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Endocrine - Coggle Diagram

- - - - Anti-thyroids: methimazole (tapazole) propylthiouracil (PTU)
        -Stops thyroid from making thyroid hormones
        -Used pre-op to stun the thyroid
        -We want this client to become euthyroid (eu being normal)
      - Iodine compounds: potassium iodine
        -Decrease size and vascularity of the gland
        -All endocrine glands are very vascular
        -Give in milk/juice and use a straw to prevent teeth staining.
      - Beta blockers: supportive therapy: propanolol
        -Decrease myocardial contractility
        -Can decrease CO
        -Decrease HR/BP
        -Decrease anxiety
        -Do not give to asthmatics/diabetics because it masks symptoms of hypoglycemia
      - Radioactive Iodine Therapy:
        -One dose, PO
        -Destroys thyroid cells -> hypothyroidism
        -Follow radioactive precautions
        -Watch for rebound thyroid storm
      - Surgery: thyroidectomy:
        -Post-op priority is hemorrhage
        -Assess laryngeal nerve dmg by listening for hoarseness and weak voice
        -Trach set at bed side
        -Assess for parathyroid removal -> s/s of hypocalcemia
        -HOB up to lower edema
        -Nutrition: increase calories
- - - - Addison's Disease: adrenocortical insufficiency - not enough steroids.
        -They don't have enough glucocorticoids, mineralcorticoids, or sex hormones.
        
        S/S:
        -extreme fatigue
        -N/V/D
        -anorexia/weight loss
        -hypotension (losing Na/water)
        -confusion
        -Decrease sodium, increased potassium, hypoglycemia
        -hyperpigmentation-bronzing color of skin and mucous membranes
        -white patchy area of depigmented skin (vitiligo)
        
        Treatment
        -Combat shock (losing sodium and water)
        -Increase sodium diet
        -Processed fruit juice/broth (lots of sodium)
        -I/O and daily weight
        -fluid volume deficit monitor
        -Medications:
        -Corticosteroids twice a day: 2/3 dose morning, 1/3 evening
        -Fludrocortisone acetate is synthetic aldosterone
      - Cushing's: too many steroids
        
        S/S:
        
        Too much glucocorticoids
        -Growth arrest
        -Thin extremities/skin
        -Increase risk of infection
        -Hyperglycemia
        -Psychosis to depression
        -Moon faced
        -Truncal obesity
        -Buffalo hump
        
        Too much sex hormones
        -Oily skin/acne
        -women with male traits
        
        Too much mineralcorticoids
        -High BP
        -CHF
        -weight gain
        -Fluid volume excess
        
        Treatment
        -adrenalectomy (uni or bilateral): lifetime replacement
        -quiet environment
        -avoid infection
        -diet pre-treatment: inc K, dec Na, inc Protein, inc Ca (steroids excrete Ca through GI tract leading to decrease)
- - - - Patho:
        No insulin > glucose builds up in blood and pulls fluid to vascular space > kidneys filter excess glucose/fluids (poly uria/polydipsia) > cells break down protein/fat for energy (polyphagia) > ketones > acidotic client
      - S/S:
        polyuria
        polydipsia
        polyphagia
      - Treatment: insulin
    - - Patho:
        Not enough insulin or insulin is no good.
        Usually overweight client
        Usually found by accident
      - Treatment:
        Diet/exercise first
        Then oral agents
        Then insulin
  - - - -Regular (clear), NPH (cloudy)
        -Draw clear one first if doing reg/NPH together.
        -All long acting insulins are clear and cannot be mixed with other insulin or given IV
        -Most common method of daily dosing is basal/bolus dosing. Long acting given once a day, rapid-acting given through before meals in divided doses.
        -Monitor for hypoglycemia
    - - Hypoglycemia S/S
        cold/clammy, confusion, shaky, headache, nervous, nausea, increased pulse, hunger
        
        What should client do? Eat simple carbohydrate. 15g.
        15 - 15 - 15 rule.
        Eat complex carb once blood sugar is up.
        If you enter a client's room and they are unconscious, assume it is hypoglycemia. D50W or injectable glucagon.
        Teach client to eat, take insulin regularly, know signs of hypoglycemia, check BG regularly.