Feb 23, 2024 NURS 6501 Knowledge Check Concepts of Endocrine Disorders
NURS 6501 Knowledge Check Concepts of Endocrine Disorders
NURS 6501 Knowledge Check Concepts of Endocrine Disorders
Scenario 4: Hypothyroidism
A patient walked into your clinic today with the following complaints: Weight gain (15 pounds), however has a decreased appetite with extreme fatigue, cold intolerance, dry skin, hair loss, and falls asleep watching television. The patient also tearfulness with depression, and with an unknown cause and has noted she is more forgetful. She does have blurry vision.
PMH: Non-contributory.
Vitals: Temp 96.4˚F, pulse 58 and regular, BP 106/92, 12 respirations. Dull facial expression with coarse facial features. Periorbital puffiness noted.
Diagnosis: hypothyroidism.
Question:
What causes hypothyroidism?
Your Answer:
Hypothyroidism can stem from various causes, each with its own implications for management. The most common cause is autoimmune thyroiditis, also known as Hashimoto’s thyroiditis, wherein the body’s immune system mistakenly attacks and damages the thyroid gland, leading to reduced hormone production. Other causes include thyroid surgery or radioactive iodine treatment, which can diminish thyroid hormone output. Congenital hypothyroidism occurs when an infant is born with an underactive or absent thyroid gland, necessitating lifelong hormone replacement therapy. Certain medications like lithium or amiodarone, as well as radiation therapy to the neck area, can also disrupt thyroid function. Dysfunction in the pituitary or hypothalamus, which regulate thyroid-stimulating hormone production, may result in hypothyroidism. Lastly, iodine deficiency, although rare in many countries due to the widespread use of iodized salt, can contribute to insufficient thyroid hormone production. Identifying the specific cause of hypothyroidism is crucial for tailoring treatment plans and ensuring effective long-term management.
Scenario 1: Syndrome of Antidiuretic Hormone (SIADH)
A 77-year-old female was brought to the clinic by her daughter who stated that her mother had become slightly confused over the past several days. She had been stumbling at home and had fallen twice but was able to walk with some difficulty. She had no other obvious problems and had been eating and drinking. The daughter became concerned when she forgot her daughter’s name, so she thought she better bring her to the clinic.
HPI: Type II diabetes mellitus (DM) with peripheral neuropathy x 30 years. Emphysema. Situational depression after death of spouse 6-months ago
SHFH: – non contributary except for 40 pack/year history tobacco use.
Meds: Metformin 1000 mg po BID, ASA 81 mg po qam, escitalopram (Lexapro) 5 mg po q am started 2 months ago
Labs-CBC WNL; Chem 7- Glucose-102 mg/dl, BUN 16 mg/dl, Creatinine 1.1 mg/dl, Na+116 mmol/L,
K+4.2 mmol/L, CO237 m mol/L, Cl–97 mmol/L.
The APRN refers the patient to the ED and called endocrinology for a consult for diagnosis and management of syndrome of inappropriate antidiuretic hormone (SIADH).
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Question:
1. Define SIADH and identify any patient characteristics that may have contributed to the development of SIADH
Selected Answer:
SIADH occurs when the body produces more ADH, causing water retention and electrolyte imbalance. ADH is produced by the hypothalamus, and it is secreted and stored by the posterior pituitary gland. ADH regulates water in the body by constricting blood vessels and regulating water retention. This is accomplished through the use of kidneys. ADH causes water retention in the renal tubules. ADH elevation causes extra water retention in the body, resulting in hyponatremia with hypo-osmolality and high urine osmolality.
Damage to the hypothalamus or posterior pituitary gland, or ADH produced elsewhere, can all be causes of SIADH. If the SIADH is not treated, the symptoms worsen, including confusion, hallucinations, seizures, and even coma. This patient has emphysema and currently smokes 40 packs of tobacco per year, according to the patient history. According to the most recent lab results, the patient’s carbon dioxide level is 37. Serum carbon dioxide levels should be between 23 and 29. In addition, their sodium level is abnormally high at 116. Serum sodium levels should be between 135 and 145. When serum sodium levels are abnormally low, the syndrome of inappropriate antidiuretic hormone secretion (SIADH) can be diagnosed.
Correct Answer:
SIADH is a group of symptoms that occurs when antidiuretic hormone (ADH, arginine vasopressin) is secreted in the absence of osmotic or physiologic stimuli. These stimuli include: Increased serum osmolality, decreased plasma volume, and hypotension. A decrease in plasma osmolality normally inhibits ADH production and secretion. SIADH is characterized by fluid retention, dilutional hyponatremia, hypochloremia, concentrated urine, and lack of intravascular volume depletion. SIADH is characterized by normal to increased blood volume in normoproteinemia, nonedematous, and hyponatremic patients with normal renal and endocrine function.
Response Feedback:
[None Given]
In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
Diabetes
Hyper- and hypothyroidism
Adrenal disorders
Parathyroidism (hyper and hypo)
Checks & balances / negative feedback
Syndrome of Inappropriate Antidiuretic Hormone
Pheochromocytosis
Diabetes insipidus
Diabetic ketoacidosis
Photo Credit: Getty Images/Science Photo Library RF
(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm Exam.)
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Complete the Knowledge Check By Day 5 of Week 6
To complete this Knowledge Check:
Module 4 Knowledge Check
Midterm Exam
This 101-question exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.
This exam will be on topics covered in Weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit.
(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm exam.)
Photo Credit: Getty Images
To prepare:
To help you review for your midterm exam, access the Midterm Exam Review document found in this week’s Learning Resources as
well as any Knowledge Check feedback you might have received. (Note: You will also need to review all of your materials from each of these weeks to also help you better prepare for your midterm.)
By Day 7 of Week 6
Submit your Midterm Exam.
To complete your exam:
Midterm Exam
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What’s Coming Up in Module 5?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In Module 5, you will analyze processes related to neurological and musculoskeletal disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.
Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders
In the Week 7 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 5. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.
Next Module
To go to the next Module:
Module 5
Week 6: Concepts of Endocrine Disorders
Endocrine disorders are complex matters, and there is not always a one-size-fits-all treatment. Particularly in matters requiring the adjustment of hormone levels, treatment may require a custom approach tailored to individual patients. An understanding of these complications is essential to supporting these individual treatment plans.
This week, you examine alterations in the endocrine system and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.
Learning Objectives
Students will:
Analyze concepts and principles of pathophysiology across the lifespan
Learning Resources
Required Readings (click to expand/reduce)
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Chapter 21: Mechanisms of Hormonal Regulation, including Summary Review
Chapter 22: Alterations of Hormonal Regulation, including Summary Review
Chapter 23: Obesity and Disorders of Nutrition, including Summary Review
American Diabetes Association (2020). Standards of medical care of patients with diabetes mellitus. Diabetes Care, 26(suppl 1), pp. s33-s50. https://care.diabetesjournals.org/content/26/suppl_1/s33
Orlander, P. R. (2018). Hypothyroidism. Retrieved from https://emedicine.medscape.com/article/122393-overview
Hoorn, E. J., & Zietse, R. (2017). Diagnosis and treatment of hyponatremia: Compilation of the guidelines. Journal of the American Society of Nephrology, 28(5), 1340–1349
Document: NURS 6501 Midterm Exam Review (PDF document)
Note: Use this document to help you as you review for your Midterm Exam in Week 6.
Required Media (click to expand/reduce)
Module 4 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 4 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Midterm. (3m)
Concepts of Endocrine Disorders – Week 6 (24m)
Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 21 through 23 related to the endocrine system and disorders. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/
Optional Resources (click to expand/reduce)
The following source provides various tutorials related to maximizing your time management and managing stress. Feel free to access this resource to support you as you move through this course.
Walden University. (2019). ASC success strategies interactive tutorials. Retrieved from https://academicguides.waldenu.edu/academic-skills-center/skills/tutorials/success-strategies
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Review Test Submission: Module 6 Knowledge Check
Course
NURS-6501N-32-Advanced Pathophysiology-2021-Summer-QTR-Term-wks-1-thru-11-(05/31/2021-08/15/2021)-PT27
Test
Module 6 Knowledge Check
Started
7/27/21 6:53 PM
Submitted
7/29/21 6:19 PM
Due Date
8/2/21 1:59 AM
Status
Completed
Attempt Score
20 out of 20 points
Time Elapsed
47 hours, 25 minutes
Results Displayed
All Answers, Submitted Answers, Correct Answers, Feedback, Incorrectly Answered Questions
Question 1
1.25 out of 1.25 points
The APRN is assessing a patient that states that Napoleon Bonaparte is the King of France even thought he has a book that says he is dead. This is an example of:
Selected Answer:
Delusion
Answers:
Delusion
Hallucination
Anhedonia
Pressured speech
Question 2
1.25 out of 1.25 points
Monoamine neurotransmission is hypothesized to be _______________ during mania.
Selected Answer:
increased
Answers:
increased
decreased
absent
suspended
Question 3
1.25 out of 1.25 points
Monoamine neurotransmission is hypothesized to be _______________ during depression.
Selected Answer:
decreased
Answers:
increased
decreased
absent
stimulated
Question 4
1.25 out of 1.25 points
The APRN is assessing a patient that has monotone speech and unchanged facial expressions even though he states he is happy and excited about his life. This is an example of:
Selected Answer:
Anhedonia
Answers:
Delusion
Hallucination
Anhedonia
Pressured speech
Question 5
1.25 out of 1.25 points
Obsessive compulsive disorder is characterized by what types of thoughts and behaviors?
Selected Answer:
repetitive irrational thoughts and ritualized behavior
Answers:
disorganized irrational thoughts and disorganized behavior
constant irrational thoughts and constant behavior
repetitive irrational thoughts and ritualized behavior
repetitive irrational thoughts and disorganized behavior
Question 6
1.25 out of 1.25 points
The APRN is assessing a patient that is talking to his mother in the corner of the room even although you are the only other person in the room. This is an example of:
Selected Answer:
Hallucination
Answers:
Delusion
Hallucination
Anhedonia
Pressured speech
Question 7
1.25 out of 1.25 points
The APRN is treating a patient with bipolar II disorder. The major focus of treatment is on:
Selected Answer:
depression
Answers:
mania
depression
anxiety
panic attacks
Question 8
1.25 out of 1.25 points
Abnormalities in brain development related to schizophrenia are thought to develop when?
Selected Answer:
Prenatal
Answers:
Prenatal
Infancy
Early Childhood
Adolescent
Question 9
1.25 out of 1.25 points
A patient with schizophrenia will have alterations in their dorsolateral prefrontal cortex. The APRN would expect it to be described as:
Selected Answer:
hypoactive
Answers:
stimulated
absent
hyperactive
hypoactive
Question 10
1.25 out of 1.25 points
The neurobiology of depression is believed to be related to the atrophy of neurons in the:
Selected Answer:
hippocampus
Answers:
hypothalmus
hippocampus
thalmus
amygdala
Question 11
1.25 out of 1.25 points
What type of thoughts are characteristic of post traumatic stress disorder?
Selected Answer:
intrusive
Answers:
disorganized
intrusive
anxious
disturbing
Question 12
1.25 out of 1.25 points
Which of the following are positive clinical manifestations of schizophrenia?
Selected Answer:
Hallucinations, delusions, and incoherent speech
Answers:
Social withdraw, blunted affect, and failure to respond to simple questions
Hallucinations, delusions, and incoherent speech
Hallucinations, blunted affect, and social withdraw
Delusions, hallucinations, and failure to respond to simple questions
Question 13
1.25 out of 1.25 points
The APRN is assessing a patient that is talking so rapidly and urgently that it is difficult to understand. This is an example of:
Selected Answer:
Pressured speech
Answers:
Delusion
Hallucination
Anhedonia
Pressured speech
Question 14
1.25 out of 1.25 points
Which of the following are negative clinical manifestations of schizophrenia?
Selected Answer:
Social withdraw, blunted affect, and failure to respond to simple questions
Answers:
Social withdraw, blunted affect, and failure to respond to simple questions
Hallucinations, delusions, and incoherent speech
Hallucinations, blunted affect, and social withdraw
Delusions, hallucinations, and failure to respond to simple questions
Question 15
1.25 out of 1.25 points
The APRN would expect to find elevated blood levels of which of the following markers for patients with a diagnosis of depression?
Selected Answer:
Proinflammatory cytokines and cortisol
Answers:
Proinflammatory cytokines and pH
Calcium and Cortisol
Calcium and pH
Proinflammatory cytokines and cortisol
Question 16
1.25 out of 1.25 points
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