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Med Surg > Chapter 45 Endocrine > Flashcards

Chapter 45 Endocrine Flashcards

1
Q

Negative Feedback is where an increase of a hormone causes ______ to be produced and a decrease in hormone causes ________ to be produced

A

less
more

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2
Q

The endocrine system is a ____________ feedback system

A

negative

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3
Q

Endocrine disorders are caused by a __________________ or ________________ of hormones

A

overproduction or underproduction

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4
Q

**Diagnostic tests for hormone levels
* Blood and _______
*S___________ or S____________ testing
* Genetics
* Radiology including
**P___ and Dexa— measures bone mineral density

A

urine
Stimulation, suppression
PET

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5
Q

The ________ gland is referred to as the “master gland”; it secretes hormones into the bloodstream

A

Pituitary

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6
Q

The _____________ is the coordinating center of the brain

A

Hypothalamus

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7
Q

Suppression tests are used to detect ____________ of an endocrine organ

A

HYPERsecretion

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8
Q

What are the hormones that the anterior pituitary gland secretes: 6

A

Follicle Stimulating Hormone
Lutenizing Hormone
Adrenocorticotropic Hormone
Thyroid Stimulating Hormone
Prolactin
Growth Hormone

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9
Q

What are the hormones that the posterior pituitary secretes:

A

Antidiuretic Hormone
Oxytocin

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10
Q

Too much GH can cause what?

A

Gigantism (before puberty) or Acromegaly (after puberty/ adult)

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11
Q

Hyperpituitarism is most often caused by what ?

A

Tumors or hyperplasia

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12
Q
  • Increased Growth Hormone causes :
  • Increased ACTH causes:
  • Increased TSH causes:
  • Increased ADH causes:
A

Gigantism/Acromegaly
Cushing’s
HYPERthyroidism
SIADH

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13
Q
  • Decreased Growth Hormone causes :
  • Decreased ACTH causes:
  • Decreased TSH causes:
  • Decreased ADH causes:
A

Dwarfism
Addison
HYPOthyroidism
DI

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14
Q

_________ therapy may be used alone or in combination with surgery and or radiation

A

Drug

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15
Q

____________ removal of the pituitary gland and tumor, called ______________ is the most common treatment for hyperpituitarism

A

Surgical, hypophysectomy

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16
Q

Immediately after surgery, advise pt to avoid activities that increase ICP such as:

A

Brushing teeth (2weeks)
Bending over
Straining
Coughing
Blowing nose

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17
Q

What is the most common surgical method for a hypophysectomy?

A

Oronasal transsphenoidal approach

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18
Q

Nursing Interventions post Hypophysectomy
Q___H Neuro Checks
Assess for ___________drip and assess drainage for ___________
Elevate _____
Avoid __________ and ___________ ________
Assess for meningitis
____________ replacement
Avoid bending/ straining/ brushing teeth
Education: decreased sense of ________

A

1
postnasal , glucose
HOB
coughing, blowing nose
Hormone
Smell

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19
Q

Growth Hormone is regulated by the ________________ based on __________

A

hypothalamus
glucose

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20
Q

an _________ in BS causes the release of GH
a _____________ in BS inhibits release of GH

A

increase
decrease

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21
Q

______________ occurs if tumor formation is pre-puberty (rapid growth)
_____________ occurs if tumor formation is after puberty (in adult)

A

Gigantism
Acromegaly

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22
Q

Common Manifestations of TOO MUCH GH
* HA and _______ changes (r/t compression of optic nerve)
* Widened _________ bone
* Growth and thickening of ______, _______, _______.
* HTN, HF, CAD, _____________ (enlargement of organs)
* ______glycemia

A

visual
brow
hands, face, feet
organomegaly
HYPER

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23
Q

What is administered for Acromegaly/ Gigantism?

A

Somatostatin analogs (synthetic somatostatin) I — inhibits the release of GH

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24
Q

The thyroid gland is stimulated by the __________ ____________ gland

A

anterior pituitary

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25
Q

TSH controls the release of :

A

T3, T4

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26
Q

The thyroid gland produces 3 hormones, they are:

A

T3
T4
Calcitonin

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27
Q

______________ decreased serum calcium by increasing its deposition in the bone

A

Calcitonin

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28
Q

The _____________ gland produces the parathormone

A

Parathyroid

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29
Q

__________________ increases bone breakdown and increases serum calcium

A

Parathormone

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30
Q

What is the most common cause of Hyperthyroidism?

A

Grave’s disease : autoimmune disorder that produces thyroid stimulating immunoglobulins

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31
Q

What are the most common manifestations of Hyperthyroidism? 9

A

High metabolic rate
Increase temp, SBP, HR
Cardiac dysrhythmias
Goiter
Weight loss
Heat intolerance
Exopthalmos

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32
Q

What is the most common treatment for hyperthyroidism?

A

Radioactive Iodine (common to especially for Graves’ disease)
** some radioactivity is present in the patient’s body fluids and stool

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33
Q

Patients taking medication for Hyperthyroidism are able to take their medication whenever they would like, no specific time. (True or False)

A

False — Patients who are taking medication for hyperthyroidism should take their medication at the same time every day

34
Q

Total or subtotal Thyroidectomy is the treatment of choice for thyroid _________ and treatment for ________

A

cancer
goiter

35
Q

Preoperative goals for thyroidectomy is the reduction of _______ and _______ to avoid precipitation of thyroid storm

A

stress
anxiety

36
Q

Nursing Care Post Thyroidectomy
* A_________ and B_____________
- Keep emergency _______ kit, suction ambu bag at bedside
- HOB elevated
- Watch for stridor, hoarseness, laryngospasm (hoarseness = sign of laryngeal nerve damage)
- Humidified air for moisture
* Diet as tolerated —clear ________ then advance
* Activity as tolerated; ______ prophylaxis

A

Airway, Breathing
Trach
liquids
DVT

37
Q

Complications of Thyroidectomy
- Hemorrhage/ bleeding
* Monitor labs — especially ____________ (watch for tetany)
* Have __________ gluconate at bedside
- Monitor pain
- Watch for s/s of infection
- Avoid tension to neck incision

A

calcium — 1st signs of tetany are numbness/ tingling in lips, mouth fingers,toes
calcium

38
Q

Patients who have a thyroidectomy only had to take hormone replacement for 3 months before their body will start making it again (true or false)

A

FALSE— patients who have a thyroidectomy have to take hormone replacement for the rest of their life

39
Q

A thyroid storm is a life threatening situation where hyperactive _______ caused excessive TH release, which leads to extremely high BP, Temp, HR.

A

thyroid

40
Q

Manifestations of thyroid storm include
* Increased _____________
* Increased ___________ _________ _________
* Increased ________ _______

A

temperature (even a 1 degree increase should be reported, this could indicate thyroid storm is on the way)
systolic blood pressure
heart rate

41
Q

One of the MAJOR nursing priorities for a patient who is at risk for thyroid storm is:

A

AIRWAY

42
Q

Common treatment for thyroid storm is :
- B_____ B_________
- __________ blanket and antipyretics
- Anti_________ medications

A

Beta Blockers
Cooling
Antithyroid

43
Q

One of the most common causes of Hypothyroidism is _____________ disease and __________ surgery

A

Hashimoto
thyroid

44
Q

T3 and T4 levels are ______________ in Hypothyroidism. But TSH levels are ______________ to try to get the body to make more thyroid hormone

A

decreased
increased

45
Q

Patients with Hypothyroidism have to take a lifelong _____________ hormone replacement

A

thyroid

46
Q

** Hypothyroidism Nursing Process**
*Recognize cues: change in ____, __________ vitals, lethargy
*Analyze cues and form priorities : _____________ function, neurological, vitals, _______glycemia
*Interventions: Monitor for increasing severity of s/s , administer meds as ordered, turn Q__H, avoid ______________
*Patient education: Life-long ____________,a void extreme cold, manifestations, avoid infection risks, follow up appts, and support system

A

LOC, decreased
Respiratory , HYPO
2, sedatives
medication

47
Q

Myxedema Coma is rare but life-threatening disorder of severe __________________

A

Hypothyroidism

48
Q

s/s of Myxedema Coma
- _____thermic
- unconscious
- ______natremia
- _______glycemia
-_____ventilation
- _____tension
- _______cardia

A

Hypo
Hypo
Hypo
Hypo
Hypo
Brady
EVERYTHING WITH HYPOTHYROIDISM WILL BE LOW

49
Q

Hyperparathyroidism is where there is an abnormal increase of _____, causing ______calcemia and _____phosphatemia

A

PTH
Hyper
Hypo

50
Q

Patients with hyperparathyroidism are at an increased risk of injury with falls (true or false)

A

TRUE

51
Q

Patients who have hypothyroidism and are taking hormone replacement need to take their medication ____ minutes before eating

A

30

52
Q

A Hypercalcemic Crisis is where there is an extreme elevation of serum calcium which results in neurological, cardiovascular, and renal symptoms that can be life threatening!! This is treated by rapid ____________ with large volumes of IV isotonic saline fluids. It is also treated with a combination of ___________ and _________________ to reduce the serum calcium level by increasing calcium deposition in the bone

A

rehydration
calcitonin, corticosteroids

53
Q

Causes of Hypoparathyroidism
- Abnormal _______________ development
- Destruction of parathyroid glands from surgery or autoimmune response (Most common)
- Vitamin ___ deficiency

A

parathyroid
D

54
Q

For a patient who has hypoparathyroidism, IV __________ __________ should be kept at the bedside

A

calcium gluconate

55
Q

Positive _____________ and _____________ signs for hypoparathyroidism

A

Chvostek — face spasm from tapping side of cheek
Trousseau — carpopedal spasm induced by occluding the blood flow to the arm for.3 min with a blood pressure cuff

56
Q

The adrenal medulla cortex produces :

A

Epinephrine: adrenaline; fight or flight
Norepinephrine: mobilized body and brain activity

57
Q

What does the adrenal cortex produce?

A

Glucocorticoids (Cortisol; energy replenishment)
Mineralocorticoids (aldosterone for F&E balance )
Sex hormones

58
Q

Glucocorticoids provide a source of energy during a __________ situation

A

stressful

59
Q

Adrenal cortex hyper function =
Adrenal Cortex Insufficiency=

A

cushing’s syndrome
addison’s disease

60
Q

Cushing’s Syndrome is due to an increased ______ leading to increased cortisol secretion

A

ACTH

61
Q

Cushing’s can also be due to _______________ use or production of androgens

A

corticosteroid

62
Q

Manifestations of Cushing’s Syndrome
- _______ skin
- ______ face
- _________ hump
- edema
Nursing Priorities
- Monitoring/ addressing _______ ________ excess

A

thin
moon
buffalo
fluid volume

63
Q

Patients who have Cushing’s syndrome have thin fragile skin, causing them to have an ___________ risk of __________

A

increased
infection

64
Q

Virilization is when a condition in which a _______ develops characteristics associated with _______ hormones (androgens)

A

female
male

65
Q

Top 3 nursing interventions for Cushing’s syndrome
- _________ and ________ restriction
- __________ prevention
- _______!!!!!

A

Sodium, water
infection
safety

66
Q

In cushing’s syndrome, labs such as __________ are often low. This should be. monitored and replaced as needed

A

potassium

67
Q

Excess cortisol reduces the number of circulating lymphocytes,inhibits maturation of macrophages, reduces antibody synthesis, and inhibits production of cytokines and inflammatory chemicals = high risk of _________

A

infection

68
Q

The primary cause of Addison’s disease is a _________ __________ malfunction. Not enough cortisol to meet needs

A

adrenal cortex

69
Q

Risk factors of Addison’s Disease
- Surgical removal of infection of _________
- ____ is a common cause
- Abrupt cessation of _________ —> TAPER

A

adrenals
TB
steroids

70
Q

Patients with Addison’s will need _________ replacement therapy for life

A

hormone

71
Q

Addison disease causes an increase in the ______________ stimulating hormone, which results in an abnormal dark pigmentation of the skin. The knuckles, knees, and elbows are especially prone to dark pigmentation

A

melanocyte

72
Q

What is an adrenocorticotropic hormone (ACTH) test?

A

This test measures how much ACTH is in the blood

73
Q

Common manifestations of Addison’s is:
- Darkened, bronzed _______
- ______tension and postural _____tension
- Weakness, fatigue
- Weight _____

A

skin
Hypo, Hypo
loss

74
Q

Addisonian Crisis is a life threatening emergency!! S/S include:
- Profound __________
- Dehydration
- Vascular Collapse (____tension)
- ______volemic shock
- AKI
- _____ sodium
- _______ potassium

A

fatigue
Hypo
Hypo
Low
High

75
Q

Patients with Addison’s disease have to take Corticosteroids (mineralcorticoids and glucocorticoids) for life. Some of the medications include:

A

Fludrocortisone (Florinef)
Prednisone (cortisol replacement)

76
Q

With addison’s treatment, you are monitoring for improvement in symptoms of Addison’s, but getting too much cortisol could cause sx of __________

A

Cushing’s

77
Q

Addison’s patients are able to stop taking medications after 3 months (true of false)

A

False— patients with Addison’s have to take their medication for life. They should also not ABRUPTLY stop taking their medications

78
Q

Aldosteronism occur when the adrenal glands produce to much ______________. This leads to increases in sodium and water retention and loss of potassium

A

aldosterone

79
Q

Treatment for aldosteronism includes potassium sparing diuretics, and potassium supplements. *** Won’t perform surgery until ______________ levels are normal

A

potassium

80
Q

Pheochromocytoma is a tumor that produces, stores, and releases excess ___________ and __________

A

epinephrine
norepinephrine

81
Q

Manifestation of pheochromocytoma
5 Hs
- H__________
- HTN
- Hyperhidrosis (___________)
- Hypermetabolism (______cardia, palpitations, ______ pain, tremors)
- ______glycemia

A

headache
sweating
tachy, chest
Hyper

Med Surg (20 decks)

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