Home > Articles > Professional Certifications > NCLEX-RN

NCLEX-RN Exam Cram: Care of the Client with Endocrine Disorders

Dec 24, 2013

📄 Contents

␡

⎙ Print

< Back Page 6 of 8 Next >

This chapter is from the book 

NCLEX-RN Exam Prep, 3rd Edition

Learn More Buy

Key Concepts

This chapter discussed alterations in the endocrine system. The nursing student should use these key concepts to answer questions as they relate to the care of this client. Remembering the pathophysiology of the disease process, the treatment, and the laboratory values will help you to be able to answer questions in the physiologic integrity portion of the NCLEX exam.

Key Terms

Acromegaly
Adrenocortical hyperplasia
Aldosterone
Androgens
Addison’s
Adrenal cortex
Adrenalectomy
Bromocriptine (Parlodel)
Buffalo hump
Corticosteroids
Cortisol
CT scan
Cushing’s disease
Diabetes insipidus
Dostinex (carbergoline)
Estrogen
FSH (follicle-stimulating hormone)
Gigantism
Gland
Gonadotrophins
Hirsutism
Hormones
Human growth hormone
Hypopituitarism
Hypothalamus
Luteinizing hormone
MRI (magnetic resonance imaging)
Ovaries
Parlodel (bromocriptine)
Parathyroid gland
Pituitary gland
Prednisone
Progesterone
Prolactin
Prolactinoma
Thymus
Thyroid gland
Transsphenoidal hyposection

Diagnostics

The exam reviewer should be knowledgeable of the preparation and care of clients receiving exams to diagnose endocrine disorders. While reviewing these diagnostic exams, the exam reviewer should be alert for information that would be an important part of nursing care for these clients. The pertinent labs and exams are as follows:

Laboratory test to determine hormone levels
X-rays to detect tumors
Computer tomography to detect tumors
Magnetic imaging to detect tumors

Pharmacological Agents Used to Treat Clients with Endocrine Disorders

An integral part of care to clients with endocrine disorders is pharmacological intervention. These medications provide an improvement or cure of the clients’ endocrine problems. The nursing exam reviewer needs to focus on the drugs in Table 4.1. Included in this table are the most common drugs used to treat endocrine disorders. These medications are not inclusive of all the agents used to treat endocrine disorders; therefore, you will want to keep a current pharmacology text handy for reference.

TABLE 4.1 Pharmacological Agents Used in the Treatment of Clients with Endocrine Disorders

Drug	Action	Side Effect	Nursing Care
Cortisone, hydro-cortisone, prednisone, and fludrocortisone (Florinet)	For replacement of a lack of cortisole or to suppress the immune response in a client suffering from allergic reaction, those with organ transplantation, or to suppress untoward effects of medications	Nausea and vomiting weight gain, decreased immunity.	Instruct the client to take the medication with meals. Instruct the client to report the signs or symptoms of excessive drug therapy: signs of Cushing‘s syndrome.
Propylthiouracil (PTU, Propyl-Thracil)	Used to treat hyperthyroidism	Slow heart rate, fatigue, drowsiness headache, neuritis, nausea, vomiting, diarrhea, and myelosuppression.	Measured dosage should be spread over 24 hours to prevent hormone release from the thyroid.
Methimazole (Tapazole)	Antithyroid medication	Same as above.	Monitor vital signs, weigh the client weekly, observe for throat soreness, fever, headache, and skin ulcers.
Iodine product, strong iodine (Lugol‘s solution)	Used to decrease the potential for a thyroid storm, which is an abrupt release of thyroid hormone	Same as above.	Bitter to taste, give with fruit juice.
SSKI (saturated solution of potassium iodide)	Used to treat and prevent thyroid storm	Same as above plus: metallic taste, stomatitis, salivation, coryza, hyperthyroid adenoma, irregular heart rate, and mental confusion.	Signs of hypothyroidism might necessitate discontinuation.
Potassium iodide tablets, solution, and syrup	Used to treat iodide deficiency that can lead to a goiter	Same as above.	Take after meals to increase absorption.
Lithium carbonate (Lithobid, Carbolith, Lithizine)	Used to treat hyperthyroidism	Dizziness, lethargy, drowsiness, fatigue, slurred speech, psychomotor retardation, incontinence, EEG changes, arrhythmias, hypotension, impaired vision, thyroid enlargement, dry mouth, abdominal pain, pruitus, and thinning hair.	Observe for hypothyroidism. Instruct the client to drink 8–12 glassfuls of fluids per day. Instruct the client to maintain adequate sodium intake to prevent toxicity.
Propanolol (Inderal, Detensol)	A beta blocker used to treat hyperthyroidism	Bradycardia, edema, lethargy, and bone marrow suppression.	Monitor pulse rate, CBC, and for signs of congestive heart failure. Take with food to decrease GI upset.
Atenolol (Tenormin)	Same as above	Same as above.	Same as above.
Levothyroixine (Levo-T, Levothroid, Levoxyl, Levothyroixine Sodium, Synthyroid)	Used to treat hypothyroidism	Tachycardia, nausea, vomiting, diarrhea, and insomnia.	Check pulse rate routinely.
Bromocriptine (Alphagen, Parlodel)	Used to treat parkinsonism or for prolactinomas	Hypotension, nausea, vomiting, blurred vision, dry mouth, urticaria, and fatigue.	Watch for orthostatic hypotension. Should not be used by pregnant clients. Dizziness, headaches, abnormal vision, constipation, hot flashes, and parathesia. Check serum prolactin levels <20mcg/liter in women or <1 5 mg.
Sulfonylureas
Carbergoline (Dostinex)	Used to treat prolactinomas; inhibits prolactin secretion	May cause headaches, depression, nervous- ness, and fatigue. Dysmenorrhea and facial flushing has also occurred.	Do not use with clients with liver disease.
Glimepride (Amaryl)	Used to treat hyperglycemia; works by increasing effects of client‘s own insulin	Hypoglycemia, watch for renal function.	Teach the client to watch for hypoglycemia, GI disturbance, allergic skin reactions, and photosensitivity. Take once daily before meals.
Glyburide (Micronase, Diabeta, glynase)	Same as above	Same as above, plus may cause gastrointestinal disturbance.	Watch for hypoglycemia. Take in divided doses.
Glipizide (Glucotrol, Glucotrol XL)	Same as above	Same as above.	Watch for hypoglycemia. Take before breakfast. Doses above 15mg should be divided. Glucotrol XL is long-acting, given one time per day.
Antidiabetic Medications—Meglitinides
Repaglinide (Prandin)	Used to treat hyperglycemia	May lead to hypoglycemia.	Watch for hypoglycemia. If NPO, withhold medication.
Antidiabetic Medications—Biguanides
Metformin (Glucophage)	Used to treat hyperglycemia; works by decreasing carbohydrate breakdown in the GI tract	Renal impairment, gastrointestinal upsepo, nausea, and vomiting.	Watch for hypoglycemia. Can cause GI disturbance, B-12 deficiencies, lactic acidosis, malaise, and respiratory dis-tress. Contraindicated in renal disease clients, liver disease, and congestive heart failure. Clients going for radiographic studies should have gluco-phage withheld for 48 hours or until renal function returns.
Antidiabetic Medications—Thiazolidinedione
Rosiglitazone (Avandia)	Used to treat hyperglycemia; works by decreasing carbohydrate breakdown in the GI tract	Abdominal pain, nausea, vomiting, anorexia, and hypoglycemia.	Watch for hypoglycemia. Clients with liver or renal disease should not take this drug. Monitor liver enzymes. It might decrease effects of oral contraceptives. Watch for signs of congestive heart failure.
Alpha-glucosidase inhibitor—Acarbose (Precose)	Used to treat hyperglycemia associated with diabetes	Flatulence, diarrhea, and abdominal discomfort.	Watch for hypoglycemia. Take with first bite of food. Contraindicated in clients with liver disease, inflammatory bowel disease, or renal disease.
Invokana (canagliflozin)	Used to treat hyperglycemia associated with diabetes. Works by decreasing renal reabsorption of glucose and increasing renal excretion of glucose.	Check renal function	Watch for hypoglycemia; Hypotension can occur with use. Watch for signs of hyperkalemia. Might cause a rise in cholesterol.
Insulins
Lispro (Humalog)	Onset five minutes, so have food available; peak 30–60 minutes; duration 2–4 hours; used to treat uncontrolled diabetes	Hypoglycemia	Watch for hypoglycemia.
Regular insulin	Onset 30–60 minutes; peak 2–4 hours; duration 6–8 hours	Hypoglycemia	Watch for hypoglycemia.
Intermediate-Acting Insulins
NPH	Onset 1–2 hours; peak 6–12 hours; duration 18–24 hours	Hypoglycemia	Watch for hypoglycemia.
Humulin N	Same as above	Hypoglycemia	Watch for hypoglycemia.
Humulin L	Same as above	Hypoglycemia	Watch for hypoglycemia.
Long-Acting Insulins
Ultra Lente	Onset 5–8 hours; peak 14–20 hours; duration 30–36 hours	Hypoglycemia	Watch for hypoglycemia.
Lantus	No peak; duration 24–36 hours	Hypoglycemia	Watch for hypoglycemia. Do not mix with other insulins. Usually given at night; however, the FDA has recently approved administration during the day.
Combination Insulins
Humulin 70/30	Onset 30 minutes; peak 4–8 hours; durations 22–24 hours	Hypoglycemia	Watch for hypoglycemia.
Humulin 50/50	Onset 30 minutes; peak 4–8 hours; durations 22–24 hours	Hypoglycemia	Watch for hypoglycemia.
Exubera	An inhaled form of insulin recently released and approved by the FDA; delivers insulin directly into the lungs; rapid onset; duration several	Hypoglycemia	Watch for hypoglycemia.

< Back Page 6 of 8 Next >

🔖 Save To Your Account

Pearson IT Certification Promotional Mailings & Special Offers

I would like to receive exclusive offers and hear about products from Pearson IT Certification and its family of brands. I can unsubscribe at any time.

Privacy Notice

Overview

Pearson Education, Inc., 221 River Street, Hoboken, New Jersey 07030, (Pearson) presents this site to provide information about Pearson IT Certification products and services that can be purchased through this site.

This privacy notice provides an overview of our commitment to privacy and describes how we collect, protect, use and share personal information collected through this site. Please note that other Pearson websites and online products and services have their own separate privacy policies.

Collection and Use of Information

To conduct business and deliver products and services, Pearson collects and uses personal information in several ways in connection with this site, including:

Questions and Inquiries

For inquiries and questions, we collect the inquiry or question, together with name, contact details (email address, phone number and mailing address) and any other additional information voluntarily submitted to us through a Contact Us form or an email. We use this information to address the inquiry and respond to the question.

Online Store

For orders and purchases placed through our online store on this site, we collect order details, name, institution name and address (if applicable), email address, phone number, shipping and billing addresses, credit/debit card information, shipping options and any instructions. We use this information to complete transactions, fulfill orders, communicate with individuals placing orders or visiting the online store, and for related purposes.

Surveys

Pearson may offer opportunities to provide feedback or participate in surveys, including surveys evaluating Pearson products, services or sites. Participation is voluntary. Pearson collects information requested in the survey questions and uses the information to evaluate, support, maintain and improve products, services or sites; develop new products and services; conduct educational research; and for other purposes specified in the survey.

Contests and Drawings

Occasionally, we may sponsor a contest or drawing. Participation is optional. Pearson collects name, contact information and other information specified on the entry form for the contest or drawing to conduct the contest or drawing. Pearson may collect additional personal information from the winners of a contest or drawing in order to award the prize and for tax reporting purposes, as required by law.

Newsletters

If you have elected to receive email newsletters or promotional mailings and special offers but want to unsubscribe, simply email information@informit.com.

Service Announcements

On rare occasions it is necessary to send out a strictly service related announcement. For instance, if our service is temporarily suspended for maintenance we might send users an email. Generally, users may not opt-out of these communications, though they can deactivate their account information. However, these communications are not promotional in nature.

Customer Service

We communicate with users on a regular basis to provide requested services and in regard to issues relating to their account we reply via email or phone in accordance with the users' wishes when a user submits their information through our Contact Us form.

Other Collection and Use of Information

Application and System Logs

Pearson automatically collects log data to help ensure the delivery, availability and security of this site. Log data may include technical information about how a user or visitor connected to this site, such as browser type, type of computer/device, operating system, internet service provider and IP address. We use this information for support purposes and to monitor the health of the site, identify problems, improve service, detect unauthorized access and fraudulent activity, prevent and respond to security incidents and appropriately scale computing resources.

Web Analytics

Pearson may use third party web trend analytical services, including Google Analytics, to collect visitor information, such as IP addresses, browser types, referring pages, pages visited and time spent on a particular site. While these analytical services collect and report information on an anonymous basis, they may use cookies to gather web trend information. The information gathered may enable Pearson (but not the third party web trend services) to link information with application and system log data. Pearson uses this information for system administration and to identify problems, improve service, detect unauthorized access and fraudulent activity, prevent and respond to security incidents, appropriately scale computing resources and otherwise support and deliver this site and its services.

Cookies and Related Technologies

This site uses cookies and similar technologies to personalize content, measure traffic patterns, control security, track use and access of information on this site, and provide interest-based messages and advertising. Users can manage and block the use of cookies through their browser. Disabling or blocking certain cookies may limit the functionality of this site.

Do Not Track

This site currently does not respond to Do Not Track signals.

Security

Pearson uses appropriate physical, administrative and technical security measures to protect personal information from unauthorized access, use and disclosure.

Children

This site is not directed to children under the age of 13.

Marketing

Pearson may send or direct marketing communications to users, provided that

Pearson will not use personal information collected or processed as a K-12 school service provider for the purpose of directed or targeted advertising.
Such marketing is consistent with applicable law and Pearson's legal obligations.
Pearson will not knowingly direct or send marketing communications to an individual who has expressed a preference not to receive marketing.
Where required by applicable law, express or implied consent to marketing exists and has not been withdrawn.

Pearson may provide personal information to a third party service provider on a restricted basis to provide marketing solely on behalf of Pearson or an affiliate or customer for whom Pearson is a service provider. Marketing preferences may be changed at any time.

Correcting/Updating Personal Information

If a user's personally identifiable information changes (such as your postal address or email address), we provide a way to correct or update that user's personal data provided to us. This can be done on the Account page. If a user no longer desires our service and desires to delete his or her account, please contact us at customer-service@informit.com and we will process the deletion of a user's account.

Choice/Opt-out

Users can always make an informed choice as to whether they should proceed with certain services offered by Adobe Press. If you choose to remove yourself from our mailing list(s) simply visit the following page and uncheck any communication you no longer want to receive: www.pearsonitcertification.com/u.aspx.

Sale of Personal Information

Pearson does not rent or sell personal information in exchange for any payment of money.

While Pearson does not sell personal information, as defined in Nevada law, Nevada residents may email a request for no sale of their personal information to NevadaDesignatedRequest@pearson.com.

Supplemental Privacy Statement for California Residents

California residents should read our Supplemental privacy statement for California residents in conjunction with this Privacy Notice. The Supplemental privacy statement for California residents explains Pearson's commitment to comply with California law and applies to personal information of California residents collected in connection with this site and the Services.

Sharing and Disclosure

Pearson may disclose personal information, as follows:

As required by law.
With the consent of the individual (or their parent, if the individual is a minor)
In response to a subpoena, court order or legal process, to the extent permitted or required by law
To protect the security and safety of individuals, data, assets and systems, consistent with applicable law
In connection the sale, joint venture or other transfer of some or all of its company or assets, subject to the provisions of this Privacy Notice
To investigate or address actual or suspected fraud or other illegal activities
To exercise its legal rights, including enforcement of the Terms of Use for this site or another contract
To affiliated Pearson companies and other companies and organizations who perform work for Pearson and are obligated to protect the privacy of personal information consistent with this Privacy Notice
To a school, organization, company or government agency, where Pearson collects or processes the personal information in a school setting or on behalf of such organization, company or government agency.

Links

This web site contains links to other sites. Please be aware that we are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of each and every web site that collects Personal Information. This privacy statement applies solely to information collected by this web site.

Requests and Contact

Please contact us about this Privacy Notice or if you have any requests or questions relating to the privacy of your personal information.

Changes to this Privacy Notice

We may revise this Privacy Notice through an updated posting. We will identify the effective date of the revision in the posting. Often, updates are made to provide greater clarity or to comply with changes in regulatory requirements. If the updates involve material changes to the collection, protection, use or disclosure of Personal Information, Pearson will provide notice of the change through a conspicuous notice on this site or other appropriate way. Continued use of the site after the effective date of a posted revision evidences acceptance. Please contact us if you have questions or concerns about the Privacy Notice or any objection to any revisions.

Last Update: November 17, 2020

Email Address