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E ndocrine
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
Diuretics
Hypertonic IV Fluids
Demeclocycline
Tolvaptan and Conivaptan
1 min
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Nonpharmacologic Interventions
Monitor Serum and Urine Osmolality
IandOs with Daily Weights
Restrict Fluid Intake
Monitor Cardiovascular and Neurological Status
Seizure Precautions
2 mins
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Pathophysiology
Hypersecretion of ADH
Increased Sensitivity to ADH
Signs & Symptoms
Serum Hypoosmolality
Coma and Seizure
Dilutional Hyponatremia
Cramps and Tremors
Euvolemia
Change in LOC
2 mins
Hypothyroidism Intervention
Medications
Levothyroxine (Synthroid)
Liothyronine (Cytomel)
Complication
Myxedema Coma
Nursing Considerations
Lifelong Replacement Hormone
Monitor Vital Signs
Fluids and Fiber
Low Calorie, Low Fat Diet
Medication Education
No Switching Brands
2 mins
Hypothyroidism Assessment
Assessment
Weight Gain - Edema
Lethargy
Cold Intolerance
Bradycardia
Hypertension
Brittle Nails and Dry Skin
Constipation
Goiter
Prolonged Menses
Slowed Thinking
Diagnostic Tests
Decreased Free T4
Increased TSH
2 mins
Hypoparathyroidism
Assessment
Hypocalcemia
Lethargy
Tetany
Arrhythmias
Diagnostic Tests
Decreased Calcium and Increased Phosphorus
Considerations
IV Calcium Chloride
Rebreather Mask
Lifelong Medications
Oral Calcium Supplements with Vitamin D
2 mins
Hypoglycemia Intervention
Interventions
Mild to Moderate Hypoglycemia
Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
Complex Carbohydrate (Whole Grains, Vegetables)
Severe Hypoglycemia or Unconscious
50% Dextrose
Glucagon
Considerations
Monitor Blood Glucose Q 10-15 Minutes
Give Small Meal After Intervention
Patient Education
Hypoglycemia Prevention
Encourage Self-Monitoring
3 mins
Hypoglycemia Assessment
Mechanism
Too much insulin
Decreased glucose
Assessment
< 70 mg/dL
Change in LOC
Lethargic
Confusion and Irritability
Tremors
Diaphoresis
Tachycardia
Vision Changes
Weakness
Seizures
2 mins
Hyperthyroidism Interventions
Drug Therapy
Propylthiouracil (PTU)
Methimazole (Tapazole)
Iodine
Beta Blockers
Other Therapies
Radioiodine Ablation
Thyroidectomy
Complications
Thyrotoxicosis
Post-Surgery Hypocalcemia
2 mins
Hyperthyroidism Assessment
Assessment
Heat Intolerance
Exophthalmos
Warm, Moist Skin and Silky Hair
Tremors
Goiter
Diarrhea
Weight Loss
Tachycardia
Hypertension
Amenorrhea
Diagnosis
Decreased TSH with Elevated Free T4
Radioactive Iodine Uptake (RAIU)
2 mins
Primary Hyperparathyroidism
Assessment
Hypercalcemia
Kidney Stones
Osteoporosis
Arrhythmias
Diagnostic Tests
Increased Calcium and Decreased Phosphorus
Considerations
Prevent Injury
Medication Education
Surgery
1 min
Hyperglycemia
Mechanism
Insulin Resistance
Too Little Insulin/Medication
Infection/Illness
Corticosteroids
Assessment
Elevated Blood Glucose
Polyphagia
Polydipsia
Polyuria
Hypotension
Fatigue/Drowsiness
1 min
Diabetes Insipidus Assessment
Polyuria
Nocturia
Low Specific Gravity (USG)
Polydipsia
Dehydration
Hypotension
Tachycardia
Confusion
2 mins
Cushing's Syndrome Assessment
Assessment
Increased Cortisol Levels
Truncal Obesity
Purple Abdominal Striae
Buffalo Hump
Decreased Bone Density
Moon Face
Thinning Skin
Hyperglycemia
Hypertension
Considerations
Long Term Glucocorticoid Use
Immunosuppression
2 mins
Acromegaly Assessment
Mechanism
Excess Growth Hormone (GH)
Signs and Symptoms
Protruding Jaw
Large Lips and Nose
Hearing Loss
Enlargement of Hands and Feet
Vision Changes and Headache
Joint Pain
Peripheral Neuropathy
Hyperglycemia
2 mins
Addison's Disease Assessment
Assessment
Deficiency of Cortisol and Aldosterone
Irritability
Hyperkalemia
Muscle Weakness
Skin Hyperpigmentation
Hyponatremia
Hypotension
Hypoglycemia
Considerations
Addisonian Crisis
2 mins
Addison's Disease Intervention
Drug Therapy
Hydrocortisone
2/3 Dose in Morning
1/3 Dose in Late Afternoon
Fludrocortisone
Androgen Replacement Therapy
Considerations
Salt Additives
Increase Dosage During Stress and Infection
Medic Alert Bracelet
Lifelong Hormone Therapy
2 mins
Addisonian Crisis
Assessment
Severe Symptoms
Shock
Interventions
High-Dose Hydrocortisone
Large Volumes of IV Fluid
Insulin with Dextrose
Kayexalate
Loop or Thiazide Diuretics
2 mins
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