx: Peptic Ulcers from stress, ectopic calcifications, neuropathies, weakness, stones, bone pain.
    • Tx: Surgery, NO thiazides, phosphorus supplements
    • Nrs: Ambulation, avoid immobility, monitor for tetany (if Ca+ drops too low)
  14. Hypoperathyroidism
    • Sx: Tingling/burning in digits, muscle ache/cramping, twitching or spasms of muscles (usually mouth), Painful menstruation, brittle nals, patchy hairloss, thinning eyebrows, dry/course skin
    • Tx: increase Ca+ in diet, decrease phosphorus in diet, med alert wristband
    • Nrs: watch for tetany, seizure precautions, cardiac monitoring
  15. Cushings
    • Increased cortisol usually related to petuitary adenoma
    • Sx: buffalo hump, thin skin, cataracts, thin limbs, poor wound healing, moon face, HTN, easy bruising, increased adb. fat, decreased lymphocytes
    • Tx: surgery
    • Nrs: I&O, cough, deep breathing, limit stress
  16. Addison's Disease
    • Idiopathic
    • All 3 steroids decreased, autoimmune, generally in patients with immune problems
    • Adrenocortical insufficiency--- primary
  17. Primary Hyperaldosteronism
    • Causes: Adenoma or hyperplasia
    • Sx: Na+ retention K+ excretion, HTN, dysrhythmias, glucose intolerance, alkalosis, tetany
    • Tx: adrenalectomy, antiHTN, K-sparing diuretics
  18. Secondary Hyperaldosteronism
    • Response to extraadrenal stimulus= renal artery stenosis, tumors
    • Tx: ance inhibitors
  19. Pheochromocytoma
    • Most common adrenal problem
    • -Tumors might be bilateral, 10% are malignant
    • Sx: Severe HTN, headaches, tachycardial, sweating
    • Tx: Surgery, symptomatic blocking agents to decrease BP
  20. Osteoarthritis
    • Sx: asymetrical pain and stiffness in joins after rest, crepitation, dislocation, nodes, sitting and rising problems due to fluid
    • Tx: first acetaminophen and topicals, then NSAIDs and steroids. Narcs generally do not help joint pain
    • Nrs: Cold/heat packs to decrease swelling and increase circulation, weight loss, exercize, Tx pain, avoid repetative movements, surgery
  21. Rheumatoid Arthritis
    • Chronic, systemic, recurrent inflammation of joints
    • Sx: bilateral, symmetric joint stiffness, swelling, fibrosis, deformities, subluxation, rheumatic nodules, vasculitis.
    • Tx: NSAIDs, DMARDs, biological response modifiers
    • Nrs: Relaxation, balanced nutrition, joint-protection, splints, body alignment, exercise.
  22. Systemic Lupus Erythematosus
    • Multisystem chronic inflammation from problems with immune regulation.
    • Sx: variable with no pattern
    • -- wt. loss, fatigue, swelling joints, erythematous, butterfly rash, sun sensitivity, increased susceptability to infection, behavioral changes.
    • Tx: NSAIDs, antimalarials (Quinalone), steroids, immunosuppressants.
    • NRS: heat, exercize, stress menagement, emotional support, skin protection from breakdown.
  23. Scleroderma
    • CREST
    • C- calcinosis (Ca+ deposits on skin often = open wounds)
    • R- raynauds
    • E- esophageal dysfunction (acid reflux and decreased motility)
    • S- Sclerodactyly (Thick, tight, syran-wrap skin)
    • T- Telargiectasia (dilation of capillaries= red marks on skin)

    • Tx: antacids, PT, anti-inflammatories
    • Nrs: No finger sticks, no barefoot, diet, emotional support.
  24. Fibromyalgia
    Chronic head aches, generalized muscle pain, sleep disorders, cognitive/memory impairment, morning stiffness, vision problems, twitches, cold symptoms.
  25. Gout
    • Acute arthritis associated with increased levels of uric acid. Urate crystals in joints cause inflammation.
    • Tx: colchicine (acute Tx), NSAIDs, Allopurinol (Chronic Tx)
  26. Osteoporosis
    • decreased bone density, risk for fractures
    • Nurse: increade Ca+ and vitamin D, weight bearing exercises
  27. Paget's Disease
    Rapid bone loss often seen in cancers
  28. Osteomyelitis
    Infection of bone
  29. Osteomalacia
    Inadequate mineralization, deficient vitamin D, kidney disorders
  30. Polymyositis/Dermatomyositis
    • Rheumatic; Inflammation of striated myscle with weakness and atrophy especially in proxmial muscles.
    • Sx: Rash, periorbital edema, polyarthalgia, polyarthritis, raynauds.
    • Tx: Steroids and immunosuppressives
    • Nrs: PT, nutrition (swallowing problems)
  31. Polymyalgia Rheumatica
    • Proximal muscle stiffness, weakness and aching (neck, shoulder, pelvic muscles)
    • Sx: low fever, weight loss, anorexia, depression, lasts months to years, possible blindness
    • Tx: Steroids and NSAIDs
  32. Sjogren's Syndrome
    • Inflammation of exocrine glands
    • Tx: Artificial Tears and Saliva
    • Nrs: Foods with fiber are hard to swallow due to lack of saliva and so you might see diarrhea. Risk for choking.

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