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medsurg 2 > endocrine problems > Flashcards

endocrine problems Flashcards

1
Q

the pituitary gland is considered the ___ ___ of the endocrine system

A

master gland

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2
Q

what hormones are released by the anterior pituitary gland? (6)

A

GH
prolactin
ACTH
TSH
FSH
LH

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3
Q

disorders of the pituitary gland include… (3)

A

Acromegaly
SIADH
DI

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4
Q

what is acromegaly?

A

rare condition, overproduction of GH

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5
Q

the mean age of diagnosis for acromegaly is __-__ years old

A

40-45

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6
Q

etiology of acromegaly:

A

benign growth hormone-secreting pituitary adenoma

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7
Q

acromegaly: excess GH causes an overgrowth in __ __ and the bone in hands, ___ and ___. does not occur in __ and __

A

soft tissue
feet
face
arms
legs

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8
Q

clinical manifestations of acromegaly (10)

A
  • thickening and enlargement of bony/soft tissue
  • proximal muscle weakness
  • joint pain (can be severe)
  • carpal tunnel syndrome & peripheral neuropathy
  • skin: thick, leathery, oily –> acne breakouts
  • hypertrophy of vocal cords –> voice deepens
  • vision changes –> headaches common
  • tongue enlargement –> dental and speech probs
  • sleep apnea from narrowing of airway
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9
Q

diagnostic studies for acromegaly (4)

A
  • evaluation of plasma insulin-like growth factor (IGF-1) to oral glucose tolerance test (OGTT) –> IGF-1 levels rise as GH rises.
  • MRI
  • CT scan with contrast media
  • eye exam to include field of vision test
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10
Q

nursing management goal for acromegaly

A

GH returns to normal

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11
Q

treatment for acromegaly (4)

A
  • surgical removal of pituitary gland (hypophysectomy) *tx of choice!!
  • monitor peripheral vision/visual acuity/extraocular movement
  • radiation therapy
  • drug therapy
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12
Q

main drug used for treatment of acromegaly, what’s it’s function? how is it given?

A
  • octreotide (Sandostatin) –> somatostatin analog.
  • reduces GH levels to normal
  • SubQ 3x/week
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13
Q

what are psychosocial effects of acromegaly?

A
  • body image disturbances
  • sexual problems
  • depression –>
  • requires lifelong thyroid hormone replacement, sex hormones, and glucocorticoids
  • referral to support group
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14
Q

what is SIADH?

A

syndrome of inappropriate diuretic hormone: overproduction or inappropriate release of ADH secretion despite normal or low plasma osmolality

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15
Q

SIADH is more common in ___ ___

A

older adults

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16
Q

most common causes of SIADH

A

cancer, especially small cell lung cancer

17
Q

clinical manifestations of SIADH

A
  • weight gain
  • low urine output
  • mild hyponatremia –> cramping, irritability, headache
  • dyspnea on exertion
  • fatigue
  • thirst
  • mental confusion
  • cerebral edema –> lethargy/seizures/coma due to continuous decline in serum osmolality
18
Q

severe manifestations of SIADH occur when serum sodium falls below ___. what manis occur?

A
  • 120 mEq/L
  • vomiting, abdominal cramps, muscle twitching
19
Q

diagnosis of SIADH determined by

A
  • low urine output –> high urine specific gravity ( > 1.030)
  • mild hyponatremia –> Na < 135 mEq/L
  • serum osmolality <280 mOsm/kg
20
Q

SIADH is a disorder of the ___ pituitary gland

A

posterior

21
Q

What are interventions for SIADH (6)

A
  • correct hyponatremia w/ fluid restriction and hypertonic solutions
  • give demeclocycline (Declomycin) to inhibit vasopressin receptors
  • treat unerlying cause
  • loop diuretic to promote diuresis
  • monitor i&o’s
  • weigh daily
22
Q

drug therapy for SIADH

A
  • vasopressor receptor antagonist
    1. conivaptan – IV
    2. tolvaptan – PO
    3. do not give to pt with liver disease
  • stop all meds that stimulate ADH release
23
Q

what is DI?

A

diabetes insipidus: hyposecretion of ADH

24
Q

causes of DI

A

deficiency of ADH, production or decreased renal response to ADH

25
Q

clinical manifestations of DI

A
  • polyuria –> low urine specific gravity/large volumes of dilute urine
  • polydipsia
  • hypernatremia
  • weight loss; increase urine output
  • dehydration/dry skin –> lead to hypovolemic shock
  • fatigue
26
Q

diagnostic test for DI

A

fluid deprivation test

27
Q
A

medsurg 2 (2 decks)

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