Endocrine Disorders Flashcards
Endocrine System
group of organs/glands that are involved in regulating moos, growth and development, tissue function, metabolism, and reproduction
What is the major endocrine gland or “Master Gland”?
pituitary gland
Pituitary Gland
- pea-sized body attached to the base of the brain
- important in controlling growth and development and the functioning of the other endocrine glands
Over-secretion/Hypersecretion of Pituitary Gland Disorders
Cushing Syndrome
Acromegaly (gigantism)
Cushing Syndromes results from what?
hypersecretion of ACTH/too much cortisol is produced and released into the body
What is the stress hormone?
ACTH
S/S of Cushing Syndrome
- weight gain
- thin purple striae
- moon face
- buffalo hump
- thinning/fragile skin that bruises easy
- slow healing
- fatigue
- muscle weakness
- irritability
Cushing Syndrome is most likely the result of what kind of tumor?
pituitary tumor
What are the complications of Cushing Syndrome?
- hypertension
- diabetes
- difficulty treating infections
- osteoporosis
What is the treatment for Cushing Syndrome?
- medication to reduce cortisol production
- surgery to remove tumor
- radiation treatment
Acromegaly (GIGANTISM) results from what?
excess growth hormones after the growth plates have closed/may be related to tumor on pituitary, lung, or pancreas
S/S Acromegaly
bones increase in size especially in hands, feet, and face
Complications of Acromegaly
- headaches
- vision loss
- cardiomyopathy
- diabetes
- osteoarthritis
- hypertension
Treatment for Acromegaly
medications to suppress the production of growth hormone or surgery to remove tumor
Under-secretion (hyposecretion) usually involves what part of the pituitary hormones?
Anterior pituitary hormones
Hyposecretion of Pituitary can lead to what?
- absence of gonadal function
- loss of secondary sex characters
- insufficiency of thyroid and adrenal function
Other general S/S of Hyposecretion of Pituitary
- weight gain
- small stature
- low BP
- excessive urination/thirst
- constipation
- fatigue
- dry skin
Treatment for Hyposecretion of Pituitary
- hormone replacement (Synthroid, Cortef)
- sex hormones
- growth hormones
- fertility hormones
Synthroid medication helps what?
thyroid
Cortef medication helps what?
adrenal
Pituitary Tumors
- usually benign
- location and effects on targeted organs may have life threatening effects
S/S of Pituitary Tumors
- hyper/hyposecretion of pituitary hormones
- Prolactinoma leads to overproduction of prolactin
- loss of menstruation in females
- spontaneous production of milk in males and females
- infertility in females
How is a pituitary tumor diagnosed?
Physical assessment
MRI
CT scan
Measure hormone levels
Hypophysectomy
surgical removal of the pituitary gland using a transsphenoidal approach
What happens during a hypophysectomy?
an incision is made beneath the upper lip; a speculum is inserted into nasal cavity; tumor is removed using forceps
Complications from Hypophysectomy
- nose bleeds
- intracranial hemorrhage
- leaking of CSF
- diabetes insipidus
- hypopituitarism
What to expect after Hypophysectomy?
- nasal packing
- pain levels
- deep breathing exercises
Pre-Op Care for Hypophysectomy
- education on what to expect
- ensure consent is signed
- patent IV
- avoid vigorous coughing, sneezing, sucking through straw, blowing nose, breathing through mouth
Post-Op for Hypophysectomy
- monitor vitals
- administer pain meds/prophylactic antibiotics
- asses change in visual acuity
- asses for leaking CSF
- maintain HOB 15-30
- monitor electrolytes
- strict I/O’s
- daily weights
- soft sponge for tooth brush
- frequently asses nasal packing
Diabetes Insipidus
decrease in production of anti-diuretic hormone (ADH)-also called vasopressin leading to excess fluid loss
What are some causes of Diabetes Insipidus?
- pituitary destruction from radiation or surgery
- severe head injuries
- tumors
- infection
How is Diabetes Insipidus diagnosed?
- 24 hr urine measure output ( > 2 L/24 hrs is positive)
- monitor ADH levels
- vasopressin test to monitor changes in serum cortisol
S/S of Diabetes Insipidus
- increased daily urine output (polyuria)
- urine is dilute
- nocturia/frequency
- specific gravity of urine is LOW
- excessive thirst (polydipsia)
- weight loss, decreased skin turgor, dry mucous membranes, tachycardia, hypotension
- hypernatremia
Treatment/Management for Diabetes Insipidus
- replacement of ADH
- monitor daily weights/vitals
- fluid replacement
- sodium restriction
- monitor neuro status
- encourage medic alert bracelet
- medication education-alternate nares w/ intranasal; alternate sites w/ injections
ADH Replacement Meds
- Desmopressin intranasally
- Vasopressin IM
What is Syndrome of Inappropriate Antidiuretic Hormone?
hypersecretion of ADH leading to excessive fluid retention
What causes SIADH?
- brain tumors
- malignancies
- head injuries
- infection
How can SIADH be diagnosed?
- monitor serum ADH
- urine specific gravity and osmolarity
