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Endocrine
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
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
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) Pharmacologic Interventions
Diuretics
Hypertonic IV Fluids
Demeclocycline
Tolvaptan and Conivaptan
1 min
Lithium
Mechanism of Action
Mood Stabilizer
Unknown Mechanism
Indications
Bipolar Disorder
Side Effects
Nephrogenic Diabetes Insipidus
Hypothyroidism
Tremor
Heart Block
Contraindication
Pregnancy
Considerations
Monitor Plasma Levels
2 mins
Diabetes Insipidus Assessment
Polyuria
Nocturia
Low Specific Gravity (USG)
Polydipsia
Dehydration
Hypotension
Tachycardia
Confusion
2 mins
Propylthiouracil (PTU) and Methimazole (MMI)
Indications
Hyperthyroidism
Mechanism
Inhibits Thyroid Peroxidase
PTU Blocks Peripheral Conversion of T4 to T3
Side Effects
Agranulocytosis
Skin Rash
Hepatotoxicity (PTU)
Teratogen (MMI)
1 min
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
Hyperthyroidism Interventions
Drug Therapy
Propylthiouracil (PTU)
Methimazole (Tapazole)
Iodine
Beta Blockers
Other Therapies
Radioiodine Ablation
Thyroidectomy
Complications
Thyrotoxicosis
Post-Surgery Hypocalcemia
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
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
Levothyroxine (Synthroid)
Mechanism
Synthetic T4
Indications
Hypothyroidism
Side Effects
Thyrotoxicosis
Tremors
Heat Intolerance
Insomnia
Tachycardia
Considerations
Do Not Use for Obesity
TSH Monitoring
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
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
Alendronate (Fosamax)
Mechanism
Inhibits Osteoclasts
Indications
Osteoporosis
Paget's Disease
Side Effects
Esophageal Ulcers
Musculoskeletal Pain
Vision Changes
Atrial Fibrillation
Osteonecrosis of the Jaw
Considerations
Take on Empty Stomach
Remain Upright
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
Addison's Disease Assessment
Assessment
Deficiency of Cortisol and Aldosterone
Irritability
Hyperkalemia
Muscle Weakness
Skin Hyperpigmentation
Hyponatremia
Hypotension
Hypoglycemia
Considerations
Addisonian Crisis
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
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
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
2 mins
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