Exam 3 Nur 135

Front 1

hormones are regulated by:
a) simple and complex feedback systems
b)the nervous system
c)natural body rhythms
d) all of the above

Back 1

d) all of the above

Front 2

The anterior pituitary secretes 6 hormones. Name the 3 we discussed in this course.

Back 2

TSH
ACTH
GH

Front 3

The posterior pituitary produces this hormone.

Back 3

ADH

Front 4

When testing thyroid function endocrinologists recommend looking particularly at these 2 lab values.

Back 4

TH
T4

Front 5

The parathyroid is composed of 4 small glands that produce and secrete PTH.What does PTH regulate?

Back 5

serum calcium levels.
Too little Ca++ in the blood,sensors tell the parathyroids to release PTH which moves Ca++ from bone into bloodstream

Front 6

The adrenal glands are made up of a cortex and a medulla. What hormone is secreted by the medulla?

Back 6

adrenaline
and noradrenaline
also known as catecholamines

Front 7

What hormone is the cortex of the adrenal glands responsible for?

Back 7

corticosteroids
particularly cortisol

Front 8

The pancreas has 3 types of cells. Alpha, Beta and Delta. Beta cells secrete insulin. What do the Alpha and Delta cells do?

Back 8

Alpha secretes glucagon
Delta secrete NT somatostatin

Front 9

The most common form of hyperthyroidism is________ _______ it is an ___________.

Back 9

Graves disease
autoimmune

Front 10

Which of the following symptoms would be observed in a pt with hyperthyroidism. Check all that apply.
a) warm, moist skin
b) increase in HR
c) decrease in body temp
d)decrease in BP
e) increased appetite
f) hair full and lush
g)constipation

Back 10

a,b,e would all be S/S of hyperthroidism. as well as diarrhea, inc. BP, dyspnea, hair loss,

Front 11

Thyroid nodules are associated with HYPO or HYPERthyroidism?

Back 11

HYPERthyroid

Front 12

Thyroid nodules may be investigated using:check all that apply.
a)ultrasound
b)CT scan
c) xray
d) angiogram
e)thyroid scan
f) MRI
g) FNA

Back 12

a,b,e,f,g

Front 13

Thyroiditis is usually caused by a virus. ANd is treated with____________for inflammation and the resulting pain. If it is found to be caused by a bacteria an antibiotic may be used in conjunction with _____to treat pain.

Back 13

steroids
NSAIDS

Front 14

In a thyroid crisis, rare but life threatening situation, list 3 things we will do for the patient.

Back 14

1. replace fluids
2. cooll body w/o aspirin
3. relieve and Resp distress
we will also stabilize CV fxn and administer meds to reduce TH( PTU, tapazole, iodine preps)

Front 15

Antithyroid drugs can be iodine preps. List 3.

Back 15

SSKI
Thyro-block
Pima

Front 16

TRUE OR FALSE
It is important when administering an iron prep to dilute with juice and consumed through a straw.

Back 16

TRUE

Front 17

iodine preps and antithyroid meds can potentiate the effects of some drugs like:choose all that apply
a) anticoagulants
b) antidiarrheals
c)antacids
d)digoxin

Back 17

anticoagulants and digoxin

Front 18

When administering antithyroid drugs it is important for the nurse to monitor:
a) appetite
b) urine output
c)S/S hypothyroid
d) stool color

Back 18

S/S hypothyroid
fatigue and weight gain may indicate too much of thyroid being destroyed

Front 19

Given the choice of a)antithyroid meds, b)iodine preps, c)surgery or d)RAI, for a nonpregnant patient what is usually the treatment of choice?

Back 19

d) radioactive iodine is the first choice treatment.
it requires no hospital stay but may result in lifetime hypothyroidism.

Front 20

Why would you assess a thyroidectomy patient for tetany?

Back 20

because incidental removal of the parathyroid with the thyroid may result in dec PTH and subsequent hypocalcemia

Front 21

Extreme or prolonged hypothyroid can result in __________ _______. It is usually the result of ___________.

Back 21

Myxedema coma
not taking medications

Front 22

When a person is hypothyroid, they are treated with:
a) PTH
b)Vessopressin
c) Synthyoid
d) testosterone

Back 22

synthroid

Front 23

Synthroid hsould be taken:
a) at the same tiem evry day
b) 1 hour before or 2 hours after each meal
c) first thing in the am and last thing at night
d) anytime the patient thinks about it.

Back 23

b) 1 hour before or 2 hours post meals

Front 24

Crusiferous veggies; turnips, spincah, cabbage, carrots and peaches are known to inhibit the actions of:
a) estrogen
b)insulin
c)TH
d) ADH

Back 24

TH

Front 25

in cases of severe hyperparathyroidism intensive IV therapy along with medications that inhibit bone resorption are implemented. List 3 medications that may be used in this capacity.

Back 25

Boniva
Calcitonin
Zometa
Fosamax
Aredia

Front 26

Hypoparathyroidism usually occurs as a result of:
a)Autoimmune destruction
b) removal of parathyroid glands in thyroid surgery
c) congenital absence or malfunction of parathyroid glands
d)all of the above

Back 26

d) all of the above

Front 27

While some clients with hypoparathyroidism may be asymptomatic what is a telltale sign we would be assessing for? And how will we assess?

Back 27

Tetany
Trousseaus sign or
Chvosteks sign

Front 28

If tetany is observed what is our immediate treatment? and then what is long term treatment for the patient?

Back 28

Calcium gluconate IV
supplemental and increased dietary Ca++, and Vit D

Front 29

What are the 4 types of Cushing's Syndrome?

Back 29

Pituitary referred to as secondary tumor, usually an adenoma
Adrenal referred to as primary tumor
Ectopic tumor: tumor away form adrenal or pituitary that produces ACTH
Iatrogenic: long term steroid use

Front 30

What is the treatment of choice for tumor caused Cushings?

Back 30

Surgery with adjunct medication

Front 31

name 2 drugs used to suppress ACTH secretion.

Back 31

Mitotane
Somatostatin

Front 32

What med can be used to suppress cortisol synthesis?

Back 32

Aminogluthemide
ketoconazole

Front 33

Adrenocortical insufficiency resulting in cortisol deficiency is known as_______________>

Back 33

addison's disease

Front 34

What is the ACTH stimulation test and what is it used to identify?

Back 34

Admin of ACTH then watch cortisol serum levels
a rise in cortisol will indicate pituitary origin of hypoadrenal function.

Front 35

What is an easy and informative test used to diagnoses Addison's disease?

Back 35

24 hour urine. Decreased androgens and cortisol indicate dx.

Front 36

Addisonian crisis is a life htreatening emergency. It can be triggered by:
a)adrenal or pituitary surgery
b) acute illness
c) abrupt steroid withdrawal
d)profuse sweating in hot weather
e) all of the above

Back 36

e) all of the above

Front 37

How do we treat Addisonian crisis?

Back 37

Rapid IV fluid replacement
admin steroids
monitor V/S
monitor K
monitor BG (steroids cause inc)

Front 38

Hyper function of the adrenal Medulla most often due to a tumor producing catecholamines, results in what rare condition?

Back 38

Pheochromocytoma

Front 39

The most dangerous effects of Pheochromocytoma are?

Back 39

peripheral vasoconstriction that results in paroxysmal HTN.

Front 40

Hyperfunction of the posterior pituitary gland is called?

Back 40

SIADH
syndrome of inappropriate ADH secretion

Front 41

SIADH can be caused by:
a) tumor, head injury
b) head injury, throid removal, canker sores
c)chlamydia and syphillis
d) none of the above

Back 41

a) tumor, head injury, meds, surgery
The most common cause is a an ectopic production of ADH by a malignant tumor

Front 42

Excess ADH causes what S/S?

Back 42

dec urine output
wt gain w/o edema
dec serum Na but inc urine Na
inc SG of urine, concentrated

Front 43

the client has just been diagnosed with SIADH. What are we goign to do to manage them?

Back 43

restrict PO fluids <800 ml
give hypertonic IV to correct Na imbalance
admin Lasix to move all retained fluids

Front 44

Hypo function of the posterior pituitary results in _______ _________>

Back 44

Diabetes insipidus

Front 45

DI can be of 3 forms:
Central
Nephrogenic
Psychogenic
what does that mean?

Back 45

Central-ADH insufficiently released by pit. maybe from trauma, radiation. surgery
Nephrogenic- the kidney has a reduced or incapibilty to respond to the ADH

Front 46

A test known as the H2O deprivation test is designed to do what?

Back 46

differentiate the origin of DI