Endocrine Disorders Flashcards
Hyperactivity of the anterior pituitary gland is associated w what disorder?
Cushing’s syndrome
Hyper activity of the posterior pituitary gland is associated w what disorder?
SIADH
Hypo activity of the posterior pituitary gland is associated w what disorder?
Diabetes insipidus
What is secreted from the thyroid gland in response to high plasma calcium levels?
Calcitonin
Calcitonin is secreted from the thyroid in response to what?
high plasma calcium levels
Calcitonin increase calcium deposits in what?
Bone
Parathormone does what to calcium?
increases it by absorbing it from the kidneys, intestine, and bones
What is tested by sharply tapping on the cheek?
Chvostek sign
What is induced by occluding the blood flow to the arm for 3 minutes with a blood pressure cuff?
Trousseau sign
What are the s/s of hyperparathyroidism?
asymptomatic
apathy
fatigue
muscle weakness
N/V/constipation
Hypertension
Dysrhythmias
How is hyperparathyroidism managed?
Surgical removal
Hydration therapy - 2000 ml or more daily
Maintain mobility
Restrict calcium
Causes of hypoparathyroidism
abnormal development
destruction of glands
vit D deficiency
What are s/s of hypoparathyroidism?
Tetany
Numbness
Tingling in extremities
Stiffness of hands and feet
Bronchospasm
Laryngeal spasm
Carpopedal spasm
Anxiety
Irritability
Depression
Delirium
ECG changes
How is hypoparathyroidism managed?
Increase calcium level to 9-10
Give IV calcium gluconate
Pentobarbital to decrease neuromuscular irritability
Admin parathormone
Quiet environment
Diet high in calcium and low phosphorus
Vit D
What does a hypercalcemic crisis result in?
neurologic, cardiovascular, and kidney symptoms that can be life threatening
How is a hypercalcemic crisis managed?
Rapid rehydration with large volumes of isotonic saline
Admin calcitonin and corticosteroids to increase calcium absorption into bone
Disease caused by adrenal suppression by exogenous steroid use
Addison’s disease
S/s of Addison’s disease
muscle weakness
anorexia
GI distress
fatigue
dark pigmentation of skin and mucosa
hypotension
low blood glucose
low serum sodium**
high serum potassium**
apathy
emotional liability
What diagnostic tests are used for Addison’s disease?
adrenocortical hormone levels, ACTH levels, ACTH stimulation test
What is the most common cause of Addison’s disease?
corticosteroid use
Does Addison’s cause elevated WBCs?
Yes
Does Addison’s cause hypoglycemia?
Yes
How is Addison’s disease assessed?
Note any illness or stressors that precipitate problems
F&E status
VS and orthostatic BP
Weight changes
Muscle weakness and fatigue
Medications
Monitor s/s of Addisonian crisis
How is Addison’s disease managed?
Place patient in recumbent position with legs elevated**
Monitor s/s fluid volume deficit
Encourage intake of fluids and high sodium foods
Admin hormone replacement as ordered
Avoid stress and activity until stable
Total care when pt is in crisis**
Hydrocortisone followed by 5% dextrose in NS
Vasopressors
Immediate treatment of Addison’s disease is directed toward combating what?
circulatory shock
What position should a patient with Addison’s disease be placed in?
Recumbent position with legs elevated
What will the patient need if adrenal function is not regained?
Lifelong replacement of corticosteroids and mineralocorticoids
Patient or family member must administer hormone replacement
What is very important about steroid replacement treatment?
Same time every time
No skipping doses
Disorder characterized by excessive adrenocortical activity or corticosteroid medications
Cushing’s Syndrome
What are s/s of Cushing’s syndrome?
Hyperglycemia
Central obesity with buffalo hump
Think trunk w thin extremities
Osteoporosis
Acne
Moon face from steroid use
Slow healing
Increased serum sodium**
Decreased serum potassium**
What test is used to diagnose Cushing’s syndrome?
Dexamethasone suppression test
How is Cushing’s syndrome managed?
Maintain CO
Decrease risk of injury and infection
Promote skin integrity
Improve body image
Improve coping
Monitor for complication like Addisonian crisis
What medication blocks synthesis of thyroid hormone?
Methimazole
