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U5 - Path Endo
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) 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
Sheehan's Syndrome
Postpartum Pituitary Gland Necrosis
Agalactorrhea
Amenorrhea
Secondary Hypothyroidism with Cold Intolerance
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
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
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
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
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
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
Primary Hyperparathyroidism
Assessment
Hypercalcemia
Kidney Stones
Osteoporosis
Arrhythmias
Diagnostic Tests
Increased Calcium and Decreased Phosphorus
Considerations
Prevent Injury
Medication Education
Surgery
1 min
MEN 1 (Multiple Endocrine Neoplasia)
Pathophysiology
Autosomal Dominant
Menin Mutation (Tumor Suppression Gene)
Chromosome 11
Signs and Symptoms
Pancreatic Endocrine Tumors
Pituitary Tumors
Parathyroid Adenomas
2 mins
MEN 2A (Multiple Endocrine Neoplasia)
Pathophysiology
Autosomal Dominant
RET Gene
Signs and Symptoms
Medullary Thyroid carcinoma
Calcitonin
Parathyroid
Pheochromocytoma
45 secs
MEN 2B (Multiple Endocrine Neoplasia)
Pathophysiology
RET Gene
Autosomal Dominant
Signs and Symptoms
Medullary Thyroid Carcinoma
Pheochromocytoma
Mucosal Neuromas
Marfanoid Body Habitus
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
Hypercalcemia
Assessment
> 10.5 mg/dL Ca2+
Pathologic Fractures
Lethargy
Hypercoagulation
Constipation
ECG Changes
QT Shortening
Interventions
No Calcium Intake
Chelating Drugs
Calcitonin
Bisphosphonates
Loop Diuretics instead of Thiazide Diuretics
Considerations
Increased Risk for Renal Calculi
Increase Fluids
3 mins
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
Diabetic Ketoacidosis (DKA) Signs and Symptoms
Kussmaul respirations
Dehydration
Abdominal Pain
Nausea/vomiting
Psychosis
Fruity breath Odor
1 min
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