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31 - The Child with Endocrine DysfunctionAce Your Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Registered Nurse (RN) School Study Aid
Peptide Hormones
- Characteristics
- Fast-Acting and Short-Lived
- Bind To Cell Membrane Receptors
- Stimulate Secondary Messengers
- Amino Acid-Derived
- Examples
- Insulin
- Parathyroid Hormone (PTH)
- Vasopressin
- Oxytocin
2 mins
Steroid Hormones
- Characteristics
- Nuclear Membrane
- Long-Lived and Slow-Acting
- Cholesterol-Derived
- Intracellular Receptors
- DNA Transcription
- Examples
- Testosterone
- Aldosterone
- Estrogen
- Cortisol
2 mins
Hypothalamus
- Characteristics
- Anterior Pituitary Stimulated Through the Hypophyseal Portal
- GHRH
- GnRH
- TRH
- PIF
- CRF Released During Stress
- Posterior Pituitary Stimulated Through Neural Control
3 mins
Thyroid Gland
- Characteristics
- TSH Stimulates T3 and T4 Release
- Metabolism Regulation
- Blood Calcium Sensor
- Calcitonin Release
- Blood Calcium Decreases
- Bone Building
2 mins
Parathyroid Gland
- Characteristics
- Blood Calcium Sensor
- Parathyroid Hormone
- Bone Resorption
- Blood Calcium Increases
- Vitamin D Activation
- Calcium Absorption From The Small Intestine
1 min
Adrenal Gland (Basic)
- Characteristics
- Adrenal Cortex
- RAAS Stimulates Aldosterone
- CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
- Cortisol Released
- Androgens Released
- Adrenal Medulla
- Epinephrine & Norepinephrine
2 mins
Anterior Pituitary
- Characteristics
- Hypothalamic Control
- FLAT PeG Mnemonic
- Tropic Hormones
- Follicle-Stimulating Hormone (FSH)
- Lutenizing Hormone (LH)
- Adrenocorticotropic Hormone (ACTH)
- Thyroid-Stimulating Hormone (TSH)
- Direct Hormones
- Prolactin (PRL)
- Growth Hormone (GH)
2 mins
Posterior Pituitary
- Characteristics
- Neuroendocrine Reflex Stimulation (By Hypothalamus)
- Direct Hormones
- Vasopressin
- Increased Water Retention (In Kidneys)
- Oxytocin
- Increased Uterine Contraction
- Mammary Glands Contraction
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
Diabetes Insipidus Assessment
- Polyuria
- Nocturia
- Low Specific Gravity (USG)
- Polydipsia
- Dehydration
- Hypotension
- Tachycardia
- Confusion
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
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
Hashimoto's Thyroiditis
- Symptoms
- Hypothyroidism with Bouts of Hyperthyroidism
- Enlarged, Nontender Thyroid
- Mechanism
- Autoimmune
- Anti-Thyroid Peroxidase (TPO)
- Anti-Thyroglobulin
- Lab Findings
- Hurthle Cells
- Lymphoid Follicles
- Associations
- HLA-DR5 and HLA-DR3
- Increased Risk Of Non-Hodgkin Lymphoma
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
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
Graves' Disease Characteristics
- Women 20-40 years old
- Pathophysiology
- Anti-TSH Receptor Antibodies
- Symptoms
- Ophthalmopathy
- Exophthalmos
- Hyperthyroidism
- Goiter
- Pretibial Myxedema
1 min
Graves' Disease Labs and Treatment
- Labs
- Decreased TSH
- Increased T3
- Increased T4
- Radioactive Iodine Uptake (RAIU)
- Treatment
- Beta blocker
- Methimazole
- Radioiodine Ablation
1 min
Hyperthyroidism Interventions
- Drug Therapy
- Propylthiouracil (PTU)
- Methimazole (Tapazole)
- Iodine
- Beta Blockers
- Other Therapies
- Radioiodine Ablation
- Thyroidectomy
- Complications
- Thyrotoxicosis
- Post-Surgery Hypocalcemia
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
Primary Hyperparathyroidism
- Assessment
- Hypercalcemia
- Kidney Stones
- Osteoporosis
- Arrhythmias
- Diagnostic Tests
- Increased Calcium and Decreased Phosphorus
- Considerations
- Prevent Injury
- Medication Education
- Surgery
1 min
Hypocalcemia
- Muscle Spasms
- Assessment
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Considerations
- Oral and IV Replacement of Ca2+
- Seizure Precautions
2 mins
Hypocalcemia Causes
- Hypoalbuminemia
- Hypomagnesemia (Less Common Hypermagnesemia)
- Hypovitaminosis D
- Hypoparathyroidism
- Medications
- Hyperphosphatemia
- Malnutrition
- Acute Pancreatitis
- Alkalosis
- Sepsis
- Chronic Kidney Disease
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
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
Adrenal Gland (Advanced)
- Characteristics
- Adrenal Cortex
- Zona Glomerulosa
- Aldosterone
- Zona Fasciculata
- Cortisol
- Zona Reticularis
- Androgens
- Adrenal Medulla
- Chromaffin Cells
- Epinephrine & Norepinephrine
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
Diabetes Assessment
- Assessment Type 1
- Juvenile Onset
- Absent Insulin Production
- Ketosis Prone
- Assessment Type 2
- Adult Onset
- Insulin Resistance
- Obesity
- Gestational Diabetes
- Onset During Pregnancy
- Glucose Intolerance
- Complications
- Retinopathy
- Peripheral Vascular Disease
- Nephropathy
- Neuropathy
2 mins
Pancreas
- Characteristics
- Acinar Cells Release Digestive Enzymes
- Ductal Epithelial Cells Release Bicarbonate
- Islets of Langerhans
- Beta Cells Release Insulin
- Alpha Cells Release Glucagon
- Delta Cells Release Somatostatin
- Somatostatin Inhibits Alpha and Beta Cells
3 mins
Diabetes Education
- Self-Monitoring (Blood Glucose)
- SubQ Injection Technique
- Lifestyle Changes
- Symptoms of Hyperglycemia and Hypoglycemia
- Sick Day Care
- Foot Care
- Exercise Therapy
- Medication
1 min
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
2 mins
Insulin
- Rapid Acting
- Insulin Lispro (Humalog)
- Insulin Aspart (Novolog)
- Insulin Glulisine (Apidra)
- Short Acting
- Regular Insulin (Humulin R)
- Intermediate Acting
- Isophane NPH (Humulin N)
- Long Acting
- Detemir (Levemir)
- Glargine (Lantus)
2 mins
Mixing NPH and Regular Insulin for Injection
- Verify Order
- Roll NPH Insulin
- Alcohol to Multiuse Vials
- Inject Air into NPH Insulin (Cloudy)
- Inject Air into Regular Insulin (Clear)
- Withdraw Regular Insulin Units
- Withdraw NPH Units
- Verify with 2nd Nurse
- Discard if Error
3 mins
Hemoglobin A1c Lab Value
- 4-6%
1 min
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
Dawn Phenomenon
- Cause/Mechanism
- Increased Hormone Production
- Assessment
- Hyperglycemia Upon Awakening
- Interventions
- Long-Acting Evening Insulin
- Change Administration Times
- Insulin Pump
- Considerations
- Closely Monitor Glucose Levels
- Between 2-6AM
- Limit Carbohydrates Before Bedtime
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
Glucagon (GlucaGen)
- Mechanism
- Increases Glucose
- Indications
- Hypoglycemic Emergency
- Side Effects
- Nausea and Vomiting
- Considerations
- Reconstitute Powder
- Consume Oral Carbohydrates
- 50% Dextrose IV (If No Effect)
2 mins
Potassium (K+) Lab Value
- 3.5 to 5.0 mEq/L
20 secs
Needle Sizes and Uses
- Adjust Size Based on Height/Weight
- Subcutaneous Injections
- 3/8 or 5/8 inch
- Intramuscular (IM)
- 1-1.5 inches
1 min
Routes of Administration Part Two (Parenteral)
- Parenteral Administration
- Intradermal
- Subcutaneous
- Intramuscular (IM)
- Intravenous
- Epidural
- Intrathecal
- Intraosseous
- Intraperitoneal
2 mins
