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LPN > Endocrine > Flashcards

Endocrine Flashcards

1
Q

what does the anterior pituitary secrete

A 
Growth 
Thyroid Stimulating
Adrenocorticotropic
Follicle-stimulating
Luteinizing
Prolactin
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2
Q

what does the posterior pituitary secrete

A

Antidiuretic

Oxytocin

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3
Q

growth hormone (anterior pituitary)

A

AKA: GH
Target: Most tissue
Action: Stimulates growth by promoting protein synthesis and fat metabolism

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4
Q

Thyroid-stimulating

A

AKA: TSH
Target: Thyroid Gland
Action: Stimulates thyroid hormone secretion and thyroid gland growth

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5
Q

Follicle Stimulating

A 
AKA: FSH
Target: Ovaries /seminiferous tubules
Action: 
Follicle maturation/estrogen secretion
Spermatogenesis
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6
Q

Luteinizing

A 
AKA: LH
Target: Ovaries /testes
Action: 
Ovulation/progesterone production
Testosterone production
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7
Q

Antidiuretic Hormone

A 
AKA:  ADH
Stored:  PPG
Produced:  Hypothalamus
Target: Kidneys
Action:  Decreases urine production
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8
Q

Oxytocin

A

Stored: PPG
Produced: Hypothalamus
Target: Uterus/Mammaries
Action: Uterine contraction & Milk ejection

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9
Q

Thyroxine & Triiodothyronine

thyroid

A

AKA: T3 & T4
Target: Most body cells
Action: Metabolism, G&D

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10
Q

Calcitonin

thyroid

A

Target: Bone
Action: Inhibits bone breakdown and decreases blood calcium

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11
Q

Parathyroid hormonoe

A 
AKA:  PTH
Target: Bone, Kidney, GI
Action:  Increases blood Ca+
Increasing bone breakdown
Increasing GI absorption of Ca+
Decreasing urine excretion of Ca+
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12
Q

Thymosin

thymus

A

Target: Immune Response Tissue

Action : Immune system development and function

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13
Q

Melatonin

pineal gland

A

Target: Hypothalamus
Action: Inhibits gonadotropin-releasing hormone
Inhibits reproduction
Regulates daily rhythms

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14
Q

Mineralocorticoids

adrenal cortex

A

AKA: aldosterone
Target: Kidney
Action : Increases Na+ and H20 absorption

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15
Q

Glucocorticoids

adrenal cortex

A 
AKA:  cortisol
Target: Most Body Cells
Action : 
Increases blood glucose 
Inhibits inflammation 
Immune response
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16
Q

Androgens

adrenal cortex

A

AKA: Testosterone & Estrogen (gonadotropins)
Target: Most Body Cells
Action : Sex characteristics and reproduction

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17
Q

Catacholamines

adrenal medulla

A 
AKA:  Epinephrine & Norepinephrine
Target: Heart, vessels, liver, adipose tissue
Action :  Stress response
Increased HR, BP, RR, BG
Increased skeletal muscle perfusion
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18
Q

Glucagon

pancreas

A

Target: Liver

Action : Increases blood glucose by increasing glycogen breakdown in liver

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19
Q

Insulin

A

Target: Liver, skeletal muscle, adipose tissue

Action : Decreases blood glucose by increasing cellular uptake and metabolism of glucose.

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20
Q

rapid acting insulin

A

aspart (NovoRapid)
glulisine (Apidra)
lipsro (Humalog)

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21
Q

short acting insulin

A

regular (Humalin R and Novolin grToronto)

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22
Q

Intermediate acting insulin

A

NPH (Humalin-N and Novolin geNPH)

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23
Q

Long lasting insulin

A

detemir (Levimir)

glargine (Lantus)

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24
Q

what is the action and uses of insulin

A

Action
Transports glucose molecules into the cells
Uses
Type 1 Diabetes
Type 2 Diabetes when uncontrolled with oral agents
Diabetic Ketoacidosis
Hypokalemia (when given with glucose)

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25
Q

Adverse Reactions of insulin

A

Hypoglycemia

Hyperglycemia

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26
Q

Contraindications and Precautions

A

C:Hypersensitivity to drug and Hypoglycemia
P:Renal impairment
Hepatic disease
Pregnancy & lactation

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27
Q

Sulfonylureas examples?

A

glyburide, glipizide

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28
Q

Sulfonylureas actions and uses

A

A:Stimulate beta cells in pancreas to produce insulin
Uses
Type 2 Diabetes
Patients with responsive beta cells

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29
Q

adverse reaction of sulfonylureas

A

Hypoglycemia

Anorexia, nausea, vomiting, epigastric pain, weight gain

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30
Q

Contraindications of sulfonyureas

A

DKA, infection, renal impairment

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31
Q

nonsulfonylureas examples

A

metformin

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32
Q

nonsulfonylureas uses and action

A

A: Affects circulating insulin by reducing glucose production in the liver, slowing GI absorption of carbs, and decreasing tissue insulin resistance
Uses
Type 2 Diabetes
Patients with insulin resistance

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33
Q

nonsulfonylureas adverse reactions?

A

Metallic taste, bloating, cramping, flatulence

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34
Q

contraindications for nonsulfonyllureas

A

Heart failure
Renal disease
>80
Pregnancy

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35
Q

pharmacology GH example?

A

somatropin

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36
Q

Pharmacology-
Growth Hormone
action and uses

A

Children: Produces skeletal growth in with open epiphyseal plates
Adults: Supplement natural GH production
Uses
Children: promote growth in GH deficiency
Adults: Chronic renal failure, HIV, or pituitary disease

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37
Q

Pharmacology-

Growth Hormone adverse reactions

A

Hypothyroidism
Insulin resistance
Swelling, joint pain, muscle pain

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38
Q

Pharmacology-

Growth Hormone contraindications and precautions

A

C:Hypersensitivity to drug
Epishyseal closure
Pituitary tumor

P:Thyroid disease
Diabetes
Pregnancy & Lactation

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39
Q

Pharmacology-

Gonadotropins Examples

A

Gonadropropin, clomiphene, cetrorelix, nafarelin

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40
Q

Pharmacology-

Gonadotropins actions and uses

A

Action: Supplements natural hormone production
Uses: Women: Induce ovulation
Boys: Cryptorchism,
Men: Induce sperm production

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41
Q

Pharmacology-

Gonadotropins adverse reactions

A 
Hotflashes
Breast tenderness
Hemoperitoneum
Nausea, Vomiting
Headache, irritability, restlessness
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42
Q

Pharmacology-

Gonadotropins contraindication and precautions

A 
C: Hypersensitivity to drug
Thyroid dysfunction
Adrenal dysfunction
Liver disease
Ovarian cysts
Hormone driven cancers
Pregnancy
P: Epilepsy
Migraines
Asthma
Cardiac dysfunction
Lactation
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43
Q

Pharmacology-Vasopressin Examples

A

vasopressin, desmopressin

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44
Q

Pharmacology-Vasopressin action and uses

A

Action: Regulates reabsorption of water by the kidneys
Secreted by pituitary when water must be conserved
Uses: Diabetes insipidus
Preventing/treating postop abdominal distention & gas

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45
Q

Pharmacology-Vasopressin adverse reactions

A

Tremor, sweating, vertigo
Nasal congestion
Nausea, vomiting, abdominal cramps
Water intoxication (in overdose)

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46
Q

Pharmacology-Vasopressin contraindication and precautions

A

C: Hypersensitivity to the drug

P: History of seizures
Migraine headaches
Asthma
Congestive heart failure
Pregnancy & lactation
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47
Q

Pharmacology-
Antithyroid Drugs Example
action and uses

A

Methimazole, radioactive iodide

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48
Q

Pharmacology-

Antithyroid Drugs

A 
Action
Inhibits thyroid hormone production
Uses
Hyperthyroidism
Thyroid cancer
49
Q

Pharmacology-
Antithyroid Drugs
adverse reactions

A 
Cold symptoms
Nausea, vomiting
Paresthesias
Agranulocytosis
Hepatitis
50
Q

Pharmacology-
Antithyroid Drugs
contraindication and precautions

A

C: Hypersensitivity to the drug
Breastfeeding
I-131 – pregnancy and lactation

P: Pregnancy
Oral anticoagulants

51
Q

Pharmacology-Thyroid Hormones Exapmples

A

levothyroxine

52
Q

Pharmacology-Thyroid Hormones action and uses

A

Action
Supplement natural hormone production
Uses
Hypothyroidism

53
Q

Pharmacology-Thyroid Hormones adverse reactions

A

Signs of hyperthyroidism

54
Q

Pharmacology-Thyroid Hormones contraindication and precautions

A

C: Hypersensitivity to drug
Adrenal cortical insufficienty
Hyperthyroidism
P: Cardiac disease & lactation

55
Q

Pharmacology-Corticosteroids Examples

A

Mineralocorticoid: fludrocortisone
Glucocorticoid: cortisone, prednisone

56
Q

Pharmacology-Corticosteroids action and uses

A 
Action
Supplement natural hormone production
Uses
Addison’s disease
Inflammatory disorders (RA, allergies, etc)
57
Q

Pharmacology-Corticosteroids adverse reactions

A 
Fluid/Lyte disturbances
Blood sugar elevation
Weight gain
Buffalo hump
Oily skin and acne
58
Q

Pharmacology-Corticosteroids contraindication and precautions

A

C: Hypersensitivity to drug
Serious infections

P: Renal disease
Hepatic disease
Hypothyroidism
GI disease
Pregnancy
Administration of certain vaccines
59
Q

prediabetic mellitus?

A

leads to type two, heart and stroke prob.
impaired fasting glucose –> 100 to 125
impaired glucose tolerance –> 140-199 lasting 2h
can treat with wt. loss and increase activity

60
Q

hyperglycemia

A

elevated blood glucose lvl.
pancreatitis
cushing syndrome–> adrenocorticoids excessive
gluccorticoids
loop diuretics, levadopa, oral contraceptives,TPN

61
Q

Type one diabetes mellitus patho/etiology

A

insulin dependent
autoimmune
absent insulin production by beta cell in islets of pancreas
usually develop in childhood can breakdown fats and protein instead of glucose = ketones

62
Q

Type two diabetes mellitus patho/etiology

A

non-insulin dependent
insulin resistance or insufficient insulin production
more common in adults (40-64) and obese kids

63
Q

assessment for diabetes mellitus?

A 
glycosuria or blood glucose of >180
kussmauls'r resperations
POLYURIA
POLYDIPSIA
POLYPHAGIA
64
Q

Signs and symptoms of diabetes mellitus

A

Type 1 –> abrupt
Type 2–> gradual
wt. loss, weakness, thirst, fatigue, dehydration and change in visual acuity

65
Q

Diagonistic for diabetes mellitus

A

develop infection easily (increase glucose =bacterial growth)
glucose may be detected in urine –> ketones
blood sugar –>before 90-130 and >180 after meals
glycosylate hemoglobin increase should be (

66
Q

medical management for diabetes mellitus

A 
diet/wt. loss
exercise
insulin
oral anti-diabetic agents
adjuvent drugs
pancreas transplant
islet cell transplant
67
Q

Nursing management for diabetes mellitus

A

med. and allergy hx, symptoms and duration, drug regimen, monitor blood glucose/urine, consult with diet,
check for change in skin, vital signs, edema, visual acuity, muscle atrophy or loss of sensation

68
Q

Diabetic ketoacidosis

A

a type of metabolic acidosis, occurs when there is an acute insulin deficiency or inability to use whatever insulin the pancreas secretes

69
Q

patho/etiology od DKA

A

can be triggered by infection
has ketones in urine
when amt of glucose transported across the membrane decreases the liver increases production of glucose –> excessive H20, K+, Na+ to be excreted

70
Q

Medical management of DKA

A

reduce blood glucose,, correct F/E imbalance, clear urine of ketones
IV insulin or isotonic fluids
watch so don’t end up hypoglycemic

71
Q

Nursing management of DKA

A

monitor IV, vital signs, blood glucose and urine, I&O

check cardiac leads–> heart conduction

72
Q

Hyperosmolar Hyperglycemic Nonketoic Syndrome

A

an acute complication of diabetes—> hyperglycemic without the ketones blood glucose over 500 but ph is normal

73
Q

patho/ etiology of HHNS?

A

serious illness where metabolic needs exceed the limit of available insulin. Fluid move form intra to extracellular, diuresis occurs with subsequent loss of Na+ and K+
more common: undiagnosed DM, older adults with type 2, drugs that elevate glucose, kidney dialysis, & TPN

74
Q

Assessment findings of HHNS

A

hypotension, mental changes, extreme thirst, dehydration, tachycardia, possible fever, increse BG, paralysis lethargy, coma, seizures, S/S hypoNa+ and K+

75
Q

Medical managment of HHNS

A

administer insulin, correct F/E imbalance,

76
Q

Nursing managemetn of HHNS?

A

measure blood glucose, assesses for F/E, assess for dehydration, observe neurological and cognitive function, protect if cognitive impair

77
Q

hypoglycemia patho/etiology?

A

to much insulin in the blood stream
caused from: not eating and still taking insulin, not eating sufficient cal, or exercise more than usual possible with alcohol intake

78
Q

assessment finding for hypoglycemia

A

weakness, headache, nausea, drowsiness, nervousness, hunger, tremors, personality change, double vision has rapid onset and if not treated –> coma or seizures

79
Q

Medical managmetn of hypoglycemia

A

15g of simple carbohydrates ASAP
if unconscious use glucose gel
do twice if unresponsive Dr. –> glucogan

80
Q

Peripheral Neuropathy

A

pathological changes in nerves can affect motor, sensory, and autonomic nerves 10 or more years

81
Q

patho/etiology of peripheral neuropathy

A

poor glucose control

motor: muscle atrophy, feet widen, deformities change in gait
sensory: parasythesis, abnormal sens. loss of feeling
autonomic: slows food in stomach, affects bladder, and orothstatic hypotension

82
Q

peripheral neuopathy assessment findings

A

pain, skeletal muscle small, feet swell, dizziness, disturbed sensation, digestion, urinary, or sexual dysfunction

83
Q

medical management of peripheral neuopathy

A

diet/exercise, medication control, several meds can reduce pain , TENS, elastic compression stocking, urinate q3h

84
Q

Nursing management of peripheral neuopathy

A

teaching: inspect foot, wash feet, dry thoroughly between toes, toenail short and straight across, use moisturizer, well fitting shoes, call if cut of foot

85
Q

diabetic retinopathy

A

refer to the progressive decrease in renal function that occurs with diabetes mellitus (usually type 1)

86
Q

patho/etiology of diabetic retinopathy

A

glomerular deterioration resulting in impaired filtration of blood during urine formation

87
Q

assessment finding of diabetic retinopathy

A

inadequate glucose control, vision changes, can cause blindness, and edema

88
Q

medical managment of diabetic retinopathy

A

yearly eye checks, ACE inhibitors, seal leakeage in retina blood vessels, vitectomy, ovinehyaluronidase to clear vision

89
Q

nursing managment of diabetic retinopathy

A

therapeutic regimen

explain purpose, explain symptoms and when to report

90
Q

vascular disturbances

A

affect many tissue and organs more susceptible to atherosclerosis and atherosclerosis

91
Q

patho/etiology of vascular disturbances r/t

A

thicken of atrial walls, coronary artery disease is increased, brain may be insensitive to leptin–>over eating

92
Q

assessment findings for vascular disturbances r/t DM

A

pale, cool skin, leg cramps, gangrene, skin ulcer, chest discomfort, MI at earlier age, hyperlipidemia,

93
Q

Medical management of vascular disturbances rt DM

A

lipid lowering measures,, low fat diet, exercise, medication, drugs that reduce platelet aggregation, no smoking, amputation of gangrene, closely monitor BG

94
Q

nursing mangagment for vascular disturbances r/t DM

A

medical proficient, individualized care r/t S/S, check BC regularly, comfort care.

95
Q

Diabetic Insipidus

A

excretion of extremely large volumes of urine
Neuogenic–> secretion of ADH is norm
Central–> renal tubules partially or completely fail –> insufficent ADH

96
Q

patho/etiology of Diabetic Insipidus (Central)

A

ADH regulates absorption of water in kidney tubules, increased circulation fluid- released to responce of thirst, fluid/volume lost –> lowers B/P, ADH incrases B/P by signally peripheral arterioles to constict

97
Q

patho/etiology of diabetic insipidus (neurologic)

A

ADH (lack) –> large vol. of diluted urine–> dehydration with F/E loss
head trauma, brain tumor, or after hypophysectomy, lithium, demeclocycline, amphoterician B or elevated prostglandin E

98
Q

assessment finding of diabetic insipidus?

A

20L/day or diluted urine (specific gravity 1.002 or less)

thirst is excessive, limited activity, weakness, dehydration, wt. loss

99
Q

diagnostic of diabetic insipidus?

A

fluid deprivation test (withhold fluids for 5 to 6 hours) then test urine volume and osmolarity
or
give demopressin -> if urine becomes more concentrated symptoms are from ADH if it continues it is nephrogenic

100
Q

medical management of diabetic insipidus?

A

IV fluids if cannot take in adequate oral
nephrogenic DI–> HCP reduces amt of excreted Na+ gives thiazide, spiruolactone prevent hypokalemia
restrict intake of protein to decrease work of kidneys

101
Q

nursing managment of diabetic insipidus?

A

correct fluid imbalance, watch I&O, measure urine q 30min, daily wt., consume sufficient fluids, teach to conserve fluids (air conditionor)

102
Q

patho/etiology of acromegaly

A

GH over secreted after the long bones have sealed. Pituitary insensitive to feedback inhibiting horomones such as somotostatin and insulin –> stimulating bone growth and enlarged organs

103
Q

assessment findings of acromegaly

A

increase blood glucose, hyperlipemia, huge bones, thick tongue/lips, heart liver and spleen enlarged, muscle weakness, masculine features

104
Q

what is medical managment of acromegaly

A 
surg--> hypophysectomy
radiation treatment (4-6wk), if pituiatry is removed need replacement drugs
105
Q

Nursing management of acromegaly

A

help cope with physical changes, pace activities, relieving discomfort, evaluate pain, encourage self-care, check increased cranial pressure, monitor drainage, avoid drinking from straw

106
Q

panhypopituitarism (simmond’s disease) patho/etiology

A

rare, events such as post partum emboli, hemorrhage, surgery or tumor, can be from TB affects all the hormones of anterior pituitary

107
Q

panhypopituitarismm assessment findings

A

gonads atrophy, s/s hypothyroidism, hypoglycemia, adrenal insuffiency, ages prematurely, pale,

108
Q

medical management of panhypopituiarism

A

replacement hormone
if untreated its fatal
GH necessary for children

109
Q

Nursing managment of panhypopituitarism

A

administer ALL meds as prescribed, adhere to med, monitor blood lvls, assess mental status, emotional state, energy level, and appitite (4-6 sm. meals)

110
Q

Syndrome of Inappropraite Antidiuretic Hormone Secretion patho/etiology?

A

renal absorption rather than excretion
causes –> lung tumor, CNS disorder, brain tumor, head trauma or drugs such as (vasopressin, general anesthetic agents, oral hypoglycemics, tricyclin antidepressants)
*Na+ and osmolarity decreased Urine one are increased

111
Q

SIADH assessments findings?

A

water retaining, headache, muscle cramps, anorexia, N/V, muscle twitching, change in LOC

112
Q

SIADH medical managment?

A

treament aimed at underlying cause, osmotic diuretics (mannitol), loop diuretic(furosemide), severe hyponatremia, 3%Sodium chloride solution

113
Q

Nursing managmenent of SIADH?

A

closely monitor I&Oand vitals, carely assess LOC, check for fluid overload(confusion, pulmonary congestion, hypertension), check for hyponatremia(weakness, cramps, anorexia, N/V, irritability, headache, wt gain without edema), inform medication and compliance

114
Q

Hyperthyroidism (Grave’s disease) patho/etiology

A

no etiology –> may be autoimmune accompanies thyroid tumors, pituitary tumors, hypothalmic tumors
results from stres, infection, increased metabolism rate because over secretes T3 and T4

115
Q

Graves disease assessment findings

A

restlessness, highly excitable, fine tremors, cannot tolerate heat, has increased appitite but experiances wt. loss, visual changes, bulging eyes (exopthamas), incrase neck swelling

116
Q

Medical management of grave’s disease?

A

antithyroid drugs, potassium iodine, radiation, subtoatl thyroidectomy, partial or total

117
Q

Diagnositic of graves disease?

A

protein bound iodine, FT3 and T4 are elevated, TSH decrased

118
Q

Nursing management of graves disease?

A

monitor HR and B/P, sleep pattern, daily wt., promote rest, increase caloric intake, take while for drugs to work, encourage frequent meals, after treatement adjustment to drugs are need

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