NURSING > STUDY GUIDE > NR325 Adult Health Mastery In-Class Assignment-REVIEWED. (All)

NR325 Adult Health Mastery In-Class Assignment-REVIEWED.

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 ENDOCRINE o 1 Hypothyroid  Patho  Deficiency of thyroid hormone that causes a general slowing of the metabolic rate; Iodine deficiency is the most common cause  Assessment  systemic effects characterized by a slowing of body processes. Manifestations include fatigue, lethargy, personality and mental changes, decreased cardiac output, anemia, and constipation, myxedema (periorbital edema, subnormal temp, hypotension, hypoventilation) [Prof. P: great!]  Diagnostics  T3/4, TSH, Iodine levels  Goal  restoration of euthyroid state as safely and rapidly as possible with hormone replacement therapy  Interventions  Teach lifelong therapy needed, avoid changing drug brands (discuss w/ HCP first)  Pharm  Levothyroxine (Synthroid) o 2 Hyperthyroid  Patho  Increase in T3/T4, low TSH thyrotoxicosis (thyroid storm)  Assessment  Thinner appearance, tachypnea, dyspnea, bounding pulse, HTN, increase bowel (diarrhea), warm skin, hair loss, loose nails, fine silky hair, sweaty, exophthalmos  Diagnostics  TSH, T3/T4, RAIU test  Goal  Suppress excessive thyroid hormone & prevent complications [Prof. P: priority here is probably cardiac]  Interventions  Thyroidectomy [Prof. P: maybe include increased calories?]  Pharm  PTU, tapazole, beta blocker, RAI therapy o 3 Hypoparathyroid  Patho  removal of a thyroid gland/decrease secretion of parathyroid hormone (PTH) low Ca levels  Assessment  Hypocalcemia (muscle cramps, paresthesia, fatigue, positive Trousseau’s & Chvostek’s [Prof. P: know these assessments!], laryngospasms)  Diagnostics  BMP  Goal  Increase Ca  Pt will be able to teach back 3 foods to increase Ca levels by the end of the day  Interventions  Monitor Ca, teach nutrition: food high in Ca (dairy, green leafy vegetables) [Prof. P: good job, also include consider frequent neuromuscular checks … super low levels of Ca can cause tetany and seizures]  Pharm \PVCC\ NR325 Adult Health Mastery Assignment 1 3/25/2019 NR325 Adult Health Mastery Assignment  Calcium carbonate, vit D supplement to increase the absorption of Ca & phosphate binders o 4 Hyperparathyroid  Patho  A tumor or an enlargement of the parathyroid glands can cause increased secretion of PTH which increases the amount of calcium in the body that leads to hypercalcemia and hypophosphatemia  Assessment  Muscle weakness, loss of appetite, fatigue, constipation, kidney stones [Prof. P: back in the day, we learned “bones, stones, abdominal moans, and psychic groans” were hallmark s/s of high Ca… most patients present asymptomatically, with like fatigue, and super high levels of Ca can cause heart block and cardiac arrest]  Diagnostics  BMP (high CA, low Phos)  Goal  Reduce Ca levels  Interventions  Parathyroidectomy, monitor Ca in

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