ENDOCRINE DISORDERS
gestational diabetes (GDM) is the result of what? - insulin resistance due to the influence of pregnancy (placenta)
what is
... [Show More] postpartum thyroiditis? - • Autoimmune inflammation of the thyroid gland *within 1 year postpartum*
• 50/50 hyper/ hypo
• usually self-resolves
what should TSH be tested in pregnant women? - with a prior history or symptoms of thyroid disease
how is hyperthyroidism managed in pregnancy? - PTU and Methimazole
- Avoid Methimazole in first trimester (fetal scalp defects)
how is hypothyroidism treated in pregnancy? - Levothyroxine
- increase dose ~25%
what is the TSH goal in pregnancy + hypothroidism? - <2.5
when does GDM often subsite? - postpartum; 50% develop T2DM
what can have an effect on glucose metabolism in pregnancy? - - Dietary habits frequently change in pregnancy
- *Human placental lactogen (hPL)*
- Estrogen and progesterone
- Insulinase
how does diet affect glucose metabolism in pregnancy? - - decreased intake due to N/V
- Food aversions/ preferences
what is human placental lactogen (hPL)? - Pregnancy-associated hormone produced in abundance by placenta
how does hPL effect glucose metabolism? - decreases glucose metabolism creating an "anti-insulin" effect
how does insulinase effect glucose metabolism in pregnancy? - degrades insulin to a limited extent
what fetal morbidity/morality complications are associated with GDM? - - congenital anomalies
- spontaneous abortion & still birth
- macrosomia
- polyhydramnios
what are the MC congenital anomalies seen with GDM? - cardiac, CNS, renal and limb deformities
The nurse working on an endocrine nursing unit understands that which correct concept is used in planning care? - Clients with hyperthyroidism must be monitored for weight gain.
Clients who have diabetes insipidus should be assessed for fluid excess.
-> Clients who have hyperparathyroidism should be protected against falls.
Clients with Cushing's syndrome are likely to experience episodic hypotension.
The nurse educator is asking the nursing student to recall the signs/symptoms of hypothyroidism. The nurse educator determines that the student understands this disorder if which are included in the student's response? Select all that apply. - -> Dry skin
Irritability
Palpitations
Weight loss
-> Constipation
-> Cold intolerance
When the nurse is reinforcing instructions to a client who has been newly diagnosed with type 1 diabetes mellitus, which statement by the client would indicate that teaching has been effective? - "I will stop taking my insulin if I'm too sick to eat."
"I will decrease my insulin dose during times of illness."
"I will adjust my insulin dose according to the level of glucose in my urine."
-> "I will notify my health care provider if my blood glucose level is consistently greater than 250 mg/dL."
During data collection on a postoperative client who has undergone hypophysectomy, the client complains of thirst and frequent urination. Knowing the expected complication of this surgery, the nurse should check which parameter next? - Serum glucose
Blood pressure
Respiratory rate
-> Urine specific gravity
The nurse should expect to note which interventions in the plan of care for a client with hypothyroidism? Select all that apply. - Provide a cool environment for the client.
Instruct the client to consume a high-fat diet.
-> Instruct the client about thyroid replacement therapy.
-> Encourage the client to consume fluids and high-fiber foods in the diet.
Inform the client that iodine preparations will be prescribed to treat the disorder.
-> Instruct the client to contact the health care provider if episodes of chest pain occur.
Glucagon hydrochloride injection would most likely be prescribed for which disorder? - Thyroid crisis
Hypoadrenalism
-> Type 1 diabetes mellitus
Excess growth hormone secretion [Show Less]