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Pathophysiology NURS 240 > Alterations of Endocrine Function > Flashcards

Alterations of Endocrine Function Flashcards

1
Q

What hormones are produced from the hypothalamus?

A

TRH, CRH, GnRH, GHRH

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2
Q

What hormones are produced from the Pituitary Gland?

A

Anterior: TSH, GH, PROLACTION
Posterior: ADH & OXYTOCIN

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3
Q

What hormones are produced from the pineal gland?

A

Melatonin

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4
Q

What hormones are produced from the Thyroid?

A

T3 and T4

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5
Q

What hormones are produced from the Parathyroid?

A

PTH

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6
Q

What does PTH regulate?

A

Calcium

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7
Q

What hormones are produced from the Pancreas?

A

Insulin & Glucagon

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8
Q

What hormones are produced from the Adrenal glands?

A

Aldosterone, Cortisol, Estrogen, Glucocorticoids, and Mineralcorticoids

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9
Q

What causes Syndrome of Inappropriate Antidiuretic Hormone Secretion?

A

Increased ADH levels without physiologic stimuli

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10
Q

What are some other common causes of SIADH?

A

Tumors, surgery, and medications

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11
Q

What are 2 key characteristics of SIADH?

A
  1. Enhanced renal water retention

2. Dilutional Hyponatremia

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12
Q

What are the Clinical Manifestations of SIADH?

A

Weight gain, confusion, lethargy, decrease LOC, seizures, cerebral edema

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13
Q

What is the treatment for SIADH?

A

Correct underlying condition, electrolyte replacement, and diuretics

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14
Q

What is the issue with Diabetes Insipidus (DI)?

A

Insufficiency of ADH activity

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15
Q

What are the two forms of DI?

A

Neurogenic and Nephrogenic

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16
Q

What is the cause of Neurogenic DI?

A

Insufficient secretion of ADH do to a lesion, infection, or ischemic injury

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17
Q

What organ is being affected by Neurogenic DI?

A

The hypothalamus or posterior pituitary

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18
Q

How soon are the symptoms prevalent in Neurogenic DI?

A

Brough on rapidly

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19
Q

What is the cause of Nephrogenic DI?

A

Inadequate response of the renal tubules to ADH

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20
Q

What organ is being affected by Nephrogenic DI?

A

Kidneys

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21
Q

How soon are the symptoms prevalent in Nephrogenic DI?

A

Gradual onset

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22
Q

What are the clinical manifestations of Nephrogenic DI?

A

Polyuria, polydipsia, and urine is normally clear

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23
Q

What is a big complication of Diabetes Insipidus?

A

DEHYDRATION

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24
Q

What is the treatment for DI?

A

Fluid replacement and monitor closely

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25
Q

What is the main cause of Hypopituitarism?

A

The absence or failure of one or more pituitary hormones

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26
Q

What are some other causes of hypopituitarism?

A

Tumor, brain injury, infection, ischemia

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27
Q

What is Dwarfism?

A

Insufficient GH in children

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28
Q

What are the risk factors for dwarfism?

A

Increased risk of mortality

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29
Q

What is treatment of hypopituitarism?

A

Give them more of that certain hormone

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30
Q

What typically causes hyperpituitarism?

A

Pituitary adenoma

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31
Q

What does a microadenoma do in hyperpituitarism?

A

It’s so small, that it tends to not cause alot of problems

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32
Q

What does macroadenoma do in hyperpituitarism?

A

Cause the majority of problems

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33
Q

When population does Giantism effect?

A

Children

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34
Q

Which population does Acromegaly affect or when does it get diagnosed?

A

Adulthood

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35
Q

What are some clinical manifestations of Acromegaly?

A

Bony prominences, flatter forehead, more protrusion the jaw, enlargement of hands/feet, have an increased risk for heart disease, and can become insulin resistance

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36
Q

What is the main cause of hyperthyroidism?

A

Excessive amounts of TH secreted from the thyroid

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37
Q

What is Graves Disease?

A

It is an autoimmune disease and type II hypersensitivity, where the body is attacking the thyroid

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38
Q

What are the clinical manifestations of hyperthyroidism?

A

Weight loss, visual disturbances, heat intolerance, and an enlarged thyroid

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39
Q

What are the treatments for hyperthyroidism?

A

Medication to lower the thyroid hormone; also keep an eye on patients mental status/stress.

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40
Q

What is Thyroid Storm?

A

Increased action of thyroid hormones to exceed metabolic demands; metabolic activity is going to exceed what your body can handle

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41
Q

How severe is thyroid storm?

A

Dangerous crisis requiring immediate intervention

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42
Q

What are the clinical manifestations of Thyroid Storm?

A

Heart failure, Delirium, Hyperthermia, and Brain Damage

43
Q

What is the treatment plane for Thyroid Storm?

A

Medication to lower thyroid hormone, and supportive care

44
Q

How long will it take before death occurs with Thyroid Storm?

A

Within 48 hours

45
Q

What is hypothyroidism?

A

A deficient production of the thyroid hormone

46
Q

What is the most common cause of primary hypothyroidism?

A

Autoimmune thyroiditis and Hashimoto

47
Q

What are the complications of primary hypothyroidism at birth?

A

Increased mortality rate, excessive sleepiness, decreased intake, trouble breast feeding, and constipation

48
Q

What can happen if the clinical manifestations are not treated quickly enough for primary hypothyroidism?

A

Can be permanent stunted growth and mental deficits

49
Q

What are they symptoms of hypothyroidism?

A

Cold intolerance, weight gain, lethargy, constipation, myxedema, and hoarse voice

50
Q

What is the treatment of hypothyroidism?

A

Replace TH

51
Q

What is Hyperparathyroidism?

A

Greater than normal secretion of parathyroid (PTH) and hypercalcemia

52
Q

What is the cause of Primary hyperparathyroidism?

A

Adenoma or Hypercalcemia

53
Q

What is the cause of Secondary hyperparathyroidism?

A

Some type of hypocalcemia- usually a vitamin D-deficiency

54
Q

What is the cause of tertiary hyperparthyroidism?

A

Secondary that is unresolved for a period of time

55
Q

What are the clinical manifestations of hyperparathyroidism?

A

Hypercalcemia, fatigue, N/V, headache, decrease neuromuscular excitability

56
Q

What is the treatment for primary hyperparathyroidism?

A

Take out the tumor with surgical removal

57
Q

What is the treatment for secondary/tertiary hyperparathyroidism?

A

Remove the calcium, give vitamin D, get the excess calcium out that signals to the parathyroid to stop secreting PTH

58
Q

What is hypoparathyroidism?

A

Abnormally low PTH levels

59
Q

What is the most common cause of hypoparathyroidism?

A

Damage to the parathyroid glands during thyroid surgery due to the anatomic proximity of the parathyroid to the thyroid

60
Q

What are the clinical manifestations of hypoparathyroidism?

A

Low calcium levels, facial twitching (Chvestok sign), increased neuromuscular, tetany, hyperphophatemia

61
Q

What is the treatment for hypoparathyroidism?

A

Calcium replacement

62
Q

What is Diabetes Mellitus?

A

Chronic disease caused by the imbalance of insulin supply and demand, leading to hyperglycemia and abnormal carbohydrate, fat, and protein metabolism.

63
Q

What is Type I Diabetes Mellitus?

A

Caused by an autoimmune destruction of beta cells in the pancreas, which leads to an absolute insulin deficiency.

64
Q

What is the initial presentation of type I?

A

Characterized by sudden onset of hyperglycemia, with ketoacidosis, and cocurs most often in children and younger adults

65
Q

What are the symptoms of type I?

A

Polyuria, polydipsia, polyphagia, weight loss, glycosuria, and not feeling well.

66
Q

What is the treatment of Type I?

A

Insulin injections

67
Q

What is Type II Diabetes Mellitus?

A

A gradual onset of hyperglycemia and is the result of the development of resistance to the action of insulin

68
Q

What are the characteristics of type II?

A

Obesity, hypertension, hyperlipidemia, and hyperglycemia in older adults

69
Q

How can type II be managed?

A

With diet and lifestyle changes

70
Q

What is HbA1?

A

Blood test that measures the amount of red blood cells that are saturated with glucose; detects your average blood sugar for the long term.

71
Q

What is FBG?

A

Fasting blood glucose; tested after 8 hours of fasting

72
Q

What is OGTT?

A

Oral glucose tolerance test; Measures how an individuals body reacts immediately to sugar

73
Q

What is “Pre-diabetes”?

A

Increased risk for developing diabetes; something in blood work is elevated

74
Q

What are the 2 types of Type I Diabetes?

A

Autoimmune or idiopathic (beta cells are being destroyed)

75
Q

What is Diabetic Ketoacidosis (DKA)?

A

Serious complication related to insulin deficiency

76
Q

What is the Acid/Base Imbalance of DKA?

A

Metabolic Acidosis

77
Q

What are the clinical manifestations of DKA?

A

Blood sugar over 300, Kussmaul respirations, Hyperventilation,Ketonuria,
Fruity acetone breath, CNS depression, Hyperkalemia, high blood sugar less responsive, decreased LOC/mental status, and cardiac dysrhythmias

78
Q

What are the diagnostics for DKA?

A

Blood sugar readings, ABGs, and Urine test

79
Q

What is the treatment of DKA?

A

Give them insulin, insulin drip, ICU bed through IV

80
Q

What could happen if a nurse brings blood sugar levels for a patient with DKA down too fast?

A

Hypoglycemic state

81
Q

What happens during type II diabetes?

A

There is a decreased insulin secretion so the pancreas isn’t able to keep up with the carbohydrates and sugars, therefore destroying the pancreas slowly and eventually turning to Type I.

82
Q

What are the clinical manifestations of Type II?

A

Polyuria, polydipsia, fatigue, headaches, nausea, and hyperinsulinemia

83
Q

What is hyperinsulinemia?

A

The amount of insulin in the blood is higher than considered normal. They have a problem controlling blood sugar, meaning that the pancreas has to secrete larger amounts of insulin to keep blood sugar at a normal level. Excess levels of insulin circulating in the blood relative to the level of glucose.

84
Q

What are some systemic complications of type II if left untreated?

A

Visual changes, Diabetic retinopathy, microvascular issues, poor wound healing, and impaired nerve sensation (diabetic neuropathy)

85
Q

What nursing interventions are possible for Type II?

A

Promoting Skin inspection

86
Q

What is a major complication of Type II?

A

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS)

87
Q

What is HHNS?

A

Higher serum glucose>solute diuresis> polyuria> dehydration> hyperosmolality

88
Q

What is gestational diabetes?

A

Any degree of glucose intolerance with onset or first recognition during pregnancy

89
Q

How is gestational diabetes diagnosed?

A

OGTT after 24 weeks gestation

90
Q

What is hypoglycemia?

A

Complication of insulin therapy and oral medications

91
Q

What are the symptoms of hyperglycemic shock?

A

Sweating, altered level of consciousness, fever, dizzy, lightheaded, nausea, visual disturbances

92
Q

What is the Dawn Phenomenon?

A

An early morning rise in blood glucose related to release of GH, cortisol without preceding hypoglycemia

93
Q

What is the treatment of Dawn Phenomenon?

A

Night-time insulin dose

94
Q

What is Somogyi Effect?

A

Low blood glucose level during the night that leads to morning rise in blood glucose level, possible to go into hypoglycemic state during the night

95
Q

What is the treatment of Somogyi Effect?

A

Bed-time snack

96
Q

What is Cushing Syndrome?

A

Excessive cortisol secretion caused by adenomas

97
Q

What are the clinical manifestations of Cushing syndrome?

A

Weight gain, personality changes, increased susceptibility to infection, gynecomastia, fat deposits on face and back of shoulders, hyperglycemia, CNS irritability, Gi distress, osteoporosis, thin extremities, amenorrhea & hirsutism, moon face, trunk edema, buffalo hump, vasoconstriction, thinning of the skin, purple striae bruises, and petechia

98
Q

What is the treatment for Cushing syndrome?

A

Medications to reduce cortisol secretion, and if related to adenoma: surgery, radiation, and chemotherapy

99
Q

What is hypocortical function?

A

Low levels of cortisol secretion from inadequate stimulation of the adrenal glands

100
Q

What type of disease is Addison’s Disease?

A

Autoimmune

101
Q

What is Addison’s Disease?

A

A primary adrenal insufficiency where the adrenal cortex is being destroyed.

102
Q

What are the clinical manifestations of Addison’s Disease?

A

Weakness, fatigue, hyperpigmentation of the skin, N/V/D, hypoglycemia, postural hypotension, weight loss, GI disturbances, changes in distribution of body hair

103
Q

What are the clinical manifestations of adrenal crisis?

A

Profound fatigue, dehydration, vascular collapse, decreased blood pressure, renal shut down, decreased serum Na, and increased serum K

104
Q

What is the treatment for Addison’s Disease?

A

A life-time cortical replacement therapy

Pathophysiology NURS 240 (4 decks)

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