Endocrine Disorder Flashcards
What is the endocrine system composed of?
glands, tissues, or clusters of cells that produce and release hormones
What is the gold standard for making the diagnosis of GH excess?
Failure to suppress serum GH levels after an oral glucose challenge test
Lab/Diagnostic Studies for Diabetes Insipidus
- Radiographic studies
- Urinalysis
- Serum Osmolarity
- Serum Sodium
- Fluid Deprivation
What are the two types of pituitary disorders?
Anterior and Posterior
Anterior Pituitary Disorders
- Growth Hormone Deficiency
- Hyperpituitarism
- Precocious Puberty
Posterior Pituitary Disorders
- Diabetes Insipidus
- Syndrome of Inappropriate Antidiuretic Hormone Secretion
When is Growth Hormone typically released?
-throughout the day, mostly secreted during sleep
What is growth hormone deficiency usually a result of?
Failure of the anterior pituitary or hypothalamic stimulation on the pituitary to produce sufficient GH
GH Deficiency is also known as what?
Hypopituitarism or Dwarfism
What is GH Deficiency characterized by?
poor growth and short stature
Complications for GH Deficiency Include?
unable to metabolize protein, fat, and carbohydrates effectively
What is the primary cause of GH Deficiency?
Injury to pituitary gland or hypothalamus
What may cause injury to the pituitary gland or hypothalamus resulting in GHD?
- tumor
- infection/infarction
- CNS irradiation
- abnormal formation in utero
- birth trauma
- Genetics (Prader-Willi or Turner)
- Psychosocial
Therapeutic Management for GHD
- supplement GH
- removal of tumors
- continue treatment until near final height
- physical exam
What would you see on a Physical Exam for a child w/ GHD?
- height at or < 3rd percentile
- higher weight to height ratio
- prominent abdominal fat
- large forehead
- high pitched voice
- delayed sexual maturity, dentition, skeletal maturation
- decreased muscle mass
Teaching Plan for GHD
- promoting growth
- enhancing the child’s self esteem
- providing appropriate education on disorder
When does treatment stop for GHD?
With fusion of growth plates
How often should you measure a child’s height w/ GHD?
q 3-6 months
What should the child notify the physician about during treatment?
- headaches
- rapid weight gain
- increased thirst/urination
- joint pain
Complications of GHD
- altered carbohydrate, protein, fat metabolism
- hypoglycemia
- glucose intolerance/diabetes
- slipped capital femoral epiphysis
- pseudotumor cerebri
- leukemia
- recurrence of CNS tumors
- Infection at injection site
- edema and sodium retention
Precocious Puberty
Development of sexual characteristics before the usual age of pubertal onset
When does Precocious Puberty begin for boys and girls?
Younger than 8 for girls and 9 for boys
What is the most common form of Precocious Puberty?
Central Precocious Puberty
Central Precocious Puberty develops as a result of what?
Increase in hormones w/ development of sexual characteristics, increased growth, and reproductive capability
What happens if Precocious Puberty is left untreated?
The child may become fertile
S/S of Precocious Puberty?
- headaches
- vision probs
- behavior changes/mood swings
- acne, body odor
- accelerated growth
- bone age is advanced
- size of uterus increased
Goals of Nursing Management of Precocious Puberty
- educating about physical changes
- teaching on meds
- self esteem issues
- promoting age appropriate physical dev and pubertal progression
Delayed Puberty for Girls
- breasts not developed by 12
- pubic hair not produced by 14
- menarche not occurred by 15
Delayed Puberty for Boys
- no testicular enlargement or scrotal changes by 14
- no pubic hair by 15
What is the most common cause of Delayed Puberty?
Constitutional Delay-“Late Bloomer”
What are the 2 types of Diabetes Insipidus?
Nephrogenic and Central
How does Nephrogenic occur?
- transmitted genetically
- acquired from renal disease, hypercalcemia, hypokalemia, drugs-lithium, rifampin
Therapeutic Management for Nephrogenic DI
- diuretics
- high fluid intake
- restricted sodium
- high-protein diet
What is the most common form of Diabetes Insipidus?
Central
Central DI is a disorder of what?
the pituitary gland
Central DI is characterized by what?
Polydipsia and polyuria
When does SIADH occur?
when the feedback mechanism that regulates ADH does not function properly
Diabetes Insipidus
- “high and dry”
- increased urination
- Hypernatremia
- serum osmolarity > 300
- decreased urine osmolarity
- dehydration, thirst
Syndrome of Inappropriate ADH
- “low and wet”
- decreased urination
- hyponatremia
- serum osmolarity <280
- increased urine osmolarity
- fluid retention
- weight gain
- HTN
Graves Disease
autoimmune disorder that causes excessive amounts of thyroid hormone to be released in response to human thyroid stimulator immunoglobin
Congenital Hypothyroidism
“Cretinism”
- failure of the thyroid gland to migrate during fetal development which causes malfunction/malformation of thyroid gland
- insufficient production of thyroid hormone
What happens if Congenital Hypothyroidism is left untreated?
- intellectual disability
- short stature
- growth failure
- delayed physical maturity
What is the most common cause of preventable intellectual disability?
Congenital Hypothyroidism
How often should you measure thyroid levels until target is reached on stabilized dose of meds?
q 2-4 weeks
Hyperthyroidism
- nervousness/anxiety
- diarrhea
- heat intolerance
- weight loss
- smooth, velvety skin
Hypothyroidism
- tiredness, fatigue
- constipation
- cold intolerance
- weight gain
- dry, thick skin, edema of face, eyes and hands
- decreased growth
Signs of Thyroid Storm
- sudden onset of severe restlessness and irritability
- fever
- diaphoresis
- severe tachycardia
- increased BP, HR, body temp to dangerous levels
Thyroid Storm
life-threatening health condition of untreated or undertreated hyperthyroidism
Addison’s Disease
deficiency in the adrenal steroids, glucocorticoids-cortisol, and mineralcorticoids,-aldosterone
S/S of Addison’s Disease
- hyponatremia
- hyperkalemia
- water loss
- hypoglycemia
- hypotension
- hyperpigmentation
- adrenal crisis
Cushing Syndrome
excess levels of one or all hormones, but most commonly glucocorticoid excess
S/S of Cushing Syndrome
- rapid weight game
- decreased linear growth
- weakness/fatigue
- irritability
- sleep problems
- HTN
- missed menstrual period
Congenital Adrenal Hyperplasia
autosomal recessive disorder in which there is an inefficient supply of the enzymes required for the synthesis of cortisol and aldosterone
What is the most common type of adrenocortical insufficiency?
Congenital Adrenal Hyperplasia
What is the obvious sign of Congenital Adrenal Hyperplasia?
Ambiguous genitalia
