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Anterior Pituitary Secretes
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Counter regulatory Hormone
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Endocrine
BC3 - Endocrine
| Question | Answer |
|---|---|
| Anterior Pituitary Secretes | growth hormone, thyroid stimulating hormone, adenocorticotropic hormone, Prolactin, Gonadotropic hormones |
| Counter regulatory Hormone | Growth Hormone |
| Too Much GH causes | giantism |
| Too little GH | they need some additional hormones |
| Posterior Pituitary secretes | Vasopressin or ADH |
| ADH is | a potent vasoconstrictor |
| When ADH is released | water is retained |
| ADH is inhibited by | increase in fluid volume, hypothermia, B-adrenergic agonists and alcohol |
| Thyroid gland produces | Calcitonin to inhibit high circulating calcium (increases Ca storage in the bones) |
| What is the main purpose of the thyroid gland | to produce, store & release Thyroxine T4 and T3 |
| Calcitonin | takes calcium out of the blood and puts it back into bone (BUILDS BONES UP) |
| The parathyroid gland secretes | Parathormone (PTH) |
| PTH | pulls calcium out of bone and into the blood (BREAKS BONE DOWN) |
| PTH and Calcitonin | are opposites of each other |
| PTH | acts on bone, kidneys & indirectly the GI tract; inhibits bone formation |
| High levels of Vitamin D | inhibit PTH |
| Low levels of Magnesiuim | stimulate PTH |
| Decreased calcium causes | tetany |
| Hyperparathyroidism occurs as we age which means | osteoporosis occurs |
| Cortisol | most potent and abundant glucocorticoid |
| Cortisol facilitates the | breakdown of glycogen (inc. blood glucose levels) |
| Cortisol also has what type of action | anti-inflammatory |
| Aldosterone acts on the renal tubule to | keep sodium and excrete potassium and hydrogen ions |
| What happens to the endocrine system as we age | increase in PTH leads to hypothyroidism |
| Tx of Hypothyroidism | synthroid |
| Exophthalmos | protrusion of the eyeballs from the orbits |
| Myxedema | puffiness, periorbital edema, masklike affect |
| Goiter | enlargement of the thyroid gland |
| Acromegaly | occurs in adulthood - growth hormone excess |
| Tx of acromegaly | Hypophysectomy is tx of choice; radiation tx is secondary tx method; drugs to reduce growth hormone levels |
| Specific post-op care of hypophysectomy | Instruct to avoid coughing,sneezing, or straining with BM; elevate HOB 30 degrees; perform mouth care; discourage toothbrushing for 10 days |
| Hypofunction of the pituitary results from | tumors, autoimmune disorders, infections, vascular disease or destruction of the gland (trauma , radiation, surgical procedures) |
| Symptoms of hypofunction of pituitary | failure to grow, infertility, or amenorrhea |
| SIADH | occurs from overproduction of ADH; occurs more frequently in the elderly (retain fluid) |
| S/S SIADH | fluid retention, hypoosmolality, dilutional hyponatremia, hypochloremia, concentrated urine, normal or inc intravascular volume, normal renal function (BLOOD WOULD BE DILUTED) |
| SIADH patient has | low urinary output, inc body weight w/o edema, lethargy, anorexia, confusion, HA, seizures, coma |
| TX of SIADH | RESTRICT FLUIDS, suck on ice chips/candy; diet supplements of Na & K, diureetics |
| Diabetes Insipidus is the opposite of | SIADH |
| Diabetes insipidus is the caus of | reduced ADH (causing inc urinary output) |
| S/S of Diabetes Insipidus | Polydipsia & Polyuria, low specific gravity, fatigue from nocturia |
| Hyperthyroidism is caused by | increased synthesis and release of thyroid hormone |
| Thyrotoxicosis refers to | physical effects of hypemetabolism r/t over secretion of T3 & T4; usually occur together in Graves Disease |
| Graves Disease | Autoimmune disease (body attacks self); diffuse thyroid enlargement & excessive secretion; They are thin (hyperthyroidism) |
| Tx of Exophthalmos"Bug Eyes" | apply artificial tears, restrict salt intake, elevate HOB, wear dark glasses, eyes may be lightly taped for sleep, exercise intraocular muscles |
| Hyperthyroidism | Increased metabolism, Everything racing: ^ HR, ^ GI, ^ nervous - jittery. They are thin |
| Thyrotoxic Crisis is also called | Thyroid Storm |
| Thyrotoxic Crisis is a life threatening condition caused by | stressors: surgery, infection, trauma |
| Tx of Thyroid Storm | must reduce circulating thyroid hormone; reduce fever, fluid replacement, and eliminate stressors |
| Dx of thyroid issues | Radioactive iodine uptake tests and blood tests for TSH, T3 & T4 |
| Tx of hyperthyroidism is based on | age, severity, complicating features, patient preference |
| Tx of hyperthyroidism | Antithyroid medications, B-adrenergic receptor blockers, thyroid ablation, subtotal thyroidectomy |
| What drugs inhibit synthesis of thyroid hormones | PTU, Tapazole |
| What drugs are B-adrenergic blockers | inderol & atenolol |
| What does iodine do | quiets the thyroid gland down and treats crisis by inhibiting T3 & T4 |
| Radioactive Iodine Therapy is done when | patient is beyond childbearing years |
| Acute intervention for hyperthyroidism | calm, quiet room; adequate rest, cool room, light bed covers, exercise large muscle groups to decrease tremors, restrict visitors |
| After thyroid surgery | prepare room wit O2, suction, trach tray; teach how to support head; assess for hemorrhage; semi-fowlers; check for signs of tetany |
| After thyroid surgery, patient should avoid foods high in | iodine |
| What foods are high in iodine | red food dye, iodate in flour, public drinking sources, kelp tablets (seaweed), milk treated with iodine |
| When patient's return home | they should reduce stress; follow-up is important; avoid high temperature; normal use od iodized salt is ok |
| Thyroid nodules | a palpable deformity of the thyroid gland; can be benign or malignant |
| If the radiology evaluation of a thyroid nodule s hot it is | benign |
| If the radiology evaluation of the thyroid nodule is cold it is | higher risk of cancer |
| Tx of thyroid nodule | surgical removal |
| Thyroiditis | inflammation by bacteria, virus or fungus |
| Hashimoto's thyroiditis | autoimmune disorder; most common type in US |
| Hyperparathyroidism | "brittle bones & kidney stones" |
| Hypothyroidism in infancy | cretinism- they have a thick protruding tongue, short - limited all their lives |
| Hypothyroidism in adults | Insidious - middle to old age - comes on slowly - they are cold |
| S/S of hypothyroidism | fatigue, lethargy, personality changes, impaired memory, slowed speech, decreased initiative, somnolence, cold, hair loss, dry skin, brittle nails, wt gain |
| Tx of hypothyroidism | take thyroid replacement like synthroid; must be taken throughout the rest of ones life |
| Hypoparathyroidism | rare - can happen if thyroid gland is removed |
| Tx of hypoparathyroidism | Administer IV Calcium slowly to avoid hypotension; tetany can occur because of dec Ca levels; patient needs instruction on long term drug therapy and nutrition |
| Long-term Tx of hypoparathyroidism | Vitamin D, supplement calcium, oral phosphate binders |
| Cushing's Syndrome is caused by | excessive corticosteroids |
| Clinical Manifestations of Cushing's | Weight gain, glucose intolerance, protein wasting, mood disturbances, Acne, HBP, Hirsuitism, Truncal obesity, Moon face, unxplained hypokalemia, Purplish striae |
| Diagnostic Findings of Cushing's | Granulocytosis, Lymphocytopenis, Eosinopenia, Hyperglycemia, Glycosuria, Hypercalciuria, Osteoporosis |
| Tx of Cushing's | Hypophysectomy (pituitary); Adrenalectomy (adrenal tumors); Drygs to suppress Cortisol |
| Nursing Mgmt of Cushing's | Monitor f/e |
| Pre-operative care of Cushing's | Hypokalemia is corrected with diet & K supplements, Manage ^BP |
| Post-operative care of Cushing's | Constant assessment for glucocorticoid imbalance; Maintain bedrest until BP stabilizes; Constant vigilance to prevent infection; Risk for hemorrhage; f/e; keep IV line in place |
| Addison's Syndrome | Hypofunction of Adrenal Cortex - DECREASED secretion; most common cause is autoimmune |
| S/S of Addison's | Weakness/fatigue, Wt. loss/anorexia, loss of hair; "tan", low BP, Low Na but high K; N/V/D |
| Subjective Assessment of Addison's | cramping/abd pain; exhaustion; profound weakness; lack of interest; inablility to tolerate stress |
| Complications of Addison's | Low BP, Shock, Circulatory Collapse, Dehydration, Low Na, High K, Hypoglycemia, Fever, Weakness, Confusion |
| Care of Addison's | Replacement of Glucocorticoids; IV hydrocortisone; Administer Na, fluids, and dextrose; may need reverse isolation |
| Teaching Plan for Addison's | Take Glucocorticoids 2/3 in am - 1/3 in afternoon; Carry emergency kit at all times |
| Complications of Corticosteroids | Hypertension, Slow healing, Inhibits antibody response to healing |
Created by:
okrecota
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