Endocrine - Pituitary + Adrenal Disorders

Question 1

Types of Pituitary Disorders

Answer 1

1 Growth Hormone [GH] Deficiency
2 Diabetes Insipidus [DI]
3 Adrenal Insufficiency

Question 2

Growth Hormone[GH]

Answer 2

• released by ANT.pituitary gland

- stim growth of bones + tissues

Question 3

GH Deficiency

s/s

Answer 3

aka dwarfism, or pituitary dwarfism

-short stature w normal body proportions

Question 4

GH Deficiency

Tx

Answer 4

somatropin
soma=body
tropin=growth

Question 5

somatropin

MOA

Answer 5

replacement hormone

Question 6

somatropin

CI

Answer 6

• severely obese

- sleep apnea

Question 7

somatropin

indications

Answer 7

• deficiency
• AIDS wasting
• cachexia (dramatic loss of skeletal muscle)

Question 8

*somatropin

A/E

Answer 8

• HYPERglycemia incr blood sugar
• renal calculi/kidney stones/nephrolatisis
• —decr UO w norm BUN/Cr - check stones or BPH

Question 9

somatropin

interactions

Answer 9

concurrent corticosteroids can inactivate

Question 10

*somatropin

admin

Answer 10

• IM or subQ

- reconstitute (roll to mix)

Question 11

*somatropin

RN/teaching

Answer 11

• adjust insulin
• monitor flank pain
• drink plenty of fluid
• rotate injection sites

Question 12

Diabetes Insipidus [DI]

Answer 12

-excessive urination due to ADH deficiency

Question 13

Diabetes Insipidus [DI]

Tx

Answer 13

vasopressin or desmopressin

Question 14

vasopressin + desmopressin

MOA

Answer 14

hormone replacement

Question 15

*vasopressin + desmopressin

CI

Answer 15

• CAD
• MI
• Angina
• -monitor EKG

Question 16

vasopressin + desmopressin

indication

Answer 16

• DI
• low BP
• nocturnal enuresis
• CPR

Question 17

vasopressin + desmopressin

A/E

Answer 17

• constricts coronary arteries
• water intoxication
• decr periph circulation

Question 18

*vasopressin + desmopressin

interactions

Answer 18

***lithium

Question 19

vasopressin + desmopressin

admin

Answer 19

• subQ + IM
• intranasal
• starts w bedtime doses

Question 20

vasopressin + desmopressin

RN/teaching

Answer 20

monitor:

• serum Na
• I+O
• urine SG
• EKG + BP

Question 21

Adrenal insufficiency

aka Addison’s Disease

Answer 21

-adrenal cortex doesn’t make enough cortisol (helps respond to stress)

Question 22

Cortisol

Answer 22

• incr blood glucose
• regulates metab
• salt water balance
• memory formation

Question 23

Adrenal insufficiency
aka Addison’s Disease
Tx

Answer 23

glucocorticoid (steroid hormones)

Question 24

glucocorticoids

drug names

Answer 24

1 hydrocortisone
2 dexamethasone
3 prednisone

Question 25

glucocorticoids [hydrocortisone, dexamethasone, prednisone] MOA

Answer 25

replacement

Question 26

glucocorticoids [hydrocortisone, dexamethasone, prednisone] CI

Answer 26

active infections | steroids decr immune system

Question 27

glucocorticoids [hydrocortisone, dexamethasone, prednisone] indications

Answer 27

- Addison's disease - tons of inflammatory disorders * **allergies (v common)

Question 28

**glucocorticoids [hydrocortisone, dexamethasone, prednisone] A/E

Answer 28

- HYPERglycemia - decr immune - wt gain - hypo-K - osteoporosis - adrenal suppression - HTN - edema - infection - Cushing syndrome (too much cortisol)

Question 29

glucocorticoids [hydrocortisone, dexamethasone, prednisone] interactions

Answer 29

vaccines, diuretics, NSAIDs, APAP, ETOH>GI bleed

Question 30

**glucocorticoids [hydrocortisone, dexamethasone, prednisone] admin

Answer 30

- must adjust insulin - taper off/don't stop abruptly - prevent infection (stay away fr sick ppl, report cough) - take Ca, vit D, wt bearing exercise (4 osteoperosis) - monitor for weakness + low BP - monitor for tarry stools med is PO in AM

Question 31

glucocorticoids [hydrocortisone, dexamethasone, prednisone] RN/teaching

Answer 31

- times of stress, incr dose - must adjust insulin - taper off/don't stop abruptly - prevent infection (stay away fr sick ppl, report cough) - take Ca, vit D, wt beating exercise (for osteoporosis) - monitor for weakness + low BP - monitor for tarry stools