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3.3 - ABSN NUR 405 Endocrine > Endocrine Labs & Diagnostic Tests > Flashcards

Endocrine Labs & Diagnostic Tests Flashcards

1
Q

What is considered the “Master Gland” of the endocrine system?

A

The pituitary gland

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2
Q

What hormones are produced by the posterior pituitary?

A

ADH

Oxytocin

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3
Q

What hormones are produced by the anterior pituitary?

A 
TSH
ACTH
FSH & LH
Growth hormone
Prolactin
Endorphins
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4
Q

What is the target organ that TSH acts on?

A

Thyroid

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5
Q

What is the target organ that ACTH works on?

A

Adrenal cortex

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6
Q

What hormone, released by the hypothalamus, acts on the anterior pituitary?

A

CRF (corticotropin-releasing factor)

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7
Q

What happens when the HPA axis responds to stress?

A

Stress triggers the hypothalamus to release CRF –> CRF acts on the anterior pituitary to release ACTH–> ACTH acts on the adrenals (adrenal cortex) to release cortisol into the circulation

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8
Q

What hormone, released by the anterior pituitary, acts on the adrenals?

A

ACTH (adrenocorticotropic hormone)

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9
Q

Describe the adrenal glands

A

Glands that sit on each kidney. An outer cortex surrounds the inner medulla.

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10
Q

What is the purpose of ADH (antidiuretic hormone)?

A

Regulator of “pure” water supply (through excretion or retention)

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11
Q

What is the body’s ADH response to high plasma osmolality?

A

Increase ADH–> increases pure water retention –> increases blood volume to equalize plasma osmolality

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12
Q

What hormones are secreted by the thyroid?

A

Thyroxine (T4), triiodothyronine (T3), and calcitonin

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13
Q

What does PTH (parathyroid hormone), made by the parathyroid, regulate in the blood?

A

Calcium and phosphorous levels

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14
Q

What is the water deprivation test (also called an ADH stimulation test) used for?

A

It is used to differentiate causes of diabetes insipidus. It is a type of pituitary study

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15
Q

3 causes of diabetes insipidus

A
  1. Neurogenic
  2. Nephrogenic
  3. Psychogenic polydipsia
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16
Q

How is a water deprivation test (ADH stimulation test) performed?

A
  1. ADH (vasopressin) administered exogenously

2. Monitor: urine output, urine specific gravity, & serum osmolality every hour/2 hours during the test

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17
Q

List the adrenal diagnostic tests

A
  1. Cortisol, aldosterone, ACTH serum levels
  2. Urine cortisol (24 hour urine)
  3. ACTH stimulation & suppression
  4. CT/MRI
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18
Q

What do cortisol tests evaluate?

A

Evaluates the status of adrenal cortex function

19
Q

What are 2 factors that affect serum cortisol levels?

A
  1. Diurnal variation (levels are highest in the morning)

2. Stress

20
Q

What does aldosterone regulate?

A

Sodium ( and water, since “salt sucks”)

21
Q

What does a serum aldosterone test assess for?

A

Hyperaldosteronism

22
Q

What must the nurse and patient keep in mind when taking an aldosterone level?

A

The patient needs to maintain whatever position has been assigned for 2 hours. They may be supine or upright. Their position affects the aldosterone level

23
Q

What are the 2 ACTH tests?

A
  1. Serum ACTH

2. ACTH stimulation or suppression tests

24
Q

What are ACTH stimulation or suppression tests

A

This is a test that evaluates adrenal function. For an ACTH stimulation test, synthetic ACTH is administered. For an ACTH suppression test, dexamethasone is administered.

25
Q

What are the thyroid studies?

A
  1. TSH, T3, & T4 serum blood tests
  2. Thyroid ultrasound
  3. Thyroid scan
  4. Radioactive iodine uptake
26
Q

What is the most sensitive test used to evaluate thyroid dysfunction?

A

TSH (thyroid stimulating hormone) serum level. TSH is secreted by the anterior pituitary.

27
Q

What do T3 & T4 serum levels help evaluate?

A

Thyroid function and monitoring of thyroid therapy

28
Q

Describe the negative feedback cycle of the thyroid gland

A

T3 & T4 circulate in the blood; when T3 & T4 levels are adequate, the anterior pituitary stops secretion of TSH.

29
Q

What does a thyroid scan evaluate for?

A

Nodules in the thyroid

30
Q

How is a thyroid scan administered?

A
  1. Radioactive isotopes are given PO or IV
  2. Scanner passes over thyroid
  3. If nodules are benign, a warm spot appears indicating that the nodules uptake the isotope
  4. If nodules are malignant, a cold spot is seen and indicates that the nodules did not uptake the isotope
31
Q

Nursing considerations following a thyroid scan

A
  1. Reactions to iodine are rare
  2. Encourage fluids for 24-48 hours to flush kidneys
  3. If cold spots were noted, a thyroid biopsy is required to confirm malignancy
32
Q

Why is a radioactive iodine uptake (RAIU) test used?

A
  1. Provides a direct measure of thyroid activity

2. Evaluates function of nodules

33
Q

How is a radioactive iodine uptake (RAIU) test administered?

A
  1. Radioactive iodine administered PO or IV
  2. Uptake is measured at several intervals (2-4 hours and 24 hours)
  3. Values are expressed as a percentage
    * Provides more information than a thyroid scan because a longer time period is being assessed
34
Q

What studies evaluate pancreatic function?

A
  1. Fasting blood glucose
  2. Casual blood glucose
  3. HbA1C
  4. Oral glucose tolerance test
  5. Urine studies (ketones)
35
Q

What does HbA1C evaluate?

A

Indicates AVERAGE glucose level over the past 120 days (3 months). Used for diagnosis and to evaluate effectiveness of interventions (medications or lifestyle modifications)

36
Q

What is an oral glucose tolerance test (OGTT) used for?

A

To diagnose gestational diabetes

37
Q

High urine ketones are associated with what?

A

Hyperglycemia

38
Q

What level of urine ketones is a medical emergency?

A

> 300 mg/dL (patient in DKA)

39
Q

Random (non-fasting) glucose level that indicates diabetes

A

≥ 200 mg/dL; especially when also presenting with hyperglycemia symptoms

40
Q

Fasting plasma glucose (NPO 8+ hours) level that indicates pre-diabetes

A

100-125 mg/dL

41
Q

Fasting plasma glucose (NPO 8+ hours) that indicates diabetes

A

≥ 126 mg/dL

42
Q

HbA1C suggesting pre-diabetes/increased diabetes risk

A

5.7-6.4%

43
Q

HbA1C indicating diabetes

A

≥ 6.5%

44
Q

Acceptable HbA1C range for those diagnosed with diabetes

A

6-8%, target is 7%

3.3 - ABSN NUR 405 Endocrine (7 decks)

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