Endocrine 4 Flashcards
describe diabetes insipidus
ADH insufficiency (posterior pituitary) water metabolism problem lose fluid (4-10 L a day) *pt randomly loses liters of pure water
what is DI usually the result of
result of trauma to head and tumor or craniotomy
ADH is inhibited
manifests r/t dehydration
urine is very diluted (low specific gravity <1.005)
DI
manifestations of DI
excessive thirst cardiac loss (K/Na) urinary output renal/urinary skin (poor skin turgor, dry membrane) dehydrated, confused concentrated blood
interventions for DI
replace hormone vasopressin (ADH) besmopressin acete (DDAVP)- ADH teach pt to weigh self daily never deprive fluids >24 hr
main nursing care for DI
replace/monitor fluid
neuro status
vital signs
describe what SIADH is
too much ADH
what occurs in SIADH
retain a lot of water dilutional hyponatremia may be result of head injury GI disturbance wt gain
what does urine look like in SIADH
decreased volume
increased specific gravity
concentrated urine
what does plasma look like in SIADH
increased volume
dilatation
decreased sodium
interventions for SIADH
monitor for fluid overload
diuretics
safe environment
neurologic assessment changes
what is a safe environment for SIADH
risk for seizure due to Na levels
describe acromegaly
too much GH in pituitary
remove/manipulate pituitary
assess nasal drainage
watch for signs of DI
describe hypopituitarism
deficiency of 1 or more anterior pituitary hormones
panhypopituitarism
life threatening
panhypopituitarism
decrease production of all anterior pituitary hormone
why is hypopituitarism life threatening
deficiency of gonadotrpoins and GH
describe hyperpituitarism
hormone oversecretion (due to turmors) overproduction of GH
what does overproduction of GH lead to
gigantism and acromegaly
what is treated with parlodel, dostinex, and permax
gigantism
what is treated with sandostatin, somavert, bromocriptine
acromegaly
what is the treatment of hyperpituitarism
hypophysectomy (removal of pituitary and tumor)
post op of hypophysectomy
*assess nasal drainage check for glucose could be CSF *avoid coughing directly after avoid bending/strain during stool *HOB elevated avoid brushing *major risk of diabetes insipidus is shock
complications of hyperpituitarism
cardiac and respiratory problems and diabetes
s/s of hyperpituitarism
enlarged pituitary headache and visual changes slanting forehead coarse facial features menstrual changes
thyroiditis
thyroid tissue is destroyed
autoimmune
triggered by infection
Hashimoto’s
what does hyperparathyroid equal
hypercalcemia and hypophosphalemia (increase Ca and decreased phosphorous)
Ca and phosphorus have an ______ relationship
inverse
when you see para think _____
calcium
what occurs in hyperparathyroid in relationship to Ca
hypercalcemia
PTH pulls calcium from bone and places in blood
INCREASES serum calcium
what does hypercalcemia cause
reduces bone density
renal calculi
education for hyperparathyroid pt
AVOID OTC meds with Ca
drink fluids
maintain active
calcium acts like a _______
sedative
s/s of hyperparathyroid
HTN
psychosis
muscle weakness
renal calculi
hyperparathyroidism therapy
aledronate (Fosamax)- inhibits bone reabsorption
Cinacalcet- reduces PTH release
s/s of hypoparathyroid
tetany
muscle spasms
hyperactive reflexes
hypoparathyroid therapy
dietary supplements
need Ca and vitamin D
post op thyroidectomy
comfort measure assess pain semi fowlers potential complications keep emergency equipment
post op adrenalectomy
periodic turning coughing, deep breathing vital signs intake/outake *asepsis during procedure
