Alterations In Endocrine Function

Question 1

The endocrine system is comprised of what: name them

Answer 1

Glands that secrete hormones. Pituitary, thyroid, parathyroid, adrenal, gonads, pancreas

Question 2

There are two parts of the pituitary gland, the anterior and posterior. Which produces hormones?

Answer 2

The anterior pituitary produces seven hormones, while the posterior pituitary only stores two hormones

Question 3

What seven hormones does the anterior pituitary secrete?

Answer 3

Growth hormones, thyroid stimulating hormone, corticotropin, follicle-stimulating hormone, Leutinizing hormones, prolactin, Melanocytes

Question 4

What to hormones does the posterior pituitary store?

Answer 4

Oxytocin and antidiuretic hormone

Question 5

What are the disorders of pituitary function?

Answer 5

Growth hormone deficiency, and diabetes insipidus

Question 6

How is growth hormone deficiency characterized?

Answer 6

During infancy and childhood it is characterized by growth retardation, short stature, and delayed bone maturation

Question 7

What are the causes of growth hormone deficiency?

Answer 7

Idiopathic, CNS infection, infarction of the pituitary gland, tumors

Question 8

What are the clinical manifestations of growth hormone deficiency?

Answer 8

Appears infantile with small mandible and small teeth, Higher pitched voices, delayed sexual maturation

Question 9

What are some diagnostic test that can be performed to determine if a person has growth hormone deficiency?

Answer 9

Wrist, provocative growth hormone tests

Question 10

How is provocative growth hormone test done?

Answer 10

Various medications are used to stimulate the release of GH. Confirmation of GH deficiency based on two failures of the provocative stimuli test. Sleep specimens, exercise tests, IGF/1

Question 11

What is the treatment for growth hormone deficiency?

Answer 11

Daily SQ/IM injections of growth hormone. Replacement is expensive starting at $35,000 a year. This is continued until they reach acceptable height or growth

Question 12

What is diabetes insipidus?

Answer 12

A disorder of the posterior pituitary resulting in hyposecretion of ADH which produces a state of uncontrolled diaresis

Question 13

What are causes of diabetes insipidus?

Answer 13

CNS trauma, brain tumor ( 50% of DI), infection, electrolyte in balance says, surgical procedure (hypophysectomy), Hypoxic brain damage, neoplasm, vascular anomaly, leukemia

Question 14

What are clinical manifestations of diabetes insipidus?

Answer 14

Sudden onset of symptoms: polyuria, polydipsia, irritability, enuresis, dehydration

Question 15

What diagnostic tests are performed to confirm diabetes insipidus

Answer 15

Serum electrolytes, serum and urine osmolality’s, measurement of plasma arginine vasopressin before and during fluid deprivation test

Question 16

What is the treatment for diabetes insipidus?

Answer 16

Water replacement therapy, does naproxen acetate (DD a VP) this is only effective for neurogenic diabetes insipidus. The goal is urine osmolality of 2 to 3 mL/kilogram/hour. specific gravity 1.010 to 1.020. Sodium of 140 to 140 5MEQ/L

Question 17

What is nursing considerations for diabetes insipidus?

Answer 17

Is in the hospital, monitor INO, check urine specific gravity you. Teach parents DDAVP administration: daily weights, I and O especially during illness and when NPO. Child should wear ID bracelet

Question 18

What are the disorders of pancreatic function?

Answer 18

Diabetes mellitus type one, diabetes mellitus type two

Question 19

What is diabetes mellitus?

Answer 19

Disorder of carbohydrates, proteins, and fat metabolism

Question 20

What are the causes of diabetes mellitus?

Answer 20

Genetic factors, autoimmune factors (type one), viral infection

Question 21

What is the pathophysiology for diabetes mellitus?

Answer 21

Disturbances and carbohydrate, protein, fat metabolism. Deficiency of insulin or insulin resistance compromise of Body’s access to essential nutrients for fuel

Question 22

Symptoms develop rapidly in which type of diabetes mellitus?

Answer 22

Type one

Question 23

What are the signs and symptoms of type one diabetes mellitus?

Answer 23

The three poly’s: polydipsia, polyuria, polyphagia. Weakness, fatigue, enuresis, dehydration, weight loss and hunger, vision changes, frequent skin and UTIs, skin changes, blood glucose levels of 200 mg/dL

Question 24

What diagnostic tests are performed for type one diabetes confirmation?

Answer 24

To fasting plasma glucose test above one 26 mg/dL her. With normal fasting glucose: two blood glucose levels above 200 mg/dL her during a two hour glucose tolerance test. Other findings: acetone or glucose in the urine, diabetic retinopathy

Question 25

What are signs and symptoms of type two diabetes mellitus?

Answer 25

Vague, long-standing symptoms develop gradually. Severe viral infection, other endocrine diseases, recent stress or trauma, obesity, particularly in the abdominal region, acanthosis nigricans: Hyperpigmentation and thickening of the skin. It is rare to see three poly’s

Question 26

What diagnostic tests are done to support diabetes mellitus type two?

Answer 26

Obesity, acanthosis nigricans, glucose levels above 200 mg/dL

Question 27

What are complications of diabetes Mellitis?

Answer 27

Diabetic ketoacidosis (DK), hypoglycemia, nephropathy, retinopathy, neuropathy, complications can occur as early as 2 to 3 years after diagnosis

Question 28

What is a diabetic ketoacidosis?

Answer 28

It occurs when the body must burn fat and protein stores for energy due to no insulin

Question 29

What are signs and symptoms of diabetic ketoacidosis?

Answer 29

3 poly’s, abdominal or chest pain, nausea and vomiting, dehydration, weight loss, tachycardia, flushed ears and cheeks, Kuszmaul restorations, fruity breath, altered LOC, hyperglycemia, glycosuria, acidosis, Keytonuria

Question 30

What are symptoms of hypoglycemia

Answer 30

Lethargy, hunger, sweating, pallor, tremors, seizures, coma

Question 31

What are signs and symptoms of hyperglycemia

Answer 31

Sweet, fruity breath, dehydration, decrease sodium, bicarbonate, chloride, and phosphate levels, vomiting, abdominal pain, coma

Question 32

What is basal bolus therapy?

Answer 32

Basal insulin administered once per day (Lantos or glargine) or twice a day (Humulin or Ultralente). Bolus of rapid acting insulin (Humalog) administered with each meal or snack based on carb count. Also includes blood glucose monitoring 4 to 8 times per day, 12 AM and 3 AM once per week. Carb counting, exercise in daily routine

Question 33

What phenylketonuria?

Answer 33

An autosomal recessive disease that leads to mental retardation, seizures, and death. It is caused by a deficiency of liver enzyme which breaks down phenylalanine into tyrosine

Question 34

What are the clinical manifestations of phenylketonuria

Answer 34

Musty or mousy odor to body and urine, vomiting, irritability, hyperactivity, eczema like rash, seizures, lighter complexion the nonaffected siblings, hypertonic, hyper reflexive deep tendon reflexes

Question 35

What diagnostic tests are performed to diagnose phenylketonuria?

Answer 35

All infants are screened via blood test in newborn. After 48 hours of age. Child needs to have been on breastmilk or formula for at least two days

Question 36

What is the treatment for phenylketonuria?

Answer 36

You special formula (loft alas), diet low in phenylalanine for entire life, avoid high-protein foods and aspartame, use elemental medical foods

Question 37

What does the endocrine system do?

Answer 37

Regulate and integrate metabolic processes in the body