- regulates sodium and electrolyte balance - affects carbohydrate, fat, and protein metabolism - influences development of sexual characteristics - sustains fight/flight response

- Outer shell of adrenal gland - makes glucocorticoids + mineralcorticoids. Secretes small amounts of sex hormones (androgens and estrogens)

- Inner core of the adrenal gland - works as part of the sympathatic nervous system - produces epinephrine + norepinephrine

- located in anterior part of the neck - controls the rate of the body metabolism + growth. - produces T3 and T4 and thyrocalcitonin

- located on thyroid gland - controls calcium + phosphorus matabolism - produces parathyroid hormone

Endocrine Flashcards by Desiree Macpherson

anterior lobe

ACTH
FSH
GH
LH
MSH
PRL
TSH

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posterior lobe

Produced by the hypothalamus, stored in posterior lobe, and secreted in blood when needed/

ADH/vasopressin
Oxitocin

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Adrenal cortex

Glucorticoids: cortisol
- STRESS

Mineralocorticoids: Aldosterone
- regulation of F+E balance by promoting sodium retention and potassium excretion.

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Adrenal gland

regulates sodium and electrolyte balance
affects carbohydrate, fat, and protein metabolism
influences development of sexual characteristics
sustains fight/flight response

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Adrenal cortex

Outer shell of adrenal gland
makes glucocorticoids + mineralcorticoids. Secretes small amounts of sex hormones (androgens and estrogens)

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Adrenal medulla

Inner core of the adrenal gland
works as part of the sympathatic nervous system
produces epinephrine + norepinephrine

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Thyroid gland

located in anterior part of the neck
controls the rate of the body metabolism + growth.
produces T3 and T4 and thyrocalcitonin

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parathyroid glands

located on thyroid gland
controls calcium + phosphorus matabolism
produces parathyroid hormone

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ovaries and testes

Ovaries:
- Located in pelvic cavity. Produces estrogen and progesterone

Testes:
- Located in the scrotum
- produces testosterone

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Negative Feedback Loop

Regulates hormone secretion by the hypothalamus and pituitary gland
increased amount target gland hormones in the blood stream DECREASE secretion of the same hormone and other hormones that stimulate its release

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Hypopituitarism

Hyposecretion of one or more pituitary hormones caused by tumors, trauma, encephalitis, autoimmunity, or stroke.

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Hypopituitarism affecting which hormones

Growth hormone (GH)
Gonadotropic hormones (LH, FSH)

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hyperpituitarism (acromegaly)

Hypersecretion of growth hormone by the anterior pituitary gland caused by pituitary tumors

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Hyperpituitarism( acromegaly) assessment

Large hands and feet
thicking + protusion of jaw
Arthritic Changes + joint pain
Visual disturbances
Diaphoresis
Oily rough skin
HTN Cardio megaly, HF
Deepening of voice
** andre the giant

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Hypophysectomy

Removal of pituitary tumor via sublabial transsphenoidal (endoscopic transsnasal)

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Complications of hypophysectomy

CSF leak
infection
diabetes inspidus
hypopituitarism

Post operative interventions

monitor VS, neurostatus, and LOC
Elevate HOB
monitor for ICP
instruct pt to avoid sneesing, coughing, and blowing the nose
monitor for bleeding

hyperthyroid causes high T3 + T4

***autoimmune disorder = graves disease
iodine excess
Levothyroxine excess = leaves too much thyroid in the body

hypothyroid causes = low T3 and T4

autoimmune disease = hashimotos = low and slow thyroid
low iodine in the diet
pituitary tumor
thyroidectomy - cannot produce any thyroid hormones

S/S of hyperthyroidism

Hypermetabolic state
-HTN
-tachycardia
-heat intolerance
-bulging eyes (exopthalamos)
-weight loss w/out trying
-insomnia
-diarrhea
-warm, dry, sweaty skin

Lab values - hyperthyroidism

T3 + T4 increased
TSH decreased - pituitary gland is trying to rein it in

Hyperthyroidism Treatment

thyroidectomy = for primary hypertyroism

Medicaitons:
- PTU
- Iodine solutions
- beta blockers: to bring down VS

Hyperthyroidism nursing care

increase pt’s calorie + protein intake (wgt loss + hypermetabolic state)
monitor I+O’s, weight, and VS
exopthalamos: tape their eyelids closed for sleep + provide eye lubricant to protect thoes eyes.

Thyroid storm

exessively high levels of thyroid hormones.
- can be from infection, stress, DKA, or thyriodectomy

Thyroid Storm S/S

- Severe HTN - CP - Dysrhythmias - Dyspnea - Delrium - Fever - N/V

Thyroid storm treatment

- Beta blockers = get VS in control - antithyroid medications? - antipyretics = treat fever

Thyroid Storm Nursing Care

- maintain patent airway - monitor for dysrhythmias

Thyroidectomy nursing care

- place pt in semi fowlers position - support their heda/neck (pillows) -do not hyperextend their neck - monitor for bleeding: check behind their neck for bleeding - monitor for S/S of parathyroid damage

S/S parathyroid damage

HYPOCALCEMIA - numbness + twitching around mouth - positive chvostek sign (cheek tap) -positive Trousseau's sign (BP cuff on arm, spams in hands + fingies) - blood test <9.5

Thyroidectomy - Pt teaching

- avoid extreme neck extension - keep head in midline position - pt will need to take thyroid replacement therapy for the rest of their lives (levothyroxine) - meds are taken on an empty stomach -

addison's disease

A disorder that occurs when the adrenal gland is unable to produce enough (glucocorticoid) cortisol and sometimes (mineralcorticoid) aldosterone

ADH and Cortisol

ADH = regulates BP through RAAS. - retains sodium but excretes potassium. Cortisol = "stress hormone" - helps deal w/ stress: illness, external stress - INCREASES blood glucose (by metabolism of sugar - breaks down fats, proteins and cards - regulates electrolytes

Cushing's Disease

increased secretion of cortisol no aldosterone involved at all (CUSHINGS = CUSHION) - an inside source producing too much cortisol (pituitary gland producing too much ACTH)

cushings syndrome

an outside cause due to medical treatment = corticoid therapy glucocorticoid therapy - prednisone

Addison's Disease - Causes

Autoimmune causing the body to attack the cortex due to: - Cancer - TB - Trauma

S/S Addison's Disease

- Fatigue + lethargy - hyperpgimentation of skin - decreased concentration + depression - hypotension - hypoglycemia - hyponatremia - hyperkalemia - salt cravings - sodium levels so low - weight loss - muscle weakness - diarrhea + nausea

S/S Cushing Syndrome/disease

- Buffalo Hump - Hirsutism - muscle wasting + osteoporosis - truncal obesity - moon face - sensitive, thin skin - hypervolemia - hypertension - hyperglycemia - hypernatremia - purple striae - hypokalemia

Addison's interventions

- monitor for hypoglycemia + hyperkalemia - give them cortisol: prednisone/hydrocortisone - report stress such as illness, surgery, or extra emotional sstress in life: increase dosage take medication as prescribed. Do not end abruptly

Cushing disease intervention

- prepare the pt for a hyphophysectomy to remove pituitary tumor - for adrenalectomy - educate about medication replacement therapy after the procedure - watch for increased CBg - watch labs for low levels of K+ - infections, skin breakdown - emotional support