Endocrine

Question 1

Endocrine means:

Answer 1

relating to or denoting glands which secrete hormones or other products directly into the blood.

Question 2

Hormones

Answer 2

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

Question 3

Other glands of this system

Answer 3

Thyroid: T3/T4
Adrenal: Aldosterone
Pancreas: Insulin

Question 4

Hypothyroidism

Answer 4

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)

Question 5

Myxedema Coma Symptoms

Answer 5

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.

Question 6

Hyperthyroidism

Answer 6

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

Question 7

Thyroid Storm=Thyrotoxicosis

Answer 7

Having a very rapid heartbeat.
Having a high fever.
Feeling very agitated and confused.
Having diarrhea and feeling sick.
Experiencing a loss of consciousness.

Question 8

Diabetes Insipidus

Answer 8

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

Question 9

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Answer 9

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

Question 10

Diabetes Mellitus

Answer 10

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.)

Question 11

Stress states and diabetes mellitus

Answer 11

The body releases more blood sugar (glucocorticoid release)

Question 12

Type One DM

Answer 12

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)

Question 13

Type 2 DM

Answer 13

Insulin Resistance

Question 14

Hypoglycemia

Answer 14

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

Question 15

Glucagon

Answer 15

Hormone
Released by pancreas
Increases blood glucose
Helps to maintain homeostasis

Question 16

Insulin

Answer 16

Released by pancreas
Hormone
Helps sugar into cells so that it can be processed into energy

Question 17

Diabetic Ketoacidosis

Answer 17

When fat is used to make energy, because the cells can’t get sugar
Metabolic Ketoacidosis

Question 18

Assessing: Signs and Symptoms of Diabetic Ketoacidosis (complication esp. DM1)

Answer 18

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

Question 19

Complications from prolonged Diabetes Mellitus

Answer 19

Delayed Wound Healing
Neuropathy
Retinopathy
Vascular Damage (Resulting in MI, CVA, etc…)

Question 20

Parathyroid Issues

Answer 20

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

Question 21

Cushing’s Syndrome

Answer 21

Excessive cortisol production
Excess weight in torso with thin extremities
Fluid retention
Moon-face appearance
Immunosuppression (Risk for Infection)
Electrolyte Imbalances
Humpback

Question 22

Addison’s Disease

Answer 22

Insufficient amount of circulating cortisol
Skin Hyperpigmentation
Hypotension
Deficiency of adrenal cortex hormones
Watch out for electrolyte disturbances, like high potassium

Question 23

Growth Hormone Anomalies

Answer 23

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

Question 24

Pheochromocytoma

Answer 24

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