Endocrine Flashcards
Endocrine means:
relating to or denoting glands which secrete hormones or other products directly into the blood.
Hormones
a regulatory substance produced in an organism and transported in tissue fluids such as blood or sap to stimulate specific cells or tissues into action
Most common mechanisms controlling hormone release and regulation: Negative Feedback Loop
Other glands of this system
Thyroid: T3/T4
Adrenal: Aldosterone
Pancreas: Insulin
Hypothyroidism
Lowered Metabolism
Intolerance to cold, fatigue, mental apathy, physical sluggishness, constipation, muscle aches, dry skin and hair, weight gain, bradycardia (slow heart rate), Most from Hashimoto’s thyroiditis (autoimmune)
Often High TSH (>4 milli-international units per liter), low T4/T3
Treatment: levothyroxine (Synthroid)
Myxedema Coma: hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, nonpitting edema of the face and periorbital area (severe lack of thyroid hormone)
Myxedema Coma Symptoms
Weakness or lethargy.
Confusion or non-responsiveness.
Feeling cold.
Low body temperature.
Swelling of the body, especially the face, tongue, and lower legs.
Difficulty breathing.
Hyperthyroidism
High heart rate, restlessness, weight loss, amenorrhea, and intolerance to heat, exophthalmos (bulging eyes)
Complication: Thyroid Storm is a dangerous complication (fever, decreased LOC, abdominal pain)
Grave’s Disease
Thyroid Storm=Thyrotoxicosis
Having a very rapid heartbeat.
Having a high fever.
Feeling very agitated and confused.
Having diarrhea and feeling sick.
Experiencing a loss of consciousness.
Diabetes Insipidus
Not enough ADH (secreted from the posterior pituitary) or inadequate response to it by the kidneys
Can be caused by head trauma, intracranial tumors, neurosurgery
Urinary frequency, thirst, dehydration, massive urine output (5-10L/day)
Treatment: Synthetic Vasopressin
Interventions: Monitor weight, Monitor I and O (intake and output), Watch for signs of hypovolemia, hydrometer may be used to measure urine specific gravity
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Too much Anti-diuretic hormone is released
Hyponatremia (from excessive fluid retention)
High urine osmolality
Adrenal insufficiency is often cause, hypothyroidism and diuretics can cause it
Hyponatremia (serum)-lethargy and confusion common symptoms
Treatment/Interventions: Fluid Restriction, underlying cause
Diabetes Mellitus
Hyperglycemia
Type One: Lack of Insulin
Type Two: Insulin Resistance; More Insulin Needed but less glucose is used
Polydipsia, polyphagia, polyuria, generalized weakness
Weight loss associated with type one
Treatment/Nursing Interventions: ADA Diet, Insulin, Oral Meds (DM2)
A1C (ave. BGs over past 2-3 mos.)
Stress states and diabetes mellitus
The body releases more blood sugar (glucocorticoid release)
Type One DM
Often Begins during Childhood
Weight Loss
Lack or No Insulin Production
Destruction of pancreatic beta cells thought to be caused by an autoimmune reaction (no longer send out insulin)
Type 2 DM
Insulin Resistance
Hypoglycemia
Often Sudden
Weakness, tremor, muscle twitching
N/V
Confusion, delirium, seizures, headache, LOC changes
Diaphoretic, pale (Cold and Clammy need some candy)
Often increased respiratory rate
Low blood glucose
Headache
Hungry
Glucagon
Hormone
Released by pancreas
Increases blood glucose
Helps to maintain homeostasis
Insulin
Released by pancreas
Hormone
Helps sugar into cells so that it can be processed into energy
Diabetic Ketoacidosis
When fat is used to make energy, because the cells can’t get sugar
Metabolic Ketoacidosis
Assessing: Signs and Symptoms of Diabetic Ketoacidosis (complication esp. DM1)
Lethargy
Muscle wasting, weight loss
Abdominal pain, cramps, N/V
Headache, Double Vision, Irritability
Tachycardia (bc of hypovolemia), hypotension
Air hunger, Kussmal’s (Deep/Fast Respirations), Acetone breath, Dyspnea
High Blood Glucose
Ketones in blood and Urine
Flushed Skin
Complications from prolonged Diabetes Mellitus
Delayed Wound Healing
Neuropathy
Retinopathy
Vascular Damage (Resulting in MI, CVA, etc…)
Parathyroid Issues
Cause problems with Calcium Regulation
Hypoparathyroidism: Muscle Twitching, Tetany, Numbness in Fingers, Heart Palpitations (Serum Calcium Low)
Hyperparathyroidism: Weak, Brittle Bones (Hypercalcemia-Cats go numb); Can be caused by thyroid tumor
Parathyroidectomy: Watch for flexion contractions (like Trousseau’s) from hypocalcemia
Cushing’s Syndrome
Excessive cortisol production
Excess weight in torso with thin extremities
Fluid retention
Moon-face appearance
Immunosuppression (Risk for Infection)
Electrolyte Imbalances
Humpback
Addison’s Disease
Insufficient amount of circulating cortisol
Skin Hyperpigmentation
Hypotension
Deficiency of adrenal cortex hormones
Watch out for electrolyte disturbances, like high potassium
Growth Hormone Anomalies
Excessive Growth Hormone (Child Onset)-Gigantism
Excessive Growth Hormone (Adult Onset)-Acromegaly; Can be the result of a growth hormone secretion (pituitary adenoma)
Dwarfism: Insufficient GH (Somatropin)
Growth hormone (GH is an anabolic agent, helping the development of body tissue
Pheochromocytoma
Benign tumor of adrenal medulla (the area secreting epinephrine and norepinephrine)
Symptoms: Repeated attacks of high blood pressure, heart palpitations, sweating, headache, Nausea, Weakness, Difficulty Breathing, Abdominal Pain
