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NUR 210 UNIT 9 STUDY GUIDE
TEST #3 โ Endocrine Drugs
Chapter 49: Pituitary, Thyroid, Parathyroid & Adrenal Disorders
EXAM PRIORITIES
Know These 5 Drugs
Drug Used For Key Teaching
Levothyroxine Hypothyroidism Take on an empty stomach
PTU Hyperthyroidism Report fever/sore throat
Calcitriol Hypoparathyroidism Raises calcium
Prednisone Inflammation/Addison's Never stop abruptly
Fludrocortisone Addison's Disease Monitor potassium
THYROID DISORDERS
HYPOTHYROIDISM
Memory Trick
LOW & SLOW
Signs & Symptoms
โ Weight gain โ Fatigue โ Constipation โ Bradycardia โ Cold intolerance โ Dry skin
โ Depression โ Slow thinking
Labs
Lab Result
T3 Low
T4 Low
TSH High
Emergency
MYXEDEMA COMA
Symptoms
โ Severe hypotension โ Bradycardia โ Respiratory depression โ Altered LOC
Priority
โ
Airway
โ
Breathing
LEVOTHYROXINE (SYNTHROID)
Used For
Hypothyroidism
Action
โ Replaces T3 and T โ Increases metabolism
Signs & Symptoms
โ Weight loss โ Tachycardia โ Diarrhea โ Heat intolerance โ Sweating โ Anxiety โ Goiter โ Exophthalmos
Labs
Lab Result
T3 High
T4 High
TSH Low
Graves Disease
Classic Signs
๐ Exophthalmos (Bulging eyes)
๐ฆ Goiter
โค Tachycardia
๐ฅ Heat intolerance
THYROID STORM
MEDICAL EMERGENCY
Early Signs
โญ Agitation
โญ Confusion
Other Signs
โ Fever โ Severe hypertension โ Severe tachycardia
Priority
Give antithyroid medications immediately
ANTITHYROID DRUGS
Propylthiouracil (PTU)
Used For
Hyperthyroidism
Graves Disease
Pregnancy
โญ Drug of choice in pregnancy
Side Effects
โ Rash โ Fever โ Sore throat
NCLEX ALERT
Report:
โ
Fever
โ
Sore throat
May indicate:
โญ Agranulocytosis
Function:
Controls blood calcium levels
NORMAL CALCIUM
โ
9.0 โ 10.5 mg/dL
Above 10.5 = Hypercalcemia
Below 9.0 = Hypocalcemia
HYPERPARATHYROIDISM
Too Much PTH
Result:
โฌ Calcium
(Hypercalcemia)
Memory
STONES, MOANS, GROANS
Symptoms
๐ชจ Kidney Stones
๐ฆด Bone Fractures
๐ฉ Constipation
Treatment
Goal:
Lower Calcium
โ IV Furosemide
โ IV Saline โ IV Phosphate โ Parathyroidectomy
HYPOPARATHYROIDISM
Too Little PTH
Result:
โฌ Calcium
(Hypocalcemia)
Causes
โญ Thyroidectomy
โญ Low Magnesium
โญ Autoimmune Disease
โญ Radiation
Signs
LOW CALCIUM = TWITCHY
Chvostek Sign
Tap cheek
Positive = facial twitch
Trousseau Sign
Inflate BP cuff
Positive = hand spasm
Functions :
โ Raises glucose โ Reduces inflammation โ Stress response
Aldosterone
Functions:
โ Retains sodium โ Retains water โ Excretes potassium
ADDISON DISEASE
LOW CORTISOL
LOW ALDOSTERONE
Symptoms
โ Fatigue โ Weakness โ Weight loss โ Hypotension
CUSHING SYNDROME
TOO MUCH CORTISOL
Symptoms
๐ Moon Face
๐ Buffalo Hump
โฌ BP
โฌ Glucose
๐ฆด Osteoporosis
๐ฉธ Easy Bruising
PREDNISONE
MOST TESTED ADRENAL DRUG
Uses
โ Asthma โ Inflammation โ Autoimmune disease โ Organ transplant
Side Effects
Think :
CUSHING SYNDROME
โ Moon face โ Weight gain โ Hyperglycemia โ Hypertension โ Fluid retention โ Osteoporosis
Nursing Teaching
MUST KNOW
โ Never stop abruptly
Can cause:
โญ Adrenal Crisis
Take with food
Avoid sick people
