Nur 122 Unit 1

The diagnosis and treatment of human response to health and illness.

A state of complete physical, mental and social well being and not merely the absence of disease and infirmity.

• -Elderly population increasing
• -increased cultural diveristy
• -changes in disease patterens(obiesity epidemic, HIV, Cancer)
• -Advances in technology
• -Demand for quality improvement(Evidence based practice)

• -Case managment( manages clients with similar needs)
• - Primary nursing/Total pt care(Total care on small number of pts)
• -Team leading( RN supervises and delegates)
• -Functional Nursing (Task and activity oriented)
• -collaborative practice( RN delefates but must retain accountability)

• -care
• -education
• -pt advocate
• -cooridnates care

being able to understand different cultural backgrounds.

Carrying out the proposed plan

• Collect pt data and ask your self:
• was it accurate?
• did the pt achieve the expected goals?
• -Include pt family or s/o in plan of care
• -identify alterations.
• Continue all steps in nursing process (ADPIE)

• -thyroid
• -parathyroid(4)
• -adrenals(2)
• -pancreas( islest of langerhans)
• -pituitary( controlled by the hypothalmus)

• -Maintian and regulate cital functions
• -growth and development
• -metabolism of energy
• -muscle and adipose tissue distribution
• -sexual development
• -fluid and electrolyte balance

regulate and integrate body functions

endocrine secrete into blood

exocrine secrete into another organ

sensors detect changes in hormone levels and respond to regulate the level. Example would be if gulcose is to high insulin is released.

• -tumors
• -autoimmune diseases
• - genetics
• -infection
• -target cells are resistant to hormone(insulin)
• -side effects from treatments(steroids)

• -abnromal growth or skin
• -increase or decrease in appetite
• -increased thirst
• -urine output
• -mental status

• -T₃ (Triiodothyronine)
• -T₄ (Thyroxine)
• -Calcitonin

• -lab(blood levels)
• -24 Hour urine
• -MRI
• -biopsy and ultrasound
• Also palpation of the thyroid gland

• Low levels of thryroid homone also known as :
• -myxedema/myxedema coma
• -autoimmune disorder (hashimotos disease)
• -creatnism

• High levels of thyroid hormone
• also known as
• -graves disease
• -thyroid storm
• -thyrotoxic crisis
• -thyrotoxicosis

• -extreme fatigue
• -hair loss
• -brittle nails, dry skin
• -numbness or tingling in fingers
• -hoarseness/husky voice
• -menstrual changes
• -low body temp & heart rate
• -weight gain/low appetite
• -personality changes

• -irritablitiy
• -weakened emotional respsonse

• -Synthroid or levothroid
• -monitor for med interactions(no calcium and vitamins at the same time of med)
• -prevent complications

occurs most frequently in older woman

deficiency of thyroid hormones (congenital hypothyroidism) due to maternal nutritional deficiency of iodine.

Hyperthyroidism is 2nd after(DM)

• -excessive levels of thyroid hormone
• -affects women 8 times more often than men
• -graves disease is the most commone type.

• -thyroiditis
• -excessive ingestion of thyroid hormone
• -emotional shock or stress
• -infection

• -continue taking meds FOREVER
• -take calcium (just not at the same time as thyroid meds)
• -when to seek medical attention
• -diet and nutrition
• -prevention of bone loss and osteoporosis

• -Nervousness
• -palpations/tachycardia
• -hot and sweaty
• -dry, itchy skin
• -Exopthalmos(bulging eyes)
• -Weight loss/ increased appetite
• -bowel and menstrual changes

• -airway
• -hemorrhage
• -hypocalcium(check calcium levels post op)
• * reasoning- parathyroid can be damaged or removed resulting in low calcium

• -PTU ana ntithyroid agent that inhibits the release of thyroid hormone. It is used until Euthyroid is reached, and the pt is weaned off of it.
• -131 I or thyroid storm is a radioactive iodine the destroys overreactive thyroid cells. given in 1 dose by a radiologist.closely monitor cardiac for dysrthmea, and fever, and neuro impairment

-produces parathormone

regulates calcium and phosphorus balance.

False. Glargine insulin is not compatable with normal insulin such a s Humulin R or Novolin

• Candy !
• (Hypoglyciemia) they need sugar.

Sugar is TOO High ! Pt needs insulin.

Increase in serum phosphate, and decrease in serum calcium

• Low parathormone production,
• -can be caused from surgery, trauma or the atrophy of the gland.

**TETANY**(test question)

Low levels of serum calcium which causes muscle tremors, twitching, uncoordinated movement, numbness and tingling in extremities and face, can lead to bronchospasms, and death.

8-10

a tumor of the adrenal medulla

• -increases production of catecholamines
• -causes acute unpredictable attacks such as:HA, diaphoresis, palpations, blurred vision, dyspnesa, vertigo, etc

A severe untreated form of Addisons disease.

Circulatory shock, weakness, abdominal pain, confusion and death if not treated !

Rapid Iv replacement of fluids and glucocortocoids

• Excessive adrenocortical activity commonly caused by corticosteroid use.(can also be caused by a pituitary tumor)
• More common in Women!

SAFETY !!! (muscle weakness is common and disturbed sleep, so safety is the first priority, after ABC's of course)

A metabloic disorder where glucose is high in the blood stream but low in the individual cells. (Type 1 & 2)

Genetice predisposition combined with immunologic enviromental factors.

• -inability of beta cells to produce insulin.
• -glucose cannot be stored
• -kidnesy cannot reabsorb the glucose so it is in urine

• -insulin resistance (decreased tissue sensitivity to insulin)
• -cellular membrane resistance