Endocrine Flashcards
anterior lobe
ACTH
FSH
GH
LH
MSH
PRL
TSH
posterior lobe
Produced by the hypothalamus, stored in posterior lobe, and secreted in blood when needed/
- ADH/vasopressin
- Oxitocin
Adrenal cortex
Glucorticoids: cortisol
- STRESS
Mineralocorticoids: Aldosterone
- regulation of F+E balance by promoting sodium retention and potassium excretion.
Adrenal gland
- regulates sodium and electrolyte balance
- affects carbohydrate, fat, and protein metabolism
- influences development of sexual characteristics
- sustains fight/flight response
Adrenal cortex
- Outer shell of adrenal gland
- makes glucocorticoids + mineralcorticoids. Secretes small amounts of sex hormones (androgens and estrogens)
Adrenal medulla
- Inner core of the adrenal gland
- works as part of the sympathatic nervous system
- produces epinephrine + norepinephrine
Thyroid gland
- located in anterior part of the neck
- controls the rate of the body metabolism + growth.
- produces T3 and T4 and thyrocalcitonin
parathyroid glands
- located on thyroid gland
- controls calcium + phosphorus matabolism
- produces parathyroid hormone
ovaries and testes
Ovaries:
- Located in pelvic cavity. Produces estrogen and progesterone
Testes:
- Located in the scrotum
- produces testosterone
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
Hypopituitarism
Hyposecretion of one or more pituitary hormones caused by tumors, trauma, encephalitis, autoimmunity, or stroke.
Hypopituitarism affecting which hormones
Growth hormone (GH)
Gonadotropic hormones (LH, FSH)
hyperpituitarism (acromegaly)
Hypersecretion of growth hormone by the anterior pituitary gland caused by pituitary tumors
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
Hypophysectomy
Removal of pituitary tumor via sublabial transsphenoidal (endoscopic transsnasal)
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
