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Nursing 232- Exam 2 > Endocrine - Adrenals > Flashcards

Endocrine - Adrenals Flashcards

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1
Q

What are the 3 types of hormones released by Cortex (Adrenal gland). Give example(s) of each.

A

(MSG)

  • Mineralocorticoids - ex. Aldosterone
  • Sex hormones - ex. Estrogen/Testosterone
  • Glucocorticoids - ex. cortisol/cortisone
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2
Q

The medulla (Adrenal gland) produces hormones known as _______. Give two examples.

A
  • Catecholamines

* Epi and Norepi

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3
Q

Aldosterone is associated with ____reabsorption and ___excretion. What stimulates aldosterone? What system is this?

A
  • Na reabsorption and K excretion
  • Low Na and High K, stimulate aldosterone
  • Renin-angiotensin system
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4
Q

excess adrenocorticoids (gluco, mineral, sex hormones)– particularly ______. This is known as ______. What adrenal gland does this affect?

A
  • Cortisol
  • Cushings syndrome
  • Cortex
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5
Q

physical appearance of someone with cushings syndrome? (6 things)

A
  • Truncal obesity w/thin limbs (muscle wasting)
  • Round moon face
  • hirsutism, thin skin w/ acne
  • Buffalo hump
  • Pendulous abdomen with purple striae
  • Edema
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6
Q

Four things that are decreased in a person with cushings syndrome?

A
  • Decreased resistance to infection/wound healing
  • Decreased Potassium (Hypokalemia)
  • Decreased bone strength (osteoporosis)
  • Decreased libido
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7
Q

thing that are increased in a person with cushings syndrome?

A
  • Hyperglycemia
  • Hypernatremia
  • Hypertension
  • Elevated plasma cortisol level
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8
Q

Cushings syndrome primary cause is? Most common in what gender/age group? What is an iatrogenic cause?

A
  • primary cause is adrenal tumor or hyperplasia
  • Females 30-60
  • Prolonged steroid use
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9
Q

Surgery for cushings syndrome if adrenal tumor? Pituitary tumor?

A
  • Adrenalectomy

* Hypophysectomy

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10
Q

Diet for a person with cushings syndrome? (4 things)

A
  • low sodium
  • high protein
  • potassium supplements
  • nutrient-dense foods
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11
Q

Addisons disease is where there is a primary _____ _____.

A

*Primary adrenal insufficiency

Deficit of MSG

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12
Q

4 risk factors for addisons disease?

A
  • Sudden cessation of glucocorticoids
  • Adrenalectomy
  • Tuburculosis/Fungus
  • Endocrine disorder
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13
Q

What may the skin color of a person with addisons disease look like?

A

*Bronze pigmentation

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14
Q

4 things that are decreased in addisons

A
  • Hyponatremia
  • Hypoglycemia
  • Hypotension
  • Decreased serum cortisol
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15
Q

2 things that are increased in addisons?

A
  • Hyperkalemia

* Increased plasma acth

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16
Q

What are 3 corticosteroids given to a client with addison’s disease? When are they taken?

A
  • Hydrocortisone, Prednisone, Methylprednisolone

* 2/3 in the morning and 1/3 in the afternoon

17
Q

What is a mineralcorticosteroid that is given for a person with Addison’s? What does it do?

A
  • fludrocortisone

* Corrects e-lyte balance and hypotension

18
Q

Diet recommendation for a person with addison’s? 3 things

A
  • High carb
  • High protein
  • ADEQUATE sodium
19
Q

3 things to teach a person with addisons to avoid?

A
  • No Vigorous exercise
  • Avoid physical/emotional stress (increase dosage during stress)
  • Never skip doses of hormone replacement
20
Q

(acute) severe exacerbation of Addison’s disease

A

Addisonian crisis

21
Q

Addisonian crisis can be precipitated by? (5 things)

A
  • Stress/emotional turmoil
  • Infection
  • Dehydration
  • Vigorous activity
  • Failure to take medications
22
Q

4 assessment findings of Addisonian crisis?

A
  • Severe hypotension
  • Severe Weakness
  • Hypovolemia
  • SHOCK
23
Q

4 pharmacological interventions for Addisonian crisis?

A
  • IV vasopressors for BP
  • IV fluids for hypovolemia
  • IV hydrocortisone for cortisol deficiency
  • Antibiotics if infection
24
Q

The client being treated for addisonian crisis should be placed on _____ ____ and have a _____ ___ with limited visitors and _____.

A
  • STRICT bed rest
  • Private room w/ limited visitors to avoid infection
  • Limit stress
25
Q

excess aldosterone secretion from cortex.?

A

Hyperaldosteronism/Conn’s Syndrome

26
Q

What is the Role of Cortisol? What is it referred to as?

A
  • Refereed to as STRESS hormone

* increases blood glucose though glucose metabolism, break downs fats, proteins, and carbs, regulates electrolytes.

27
Q

Who is conn’s syndrome seen in and what is the main cause?

A
  • Females 30-50

* Primary tumor or hyperplasia

28
Q

What happens to electrolytes in conn’s syndrome and what is the after effect?

A
  • Excretion of K - hypokalemia and retention of Na
  • Excess NA leads to h20 retention
  • Increase in blood volume and blood pressure
29
Q

4 nursing interventions for conn’s syndrome

A
  • Monitor VS, I&O, daily weight
  • Maintain Sodium restriction
  • Administer spironolactone & K+ supplements
  • Prepare client for adrenelectomy
30
Q

Functioning tumor of the adrenal medulla is called? ___ and ____ are secreted in _____amounts. Most common in what ages?

A
  • Pheochromocytoma
  • Epi and Norepi are secreted in excessive amounts
  • most common in 25-50
31
Q

5 assessment findings for Pheochromocytoma?

A
  • Severe headache/dilated pupils
  • HYPERTENSION/Tachycardia
  • Hyperglycemia
  • Cold extremities
  • Vomitting
32
Q

in pheochromocytoma, what two results in the urine screen will be Elevated?

A

vanillylmandelic acid (VMA) & catecholamines

33
Q

interventions for pheochromocytoma?

  • Monitor VS, especially_____ and _____
  • Meds, as ordered for ____ and ___
  • Decrease _______stimuli
  • High ____diet, avoid _______
  • Prepare client for ______
A
  • BLOOD PRESSURE and blood/urine glucose
  • BP/Glucose
  • Decrease stressful stimuli (can cause hypertensive crisis)
  • High calorie diet, avoid stimulants
  • Adrenalectomy
34
Q

3 indications for adrenalectomy?

A
  • Tumor of cortex (Cushing’s syndrome, hyperaldosteronism)
  • Tumor of medulla (Pheochromocytoma)
  • Metastatic cancer of the breast or prostate
35
Q

what should be administered on morning of adrenalectomy and why?

A

Administer glucocorticord preparation on the morning of surgery to prevent acute adrenal insufficiency

Nursing 232- Exam 2 (11 decks)

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