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NSG219 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

The endocrine system consists of glands located throughout the body to carry out vital functions such as

A

regulating metabolism, nutrition, elimination, temperature, fluid and electrolyte balance, and growth and reproduction.

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2
Q

The hypothalamus plays a major role in endocrine function because of its control of the

A

anterior and pituitary glands

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3
Q

Hormones from the endocrine glands are secreted directly into the _________ compared to exocrine glands that are released through _____

A

blood stream

ducts

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4
Q

Exocrine glands include ______ and ______ glands

A

salivary and sweat glands

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5
Q

negative feedback system that increases

A

hormone secretion when circulating levels are decreased

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6
Q

Hypothalamus (Control Center) target is…

A

anterior pituitary

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7
Q

Anterior pituitary (Distribution) targets…..

A

adrenal, thyroid, reproductive, growth

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8
Q

Posterior pituitary (storage and distriubtion) targets….

A

ADH release (fluid balance) and oxytocin

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9
Q

The adrenal gland consists of an

A

adrenal cortex and medulla

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10
Q

The cortex triggers release of ……

A

glucocorticoids and mineralcorticoids

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11
Q

Glucocorticoids help regulate……

A

fluid balance, have anti-inflammatory properties, aid in growth and development, and play a role in regulating blood glucose levels

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12
Q

what is the primary glucocorticoid

A

cortisol

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13
Q

what does cortisol do

A

promotes glucogenesis and glycogenolysis that can increase glucose levels

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14
Q

what does the medulla release

A

catecholamines (epinephrine and norepinephrine).

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15
Q

Thyroid gland affects

A

affects metabolism, heart rate and contractility, red blood cell production, respiratory rate and drive

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16
Q

what are the hormones in thyroid gland

A

T3 and T4

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17
Q

where is TSH and TRH secreted from

A

hypothalamus

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18
Q

TSH and TRH secreted from the hypothalamus trigger

A

T3 and T4 release from thyroid

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19
Q

Parathyroid gland secretes ______ to regulate_____

A

calcitonin to regulate calcium levels

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20
Q

calcium serum levels determine how much _______ is secreted

A

calcitonin

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21
Q

Calcitonin lowers calcium and phosphate levels by

A

reducing bone release of these minerals.

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22
Q

Gonads include the

A

reproductive organs, ovaries and testes.

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23
Q

what hormones are released from the gonads

A

testosterone and progesterone, and estrogen.

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24
Q

Pancreas secretes ____ and _____ to….

A

glucagon and insulin to maintain appropriate blood glucose levels

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25
Q

In addition to levels of circulating hormones, release of hormones is influenced by

A

intrinsic factors

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26
Q

When patients are prescribed certain medications such as corticosteroids for inflammation, these exogenous agents impact the function of the ________ so they must be _______ to prevent _____

A

negative feedback system. Therefore, they must be tapered to prevent abrupt withdrawal of the exogenous drug which may lead to adrenal insufficiency

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27
Q

what is adrenal insufficiency

A

medical emergency characterized by decreased blood pressure and hypoglycemia.

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28
Q

what is included to look for in physical assessment

A
  • Hair distribution, coarseness
  • -Bulging eyes
  • -Round or puffy face
  • Thyroid nodule: easiest to assess during swallowing
  • Jugular Vein Distention
  • Skin: pigment, slow healing wounds, edema
  • Fingernails
  • Trunk: Breast for abnormalities
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29
Q

where is the buffalo hump and what does it indicate?

A

between shoulder blades may indicate adrenal cortical excess.

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30
Q

what is a striae and what may it indicate

A

reddish purple “stretch mark” on breasts or abdomen may indicate adrenal cortical excess.

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31
Q

what are you listening for during a physical assessment

A

Auscultate the chest and assess heart rate and rhythm. Endocrine problems can cause dehydration, volume depletion, or fluid excess. Document orthostatic blood pressures and monitor trends.

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32
Q

what are you palpating during a physical assessment

A

The thyroid gland and testes should only be palpated by a healthcare professional– never manipulate a gland

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33
Q

Applying pressure to the thyroid can stimulate …..

A

sudden release of thyroid hormones and cause a thyroid storm.

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34
Q

what endocrine issues are more common in older adults

A

such as diabetes, loss of ovarian function, and decreased thyroid function

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35
Q

thyroid problems are more common in men or women.

A

women

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36
Q

what questions should you ask during an endocrine assessment

A

Did symptoms occur gradually or start suddenly?
Ask about elimination patterns
Ask about changes in menstrual cycle
Has the client experience impotence, change in libido?
Has hair texture changed?
Has the client been experiencing fatigue?
Has the client been experiencing temperature changes?

37
Q

The thyroid, parathyroid, ovaries, and testes should be evaluated using

A

ultrasound

38
Q

what imaging is used to look at to evaluate ovaries, pancreas, and adrenal glands

A

CT scan

39
Q

what is a Provocative Suppression Tests

A

are performed by “provoking” a hormone response

40
Q

what happens if the hormone doesnt respond during a provocative suppression test

A

client would be considered to have hypofunction

41
Q

what happens if the hormone over responds during a provocative suppression test

A

hyperfunction.

42
Q

Hormones and metabolites can be accurately measured by collecting a _______ and why

A

24 hour urine

Because many endocrine hormones are secreted in a pulsatile fashion, a one-time collection wouldn’t be accurate

43
Q

what labs would you take to evaluate the posterior pituitary glands

A

Hematocrit, serum sodium, urine-specific gravity

44
Q

what labs would you take to evaluate the anterior pituitary gland

A

ALL THE LABS and growth hormone

45
Q

what labs would you take to evaluate the parathyroid

A

Calcium, ionized calcium, vitamin D, magnesium, and phosphorus

46
Q

what labs would you take to evaluate the thyroid

A

T3, T4, TSH

47
Q

what labs would you look at to evaluate the adrenal

A

Cortisol, potassium, and sodium

48
Q

what does aldosterone do

A

a mineralocorticoid, promotes sodium and potassium excretion by the kidney

49
Q

what labs would you take to evaluate the ovaries

A

FSH, Luteinizing hormone, estrogen levels

50
Q

what labs would you take to evaluate the testes

A

testosterone

51
Q

what labs would you take to evaluate the pancreas

A

insulin, and glucose levels

52
Q

The three endocrine tissues that usually have reduced function with aging are the

A

gonads, the thyroid gland, and the endocrine pancreas

53
Q

Decreased ADH production causes

A

more UOP and risk of dehydration

54
Q

Decreased glucose tolerance- causes what

A

elevated glucose levels, polydipsia, polyuria, slow wound healing, and frequent UTI or yeast infections.

55
Q

decreased metabolism causes what

A

colder, decreased appetite, BP and HR decreased.

56
Q

The anterior pituitary regulates

A

growth, metabolism, pigmentation, and sexual development

57
Q

Hormones secreted from the anterior pituitary gland are regulated by the

A

hypothalamus

58
Q

The hormones released by the posterior pituitary are synthesized in the ________ but stored and released from the ______ ______when needed.

A

hypothalamus

posterior pituitary

59
Q

what are the anterior pituitary gland hormones

A 
Adrenocorticotropic hormone (ACTH) 
growth hormone 
follicle stimulating 
Luteinizing 
prolactin 
thyroid stimulating
60
Q

Adrenocorticotropic hormone (ACTH) is involved in synthesis of….

A

Corticosteroid’s

61
Q

Growth hormone stimulates

A

growth through metabolism

62
Q

Follicle stimulating hormone assists in the

A

maturation of the ovaries and spermatogenesis in males

63
Q

Luteinizing hormone is involved in

A

ovulation in females and production of testosterone in males

64
Q

Prolactin stimulates the

A

mammary glands for milk production.

65
Q

Thyroid stimulating hormone controls secretion

A

T3and T4

66
Q

Weakness and bone fractures are a s/s of

A

decreased levels of GH

67
Q

Ensure the client with hypopituitarism has adequate amounts of

A

vitamin D and calcium.

68
Q

Hyperpituitarism is usually related to a

A

hypersecreting tumor

69
Q

what are the Signs and symptoms of hyperpituitarism

A

hyperglycemia, hypernatremia, hypertension, increased bone density, menstrual irregularities, weight loss, exopthalamos, and exaggerated facial features. In children before the closure of epiphyses, gigantism develops. An excess of growth hormone in adults does not affect bone length because of the closure. Acromegaly can occur especially in hands, feet, and facial bones

70
Q

what labs would you assess for hyperpituitarism

A

TSH, FSH, LH, prolactin, GH, and ACTH stimulation test.

71
Q

what does the med Dopamine agonist (bromocriptine mesylate do

A

for hyperpituitarism

inhibits release of anterior pituitary hormones

72
Q

what is Stereotactic radiosurgery

A

a minimal invasive procedure. It delivers high dose radiation to a precisely targeted area of the brain. The goal is eradication of the tumor with minimal effects to adjacent normal brain tissues.

73
Q

what is Transsphenoidal Hypophysectomy

A

The sublabial transseptal approach to a pituitary tumor involves an incision made under the top lip, with entry to the nasal cavity through the floor of the nose. The septum is moved to the side and the sphenoid sinus is opened to access the pituitary gland. A muscle graft is placed after removal of the tumor, typically from the thigh muscle. The graft aids in healing and prevents cerebrospinal fluid leakage. Nasal packing is placed and a “moustache dressing”.

74
Q

what vital signs would indicate DI after Transsphenoidal Hypophysectomy

A

decreased BP and tachycardia increased thirst or UOP

75
Q

what are the ss od meningitis

A

temperature, stiff neck, and photophobia

76
Q

what will you report after Transsphenoidal Hypophysectomy

A

clear drainage from nose

77
Q

what interventions are involved after Transsphenoidal Hypophysectomy

A

If needed, administer IVF to correct sodium levels. Administer vasopressin to cause water reabsorption in the kidneys and help decrease UOP. Maintain HOB greater than 45 degrees, provide adequate oral fluids, and provide frequent mouth care.

78
Q

ADH helps maintain

A

fluid and electrolyte balance

79
Q

Oxytocin plays a major role in

A

circadian homeostasis, release of breast milk, and cervical and uterine changes during labor

80
Q

Diabetes insipidus is classified as either

A

central or nephrogenic.

81
Q

Central DI is caused by a

A

decreased secretion of ADH from the posterior pituitary gland.

82
Q

Nephrogenic DI occurs when

A

kidneys are resistant to ADH and unable to concentrate urine. This type of DI is observed in clients with chronic renal insufficiency, hypercalcemia, hypokalemia, and interstitial disease of the renal tubules.

83
Q

what are the ss of diabetes insipidus

A

will depend on the amount of water loss. Lack of ADH causes an increase in water secretion. Excessive water loss leads to hemoconcentration observed with elevations in serum sodium and hematocrit. The patient may have hypotension and tachycardia secondary to hypovolemia. Polyuria, polydipsia, and nocturia are the primary clinical manifestations.

84
Q

Urine specific gravity less than 1.005 and urine osmolality less than 200 are key indicators

A

of DI

85
Q

what is the med Desmopressin used for and how does it work

A

a synthetic analog of ADH and is the drug of choice in clients with DI. It works by increasing the amount of fluid absorbed in the kidney. The fluid is returned to the blood stream.

86
Q

what is Syndrome of Inappropriate Antidiuretic Hormone

A

a disorder related to an increase in ADH. Water overload and hemodilution are characteristics of SIADH.
cause by CNS disorders such as tumors, side effects of NSAIDs, psychotropic medications, and bronchogenic carcinoma.

87
Q

what are the ss of Syndrome of Inappropriate Antidiuretic Hormone

A

Decreased UOP, increase in osmolality and specific gravity, are common. Hyponatremia is the cardinal symptom of SIADH. As sodium levels decrease the patient may have seizures or become comatose.

88
Q

Demeclocycline is used to

A

increase water secretion from the kidneys.

NSG219 (11 decks)

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