Endocrine - Adrenals Flashcards
What are the 3 types of hormones released by Cortex (Adrenal gland). Give example(s) of each.
(MSG)
- Mineralocorticoids - ex. Aldosterone
- Sex hormones - ex. Estrogen/Testosterone
- Glucocorticoids - ex. cortisol/cortisone
The medulla (Adrenal gland) produces hormones known as _______. Give two examples.
- Catecholamines
* Epi and Norepi
Aldosterone is associated with ____reabsorption and ___excretion. What stimulates aldosterone? What system is this?
- Na reabsorption and K excretion
- Low Na and High K, stimulate aldosterone
- Renin-angiotensin system
excess adrenocorticoids (gluco, mineral, sex hormones)– particularly ______. This is known as ______. What adrenal gland does this affect?
- Cortisol
- Cushings syndrome
- Cortex
physical appearance of someone with cushings syndrome? (6 things)
- Truncal obesity w/thin limbs (muscle wasting)
- Round moon face
- hirsutism, thin skin w/ acne
- Buffalo hump
- Pendulous abdomen with purple striae
- Edema
Four things that are decreased in a person with cushings syndrome?
- Decreased resistance to infection/wound healing
- Decreased Potassium (Hypokalemia)
- Decreased bone strength (osteoporosis)
- Decreased libido
thing that are increased in a person with cushings syndrome?
- Hyperglycemia
- Hypernatremia
- Hypertension
- Elevated plasma cortisol level
Cushings syndrome primary cause is? Most common in what gender/age group? What is an iatrogenic cause?
- primary cause is adrenal tumor or hyperplasia
- Females 30-60
- Prolonged steroid use
Surgery for cushings syndrome if adrenal tumor? Pituitary tumor?
- Adrenalectomy
* Hypophysectomy
Diet for a person with cushings syndrome? (4 things)
- low sodium
- high protein
- potassium supplements
- nutrient-dense foods
Addisons disease is where there is a primary _____ _____.
*Primary adrenal insufficiency
Deficit of MSG
4 risk factors for addisons disease?
- Sudden cessation of glucocorticoids
- Adrenalectomy
- Tuburculosis/Fungus
- Endocrine disorder
What may the skin color of a person with addisons disease look like?
*Bronze pigmentation
4 things that are decreased in addisons
- Hyponatremia
- Hypoglycemia
- Hypotension
- Decreased serum cortisol
2 things that are increased in addisons?
- Hyperkalemia
* Increased plasma acth
What are 3 corticosteroids given to a client with addison’s disease? When are they taken?
- Hydrocortisone, Prednisone, Methylprednisolone
* 2/3 in the morning and 1/3 in the afternoon
What is a mineralcorticosteroid that is given for a person with Addison’s? What does it do?
- fludrocortisone
* Corrects e-lyte balance and hypotension
Diet recommendation for a person with addison’s? 3 things
- High carb
- High protein
- ADEQUATE sodium
3 things to teach a person with addisons to avoid?
- No Vigorous exercise
- Avoid physical/emotional stress (increase dosage during stress)
- Never skip doses of hormone replacement
(acute) severe exacerbation of Addison’s disease
Addisonian crisis
Addisonian crisis can be precipitated by? (5 things)
- Stress/emotional turmoil
- Infection
- Dehydration
- Vigorous activity
- Failure to take medications
4 assessment findings of Addisonian crisis?
- Severe hypotension
- Severe Weakness
- Hypovolemia
- SHOCK
4 pharmacological interventions for Addisonian crisis?
- IV vasopressors for BP
- IV fluids for hypovolemia
- IV hydrocortisone for cortisol deficiency
- Antibiotics if infection
The client being treated for addisonian crisis should be placed on _____ ____ and have a _____ ___ with limited visitors and _____.
- STRICT bed rest
- Private room w/ limited visitors to avoid infection
- Limit stress
excess aldosterone secretion from cortex.?
Hyperaldosteronism/Conn’s Syndrome
What is the Role of Cortisol? What is it referred to as?
- Refereed to as STRESS hormone
* increases blood glucose though glucose metabolism, break downs fats, proteins, and carbs, regulates electrolytes.
Who is conn’s syndrome seen in and what is the main cause?
- Females 30-50
* Primary tumor or hyperplasia
What happens to electrolytes in conn’s syndrome and what is the after effect?
- Excretion of K - hypokalemia and retention of Na
- Excess NA leads to h20 retention
- Increase in blood volume and blood pressure
4 nursing interventions for conn’s syndrome
- Monitor VS, I&O, daily weight
- Maintain Sodium restriction
- Administer spironolactone & K+ supplements
- Prepare client for adrenelectomy
Functioning tumor of the adrenal medulla is called? ___ and ____ are secreted in _____amounts. Most common in what ages?
- Pheochromocytoma
- Epi and Norepi are secreted in excessive amounts
- most common in 25-50
5 assessment findings for Pheochromocytoma?
- Severe headache/dilated pupils
- HYPERTENSION/Tachycardia
- Hyperglycemia
- Cold extremities
- Vomitting
in pheochromocytoma, what two results in the urine screen will be Elevated?
vanillylmandelic acid (VMA) & catecholamines
interventions for pheochromocytoma?
- Monitor VS, especially_____ and _____
- Meds, as ordered for ____ and ___
- Decrease _______stimuli
- High ____diet, avoid _______
- Prepare client for ______
- BLOOD PRESSURE and blood/urine glucose
- BP/Glucose
- Decrease stressful stimuli (can cause hypertensive crisis)
- High calorie diet, avoid stimulants
- Adrenalectomy
3 indications for adrenalectomy?
- Tumor of cortex (Cushing’s syndrome, hyperaldosteronism)
- Tumor of medulla (Pheochromocytoma)
- Metastatic cancer of the breast or prostate
what should be administered on morning of adrenalectomy and why?
Administer glucocorticord preparation on the morning of surgery to prevent acute adrenal insufficiency
