Alterations In Endocrine Function Flashcards
The endocrine system is comprised of what: name them
Glands that secrete hormones. Pituitary, thyroid, parathyroid, adrenal, gonads, pancreas
There are two parts of the pituitary gland, the anterior and posterior. Which produces hormones?
The anterior pituitary produces seven hormones, while the posterior pituitary only stores two hormones
What seven hormones does the anterior pituitary secrete?
Growth hormones, thyroid stimulating hormone, corticotropin, follicle-stimulating hormone, Leutinizing hormones, prolactin, Melanocytes
What to hormones does the posterior pituitary store?
Oxytocin and antidiuretic hormone
What are the disorders of pituitary function?
Growth hormone deficiency, and diabetes insipidus
How is growth hormone deficiency characterized?
During infancy and childhood it is characterized by growth retardation, short stature, and delayed bone maturation
What are the causes of growth hormone deficiency?
Idiopathic, CNS infection, infarction of the pituitary gland, tumors
What are the clinical manifestations of growth hormone deficiency?
Appears infantile with small mandible and small teeth, Higher pitched voices, delayed sexual maturation
What are some diagnostic test that can be performed to determine if a person has growth hormone deficiency?
Wrist, provocative growth hormone tests
How is provocative growth hormone test done?
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
What is the treatment for growth hormone deficiency?
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
What is diabetes insipidus?
A disorder of the posterior pituitary resulting in hyposecretion of ADH which produces a state of uncontrolled diaresis
What are causes of diabetes insipidus?
CNS trauma, brain tumor ( 50% of DI), infection, electrolyte in balance says, surgical procedure (hypophysectomy), Hypoxic brain damage, neoplasm, vascular anomaly, leukemia
What are clinical manifestations of diabetes insipidus?
Sudden onset of symptoms: polyuria, polydipsia, irritability, enuresis, dehydration
What diagnostic tests are performed to confirm diabetes insipidus
Serum electrolytes, serum and urine osmolality’s, measurement of plasma arginine vasopressin before and during fluid deprivation test
What is the treatment for diabetes insipidus?
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
What is nursing considerations for diabetes insipidus?
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
What are the disorders of pancreatic function?
Diabetes mellitus type one, diabetes mellitus type two
What is diabetes mellitus?
Disorder of carbohydrates, proteins, and fat metabolism
What are the causes of diabetes mellitus?
Genetic factors, autoimmune factors (type one), viral infection
What is the pathophysiology for diabetes mellitus?
Disturbances and carbohydrate, protein, fat metabolism. Deficiency of insulin or insulin resistance compromise of Body’s access to essential nutrients for fuel
Symptoms develop rapidly in which type of diabetes mellitus?
Type one
What are the signs and symptoms of type one diabetes mellitus?
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
What diagnostic tests are performed for type one diabetes confirmation?
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
What are signs and symptoms of type two diabetes mellitus?
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
What diagnostic tests are done to support diabetes mellitus type two?
Obesity, acanthosis nigricans, glucose levels above 200 mg/dL
What are complications of diabetes Mellitis?
Diabetic ketoacidosis (DK), hypoglycemia, nephropathy, retinopathy, neuropathy, complications can occur as early as 2 to 3 years after diagnosis
What is a diabetic ketoacidosis?
It occurs when the body must burn fat and protein stores for energy due to no insulin
What are signs and symptoms of diabetic ketoacidosis?
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
What are symptoms of hypoglycemia
Lethargy, hunger, sweating, pallor, tremors, seizures, coma
What are signs and symptoms of hyperglycemia
Sweet, fruity breath, dehydration, decrease sodium, bicarbonate, chloride, and phosphate levels, vomiting, abdominal pain, coma
What is basal bolus therapy?
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
What phenylketonuria?
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
What are the clinical manifestations of phenylketonuria
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
What diagnostic tests are performed to diagnose phenylketonuria?
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
What is the treatment for phenylketonuria?
You special formula (loft alas), diet low in phenylalanine for entire life, avoid high-protein foods and aspartame, use elemental medical foods
What does the endocrine system do?
Regulate and integrate metabolic processes in the body
