Med-Surg Ch. 52 Assessment and
Management of Patients with Endocrine
Disorders
What is the most common disorder related to posterior lobe dysfunction? - correct
answer-Diabetes insipidus (DI)
What are some causes of diabetes insipidus (DI)? - correct answer-A deficiency of ADH
(vasopressin) and failure of the renal tubules to respond to ADH.
What are clinical manifestations of diabetes insipidus (DI)? - correct answer-Excessive thirst
(polydipsia)
Large volumes of dilute urine (greater than 250 mL per hour) with specific gravity of 1.001 to
1.005.
Because of intense thirst, the patient tends to drink how much fluid daily? - correct answer-2
to 20 L and craves cold water
Undersecretion of antidiuretic hormone results in what? - correct answer-Hypernatremia and
an elevated serum osmolality
fluid deprivation test - correct answer-Withholding fluids for 8 to 12 hours or until 3% to 5% of
the body weight is lost.
Patient is weighed frequently during the test.
Test is terminated if tachycardia, excessive weight loss, or hypotension develops.
What is a characteristic of diabetes insipidus (DI)? - correct answer-The inability to increase
the specific gravity and osmolality of the urine.
Demopressin - correct answer-Administered intranasally
One or two daily usually control the symptoms.
Ineffective if the diabetes insipidus is renal in origin
What is used to treat the nephrogenic form of DI? - correct answer-Thiazide diuretics, mild
salt depletion, and prostaglandin inhibitors
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) - correct
answer-Includes excessive ADH secretion from pituitary gland.
Patients cannot excrete a dilute urine, retain fluids, and develop a sodium deficiency.
, May occur in patients with bronchogenic carcinoma in which malignant lung cells synthesize
and release ADH.
Also occurred in patients with severe pneumonia
Produced by disorders of the central nervous system, such as head injury, brain surgery or
tumor, and infection
SIADH - Medical Management - correct answer-Interventions include eliminating the
underlying cause, if possible, and restricting fluid intake.
Diuretic agents such as furosemide (Lasix) may be used alone with fluid restriction if severe
hyponatremia is present.
What is the most common cause of hypothyroidism in adults? - correct answer-Autoimmune
thyroiditis (Hashimoto's disease), in which the immune system attacks the thyroid gland.
Hypothyroidism - correct answer-Commonly occurs in patients with previous hyperthyroidism
that has been treated with radioiodine or antithyroid medications or thyroidectomy.
Clinical Manifestations of Hypothyroidism - correct answer-Weakness, fatigue, intolerance to
cold, and weight gain
Reports of hair loss, brittle nails, and dry skin are common and numbness and tingling of the
fingers may occur.
Patient complains of constipation
Manifestations of Advanced Hypothyroidism - correct answer-May produce personality and
cognitive changes characteristic of dementia.
Myxedema coma - correct answer-A rare life-threatening condition
Patient is hypothermic and unconscious
May develop with undiagnosed hypothyroidism and may be precipitated by infection or other
systemic disease or by use of sedatives or opioid analgesic agents.
In patients who forget to take their thyroid replacement medication.
Patients can exhibit hyponatremia, hypoglycemia, hypoventilation, hypotension, bradycardia,
and hypothermia.
Hypothyroidism - Prevention of Medication Interactions - correct
answer-Magnesium-containing antacids - decrease in thyroid hormone absorption
Digitalis glycosides - decreases due to thyroid hormones
Management of Patients with Endocrine
Disorders
What is the most common disorder related to posterior lobe dysfunction? - correct
answer-Diabetes insipidus (DI)
What are some causes of diabetes insipidus (DI)? - correct answer-A deficiency of ADH
(vasopressin) and failure of the renal tubules to respond to ADH.
What are clinical manifestations of diabetes insipidus (DI)? - correct answer-Excessive thirst
(polydipsia)
Large volumes of dilute urine (greater than 250 mL per hour) with specific gravity of 1.001 to
1.005.
Because of intense thirst, the patient tends to drink how much fluid daily? - correct answer-2
to 20 L and craves cold water
Undersecretion of antidiuretic hormone results in what? - correct answer-Hypernatremia and
an elevated serum osmolality
fluid deprivation test - correct answer-Withholding fluids for 8 to 12 hours or until 3% to 5% of
the body weight is lost.
Patient is weighed frequently during the test.
Test is terminated if tachycardia, excessive weight loss, or hypotension develops.
What is a characteristic of diabetes insipidus (DI)? - correct answer-The inability to increase
the specific gravity and osmolality of the urine.
Demopressin - correct answer-Administered intranasally
One or two daily usually control the symptoms.
Ineffective if the diabetes insipidus is renal in origin
What is used to treat the nephrogenic form of DI? - correct answer-Thiazide diuretics, mild
salt depletion, and prostaglandin inhibitors
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) - correct
answer-Includes excessive ADH secretion from pituitary gland.
Patients cannot excrete a dilute urine, retain fluids, and develop a sodium deficiency.
, May occur in patients with bronchogenic carcinoma in which malignant lung cells synthesize
and release ADH.
Also occurred in patients with severe pneumonia
Produced by disorders of the central nervous system, such as head injury, brain surgery or
tumor, and infection
SIADH - Medical Management - correct answer-Interventions include eliminating the
underlying cause, if possible, and restricting fluid intake.
Diuretic agents such as furosemide (Lasix) may be used alone with fluid restriction if severe
hyponatremia is present.
What is the most common cause of hypothyroidism in adults? - correct answer-Autoimmune
thyroiditis (Hashimoto's disease), in which the immune system attacks the thyroid gland.
Hypothyroidism - correct answer-Commonly occurs in patients with previous hyperthyroidism
that has been treated with radioiodine or antithyroid medications or thyroidectomy.
Clinical Manifestations of Hypothyroidism - correct answer-Weakness, fatigue, intolerance to
cold, and weight gain
Reports of hair loss, brittle nails, and dry skin are common and numbness and tingling of the
fingers may occur.
Patient complains of constipation
Manifestations of Advanced Hypothyroidism - correct answer-May produce personality and
cognitive changes characteristic of dementia.
Myxedema coma - correct answer-A rare life-threatening condition
Patient is hypothermic and unconscious
May develop with undiagnosed hypothyroidism and may be precipitated by infection or other
systemic disease or by use of sedatives or opioid analgesic agents.
In patients who forget to take their thyroid replacement medication.
Patients can exhibit hyponatremia, hypoglycemia, hypoventilation, hypotension, bradycardia,
and hypothermia.
Hypothyroidism - Prevention of Medication Interactions - correct
answer-Magnesium-containing antacids - decrease in thyroid hormone absorption
Digitalis glycosides - decreases due to thyroid hormones
