Endocrine Flashcards
What is the role of the endocrine system?
Orchestrates cellular interactions for metabolism, growth, reproduction, aging, and response to adverse conditions
What are the major hormone-secreting glands?
- Pituitary Gland
- Thyroid Gland
- Parathyroid Glands
- Adrenal Glands
What hormones are secreted by the anterior pituitary gland?
- Follicle Stimulating Hormone (FSH)
- Luteinizing Hormone (LH)
- Prolactin
- Adrenocorticotropic Hormone (ACTH)
- Thyroid Stimulating Hormone (TSH)
- Growth Hormone (GH)
What conditions are associated with hypersecretion from the anterior pituitary gland?
- Cushing’s syndrome
- Acromegaly (Gigantism)
What conditions are associated with hyposecretion from the anterior pituitary gland?
- Addison’s Disease
- Dwarfism
- Panhypopituitarism (failure to produce all hormones)
What hormones are secreted by the posterior pituitary gland?
- Antidiuretic Hormone (ADH); also called Vasopressin
- Oxytocin
What conditions are associated with hypersecretion from the posterior pituitary gland?
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
What conditions are associated with hyposecretion from the posterior pituitary gland?
Diabetes Insipidus (DI)
What is Diabetes Insipidus (DI)?
ADH deficiency causing excretion of large amounts of dilute urine and extreme thirst
What are the types of Diabetes Insipidus?
- Central (brain tumor)
- Nephrogenic (kidney injury)
- Dipsogenic (defect in hypothalamus)
- Gestational (pregnancy induced)
How is Diabetes Insipidus diagnosed?
Daily weight, strict I&O, specific gravity & osmolality of urine, increased serum osmolality, elevated serum sodium levels, plasma ADH levels.
What is the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)?
Failure of negative feedback system regulating ADH secretion, causing fluid retention and hyponatremia
What are the diagnostic tests for thyroid function?
- TSH
- Serum-free T4
- T3 and T4
- T3 resin uptake
- Thyroid antibodies
- Radioactive iodine uptake
What are causes of hypothyroidism?
- Autoimmune disease
- Atrophy of thyroid gland
*Infiltrative diseases - Iodine deficiency, excess, or compounds
- Medications
- Radioactive iodine
- Hyperthyroidism therapy
- Thyroidectomy
- Radiation to head/neck
What are the clinical manifestations of hypothyroidism?
- Lethargy/impaired memory
- Course, dry, brittle hair
- Loss of lateral eyebrows
- Pallor
- Large tongue
- Periorbital edema
- Cold intolerance
- Slow pulse
- Weight gain
- Muscle weakness/aches
What are causes of hyperthyroidism?
- Graves disease (most common)
- Thyrotoxicosis: excessive output of thyroid hormone
What are the clinical manifestations of hyperthyroidism?
- Nervousness
- Rapid pulse
- Heat intolerance
- Tremors
- Skin flushed, warm, soft, and moist
- Exophthalmos
- Increased appetite
- Weight loss
What is hyperparathyroidism?
Over production of parathormone = bone decalcification and development of renal calculi (kidney stones).
What are causes of hypoparathyroidism?
Abnormal parathyroid development
Destruction of the parathyroid glands (surgical removal or autoimmune response)
Vitamin D deficiency
What are diagnostics for hypoparathyroidism?
Low serum calcium levels <8 mg/dL and high serum phosphate levels.
What are clinical manifestations of hypoparathyroidism?
- Tetany (muscle spams/tremors)
- numbness
- tingling in extremities
- stiffness of hands and feet
- broncho, larngeal, carpodeal (hands and feet) spasms
- anxiety, irritability, depression, delirium
- ECG changes
What is Addison’s disease?
Adrenal insufficiency resulting in insufficient steroid production by the adrenal glands
What are the clinical manifestations of Cushing’s syndrome?
- Hyperglycemia
- Central-type obesity
- Fragile skin
- Muscle wasting
- Hypertension
- Moon face
What is the primary function of parathormone (PTH)?
Regulates calcium and phosphorus balance in the body
What are the clinical manifestations of hyperparathyroidism?
- Apathy
- Fatigue
- Muscle weakness
- Nausea
- Vomiting
- Constipation
- Hypertension
What is tetany?
General muscle hypertonia with tremor and spasmodic contractions
What are Chvostek and Trousseau signs?
- Chvostek: Spasm/twitching of facial muscles upon tapping the facial nerve
- Trousseau: Carpopedal spasm induced by occluding blood flow to the arm
What medications can alter thyroid function test results?
- Amiodarone
- Aspirin
- Cimetidine
- Diazepam
- Estrogens
- Furosemide
- Glucocorticoids
- Heparin
- Lithium
- Phenytoin
- Propranolol
- Methimazole
What role does TSH play in thyroid hormone release?
TSH from the anterior pituitary controls the release of thyroid hormone
What is the typical age range for primary hyperparathyroidism?
Median age 60-70 years
What is the diagnostic test for Addison’s disease?
Adrenocortical hormone levels, ACTH levels, ACTH stimulation test
What are the nursing management strategies for patients with Diabetes Insipidus?
- Monitor vital signs
- Strict I & O
- Patient education on symptoms of hyponatremia
What is the recommended management for SIADH?
- Fluid restriction
- Surgical removal of tumors if applicable
- Hypertonic IV fluids for severe hyponatremia
What is a key characteristic of SIADH?
Fluid retention and dilutional hyponatremia
What is the medical management for SIADH when caused by a tumor?
Surgical removal of the organ or tumor
What is the purpose of fluid restriction in SIADH management?
To limit retained water in kidneys and sodium levels
What medication is commonly used in the management of SIADH?
Furosemide
What intravenous fluid is used for severe hyponatremia in SIADH?
Hypertonic IVFs (3% NaCl)
What is the nursing management for SIADH?
Strict I & O’s, daily weights, monitor urinalysis and CMP/BMP, assess neurologic status
What needs to be monitored for hypothyroidism?
TSH and FT4 levels
What is the synthetic hormone replacement for hypothyroidism?
Levothyroxine 75-150 mcg per day
What are potential complications of untreated hypothyroidism?
- Cardiac dysfunction
- Increased serum cholesterol
- Atherosclerosis/CAD
- Angina
- Arrhythmias
- Myxedema/coma
What are the signs of myxedema in hypothyroidism?
- Decreased LOC
- Decreased vital signs
- Difficulty to arouse/awake
What dietary recommendations are made for patients with hypothyroidism?
High fiber diet and encourage fluids
What is the primary treatment for hyperthyroidism?
Radioactive 131I therapy
What medications are used in the management of hyperthyroidism?
- Propylthiouracil
- Methimazole
- Sodium or potassium iodine solutions
- Dexamethasone
- Beta-blockers
What is the nursing management goal for patients with hyperthyroidism?
Maintain adequate cardiac output
What are the symptoms of hyperparathyroidism?
- Apathy
- Fatigue
- Muscle weakness
- Nausea/vomiting
- Constipation
- Hypertension
- Cardiac arrhythmias
What is a treatment goal for hyperparathyroidism?
Increase serum calcium levels to 9-10 mg/dL
What should be monitored for
in patients with hypoparathyroidism?
- Tetany
- Chvostek’s sign
- Trousseau’s sign
- Seizures
- Respiratory difficulties
What dietary recommendations are made for patients with hypoparathyroidism?
High calcium and vitamin D, low phosphorus
What is the treatment of choice for thyroid cancer?
Thyroidectomy
What is a key preoperative goal for thyroid surgery?
Reduction of stress and anxiety to avoid thyroid storm
What should be monitored postoperatively after thyroidectomy?
- Airway/breathing
- Hemorrhage/hematoma
- Serum calcium levels
What is a key treatment goal for Addison’s disease?
Combat circulatory shock and restore blood circulation
What should be monitored for in Cushing’s syndrome?
Addisonian crisis after surgery or withdrawal of steroids
What is a common intervention for managing Cushing’s syndrome?
Surgical removal of the pituitary gland (Hypophysectomy)
What are the signs of an Addisonian crisis?
- Rapid, weak pulse
- Rapid respiratory rate
- Pallor
- Extreme weakness
Fill in the blank: The treatment for severe hypocalcemia in hypoparathyroidism is _______.
Calcium gluconate
True or False: A nodular goiter can become malignant (cancerous) or cause a hyperthyroid state.
True
What is the recommended fluid intake for patients with hyperparathyroidism?
Greater than 2000 mL/day
What is a critical postoperative care consideration after thyroid surgery?
Monitor airway/breathing due to potential edema or injury
