Endocrine 3 Flashcards
what is the MAJOR mineralocorticoid
ALDOSTERONE
what is the role of aldosterone
RETAIN sodium and water and LOSE potassium
too much aldosterone results in
FLUID VOLUME EXCESS
too little aldosterone results in
RETAIN K
FLUID VOLUME DEFICIT
what are the sex hormones
testosterone and progesterone
increase in sex hormones results in
acne, irregular menstruation, hirsutism
decrease in sex hormones results in
decreased axillary/pubic hair, decreased libido
4 components of Addison’s
1) not enough steroids
2) risk of SHOCK
3) hypercalcemia
4) hypoglycemia
what is the main problem with Addison’s
adrenocortical insufficiency (not enough steroids)
what is okay to increase in Addison’s pt
Salt in diet so fruit juice and broccoli are okay
what occurs in Addison’s pt (electrolyte)
- lose sodium and water
- retain/increase serum K due to decreased aldosterone
what must an Addison’s pt do daily
weigh themselves
indicators of adrenal crisis
profound fatigue dehydration vascular collapse (decrease BP) decreased Na increased K
s/s of addison’s
depression hypoglycemia postural hypotension wt loss/ anorexia weakness/fatigue GI disturbance tachy bronze color
treatment of Addison’s
replace both steroids (glucocorticoids and mineralocorticoids)
glucocorticoid treatment
Prednisone
- give 2x a day, split dose
- 2/3 in morning and 1/3 at night
mineralocorticoid treatment
Fludrocortisone
aka aldosterone
education with Addison’s meds
-daily wt cheks and BP checks
-report wt gain >5 lbs
-will be on this med for rest of life
do NOT abruptly stop taking meds
when Addison’s meds are taken…
glands stop producing steroids (dangerous to stop meds abruptly)
can cause an addisonian crisis
explain an addisonian crisis
acute onset of hypotension
vascular collapse
x100 worse than addisons
can lead to shock (loss of volume)
main problem with cushing’s syndrome
too many steroids
what occurs in cushing’s
fluid volume excess (retention of Na and water)
-leads to edema
potassium levels in cushing’s
decreased due to increased aldosterone
describe steroids in relationship to Ca
steroids increase the uptake of Ca, excreted through GI tract
how does body compensate for steroids increased Ca uptake
-body compensates by pulling Ca from bone to blood (causing osteoporosis)
blood work on a pt with cushings would show…
high corticosteroid level
s/s of cushings
hyperglycemia personality changes *moon face increased infection risk osteoporosis Na and fluid retention thin extremities GI distress thin skin bruises, petechiae obesity
what is the opposite of cushings
addisons
surgical treatment of cushings
adrenalectomy (unilateral or bilateral)
if total adrenalectomy what is needed
lifetime supply of steroid (meds)
cushings pt cannot handle _____
stress, needs a quiet environment
diet for cushings
diet: NO extra sodium (should decrease)
- increase protein, potassium, and calcium in diet
other treatment for cushings
fluid restriction (watch intake/output)
stop production of ACTH (want to decrease corticosteroid secretion)
get wt daily
compare cushings and conns
cushings=too much of ALL steroids
conns= ONLY too much mineralocorticoid (aldosterone)
describe what ADH does
antidiuretic HOLS fluid (just water)
alcohol naturally inhibits ____
ADH
describe how alcohol affects ADH
inhibits it so makes you pee a lot (clear, dilute)
dehydrates you-results in vasoconstriction
what is the opposite of SIADH
diabetes insipidus
