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endocrine disorder

SITUATION I

 

Question 1:

Time: Morning

Why: To prevent insomnia

 

Question 2:

The medication will be taken for life

 

Question 3:

1. Weight loss

2. Insomnia

3. Anxiety

4. Palpitations

Tip: These are signs and symptoms of hyperthyroidism

 

Question 4:

1. Maintain a healthy bone by taking calcium supplements and do weight bearing exercises

2. Thyroid hormone levels are regularly check

3. A bone density can be done to check any bone loss

 

SITUATION II

 

Question 1:

1. It decreases heart rate and blood pressure

2. It decreases myocardial contractility

3. It decreases cardiac output

 

SITUATION III

 

Question 1:

Decrease bleed during the operation

 

Iodine compounds decrease the size and the vascularity of the gland - this is especially good for the preoperative patient to decrease bleeding.

 

Question 2:

Use a straw because iodine stains the teeth.Give iodine compounds in milk and juice

 

Antithyroid inhibit the production of thyroid hormone, therefore making the client euthyroid (aka normal thyroid).

 

Question 3:

Sore throat

 

Question 4:

White blood cells

 

Question 5:

Bleeding should be checked behind the neck. Semi-fowler's position to decrease pooling of blood.

 

Question 6: 

To assess any nerve damage from surgery

 

Nerve damage is checked by looking for hoarseness in voice (in unilateral nerve damage), breathing difficulties(in bilateral nerve damage), or inability to speak (in bilateral nerve damage). Nerve damage could lead to vocal cord paralysis > airway obstruction > requires a tracheostomy. Make sure the patient gets a lot of calories due to hyperthyroidism.

 

Question 7:

Thyroid storm

Interventions: Administer Tylenol, cover the patient with cool blanket 

 

SITUATION IV

 

Question 1:

Numbness and tingling around the mouth, signs of hypocalcemia

 

Question 2:

Administer calcium gluconate 650 mg PRN

 

SITUATION V

 

Question 1:

Vitamin D

 

SITUATION VI

 

Question 1:

Check the patient’s blood glucose.

 

Question 2:

Peak effect of regular insulin causing hypoglycemia.

 

SITUATION VII

 

Question 1:

HbA1C, To determine if the patient has uncontrolled diabetes or hyperglycemia for the past 3-4 months.

 

Question 2:

5,2,4,3,1

_5_Withdraw 12 units of NPH insulin

_2_Inject 12 units of air into the  NPH vial

_4_Withdraw 6 units of Humalog insulin

_3_Inject 6 units of air into the Humalog vial

_1_Wipe off the vials with an alcohol swab

 

SITUATION VIII

 

Question 1:

30 minutes before breakfast.

 

Question 2:

1. Inject insulin on the body parts that he will not be using, in this case, abdominal area

2. Do activities when his blood glucose is high, after a meal or morning after breakfast

 

SITUATION IX

 

Question 1:

Give fast acting carbohydrates (1/2 cup of fruit juice to drink)

 

Question 2:

Give the patient a small snack of carbohydrates and protein

 

Question 3:

1. Monitor blood glucose regularly                         

2. Eat a healthy diet

3. Be active (exercise)                

4. Take medications as prescribed

More: foot care, stress management, smoking cessation, eye exams, hypo/hyperglycemia knowledge

 

SITUATION X

 

1. Use of disposable eating utensils 

2. Avoid kissing and sexual intercourse

3. Avoid holding young children or babies


The client with hyperthyroidism can receive radioactive iodine as an outpatient with some precautions, such as using disposable eating utensils, and avoiding kissing, sexual intercourse, and holding babies. Good hand washing is always necessary to prevent the spread of infection; however, it provides no protection against radioactive iodine therapy. Isolation isn't necessary, but radiation precautions are.

 

SITUATION XI

 

Question 1:

1. Sedentary lifestyle

2. Overweight with a waist/hip ratio >1

3. Blood pressure of 140/90 mmHg

 

Question 2:

1. Follow a healthy diet

2. Exercise regularly

3. Maintain a healthy weight

4. Have his blood glucose, blood pressure, and cholesterol level tested regularly

 

SITUATION XII

 

Question 1:

Confused, cold and clammy skin etc...

 

Any answers pertaining signs and symptoms of hypoglycemia

 

Question 2:

1. Wrap the finger in a warm cloth for 30-60 seconds
2. The hand is lowered to increase venous flow
3. The finger is pierced from lateral to the middle of the pad perpendicular to the skin surface

 

SITUATION XIII

 

Question 1:

Position to a right side-lying position, with a pillow under the biopsy site


Positioning the client in a right side-lying position with a pillow under the biopsy site reflects proper care. Place a pillow under the costal margin and caution the patient to remain in this position and immobile for several hours Instruct the patient to avoid coughing or straining.

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