adrenal glands

Question 1

what NS is the adrenal medulla a part of

Answer 1

autonomic NS

Question 2

what…
-secretes catecholamines
-regulates metabolic pathways
-fight/flight

Answer 2

adrenal medulla

Question 3

what is a tumor of the adrenal medulla called (usually benign)

Answer 3

pheochromocytoma

Question 4

what are risk factors that can cause pheochromocytoma

Answer 4

anything that stimulates a paroxysm of catecholamine release

Question 5

pheochromocytomas without early intervention can lead to….

Answer 5

cerebral hemorrhage and cardiac failure

Question 6

s/sx of pheochromocytoma

Answer 6

*** HTN with pounding headaches
-hyperthyroidism
n/v from inc. pressure

Question 7

5 H signs of pheochromocytoma

Answer 7

-HTN
-headache
-hyperhidrosis
-hypermetabolism
-hyperglycemia

Question 8

what tests are done for pheochromocytoma

Answer 8

-urine and plasma levels of catecholamines
-vanillymandelic acid (VMA) urine test
-clonidine suppression test
-imaging studies (CT, MRI, US)

Question 9

medical management of pheochromocytoma

Answer 9

pharmacologic therapy
pre-op meds
-surgical management (adrenalectomy, corticosteroid replacement)

Question 10

what are the pre-op meds for pheochromocytoma

Answer 10

-low dose alpha adrenergic blockers
-doxazosin
-may try calcium channel blockers
-nifedipine
-beta blockers
-metyrosine

Question 11

nursing management of pheochromocytoma

Answer 11

pre-op assessment (neuro/ control HTN)
post-op care (adequate perfusion, nutritional needs, comfort measures, prevent shock)

Question 12

what’s secretions help the body adapt to stress?

Answer 12

adrenal cortex

Question 13

what hormones are secreted by the adrenal cortex?

Answer 13

-glucocorticoids
-mineralocorticoids
-adrenal sex hormones
(sugar salt and sex)

Question 14

what are the 2 disorders of the adrenal cortex?

Answer 14

addisons and cushings

Question 15

what disorder is hypofunction of the adrenal cortex and deficiency of the hormones inside?

Answer 15

addison’s

Question 16

what disorder is hyperfunction of the adrenal cortex and excess hormones inside?

Answer 16

cushing’s

Question 17

is addison’s autoimmune?

Answer 17

yes

Question 18

how to help addison’s

Answer 18

adrenalectomy

Question 19

what are risk factors of addison’s

Answer 19

-history of endocrine probs
-sudden stopping of glucocorticoids
-taking glucocorticoids
-adrenalectomy
-tuberculosis

Question 20

what are s/sx of addison’s

Answer 20

-slow insidious onset
-fatigue
-irritability
-weight loss
-bronze skin
-n/v
-hypotension (postural)
-changes in distribution of body hair

Question 21

what are symptoms of adrenal crisis

Answer 21

-profound fatigue
-dehydration
-vascular collapse
-renal shutdown
-low sodium high potassium

Question 22

how to diagnose addison’s

Answer 22

-blood/urine hormonal assay (cortisol/ACTH)
-serum electrolytes
-blood sugar
-CBC
-CT/MRI

Question 23

medical management of addison’s

Answer 23

-combat shock
-restore circulation
-administer fluids and corticosteroids
-monitor VS
-trendelenburg (lower BP, blood to heart)

Question 24

nursing management of addison’s

Answer 24

-assess patient
-monitor for addisonian crisis
-restore fluid balance
-improve activity

Question 25

characteristics of addisonian crisis

Answer 25

back, abd, leg pain depressed/status change hypotension/low volume loss of consciousness shock hypoglycemia

Question 26

treatment of addisonian crisis

Answer 26

correct fluid/electrolytes correct hypoglycemia replace steroids

Question 27

what is the most common cause of cushing syndrome

Answer 27

long term use of corticosteroids

Question 28

what does the overactivity of the adrenal cortex cause

Answer 28

cushing's

Question 29

what is a tumor of the pituitary that produces too much ACTH cause?

Answer 29

cushing's

Question 30

s/sx of cushing's

Answer 30

-personality change -moon face -male: gynecomastia -fat deposits -thin/purple/bruised skin -thin extremities -GI distress -> inc. acid -Na and fluid retention (edema) -hyperglycemia

Question 31

what is the diagnosis of cushing's

Answer 31

-labs -xray, CT, MRI -arteriography -overnight dexamethasone suppression test!

Question 32

what labs help find cushing's

Answer 32

-palsma cortisol -glucose and serum sodium -inc. WBC, but dec. eosinophil and lymphocyte -urinary free cortisol -low dose dexamethasone suppression test

Question 33

what is the surgical managemnt of cushing's if its caused by a benign tumor / adrenal carcinoma

Answer 33

adrenalectomy

Question 34

what is the surgical management of cushing's if its caused by pituitary tumor or unidentified lesion

Answer 34

transphenoidal hypophysectomy (replace cortisol and TH)

Question 35

drug therapy for cushing's

Answer 35

adrenal enzyme inhibitor (ketoconazole) ACTH-reproducing agents (cyproheptadine or somatostatin)

Question 36

nursing management for cushing's

Answer 36

-VS -DW -I&O -glucose -physical apprearance -electrolytes -protect from infection -minimize stress -diet education