Endocrine Problems Flashcards
Anterior Pituitary problems
- acromegaly: too much GH
- hypopituitarism: too little of 1 or more hormones
Posterior Pituitary Gland Problems
- SIADH: too much ADH
- Diabetes insipidus: too little ADH
Acromegaly
- enlarged gland, headache, visual probs, enlargement of hands and feet and tissues, tongue overgrowth
- high somatotropin, X-rays, MRI
- surgery: hypophysectomy
Hypopituitarism
- personality changes, weight loss, weakness, sudden death
- treatment: surgery, radiation, meds
- treatment contraindicated for phlebitis, pulmonary embolism, some cancers
SIADH signs
Low urine output, increased body weight, thirst, confusion, seizures
Diabetes insipidus signs
Polyuria and polydipsia
hypotension
Tachycardia
SIADH Care
- I&O, daily weights, fluid restriction
- fall and seizure precautions
- ice and sugarless gum to decrease thirst
Diabetes insipidus care
Replace fluids and electrolytes
Low salt diet
Goiter
Enlarged thyroid gland
Thyroiditis
Inflammation of thyroid gland
Thyroid hormones
Growth and development
Graves Disease
Hyperthyroidism
- too much TH
- thyrotoxicosis
- intolerance to heat, exophthalmos, increased appetite, enlarged gland
- dependent edema, systolic HTN, increased HR
Hypothyroidism
Too little TH, slow body processes
- tired, slow speech, weight gain, scaly tongue
- intolerance to cold
Hyperthyroidism care
- low calorie diet, iodine
- surgery: monitor for laryngeal strider (hypocalcemia)
- F&E
- monitor for dysrhythmias
- cool environment
Hypothyroidism care
- mxyedema coma: mechanical respiratory support and cardiac monitoring
- lifelong drug therapy
Hyperparathyroidism
- excess PTH
- hypercalcemia and hypo phosphorus
- loss of appetite, constipation, fatigue, skeletal pain
- surgery (watch for tetany); calcium supplements (Chvosteks and Trousseaus)
HypoPT
Little PTH
- hypotension, edema, abdominal cramps, difficulty walking, muscle spasms, hyperactive deep tendon reflex
- IV calcium for tetany (monitor EKG and give slowly)
- breathe in and out paper bag
- long term vitamin D
Cushings
Too much ACTH
- truncal obesity, moon face, purple striae, hyperglycemia,
- labs: glucose
- VS, weight, watch for clot and inflammation
- watch BP and infections post surgery
Addisons
too little ACTH
- brown pigmentation, hypoglycemia, hypotension, anorexia, nausea, weight loss
- life long steroids, how to take BP, increase salt intake, manage stress
- prevent infections, daily hygiene, avoid extreme temps, light, and noise
Cushing preop
- control HTN and hyperglycemia
- correct hypo kale is
- high protein diet
Cushings postoperative
Acute adrenal insufficiency: vomiting, dehydration, painful joints
- bed rest until stable BP
- wear alert bracelet at all times
- avoid exposure to extreme temps
Adrenal therapy side effects
- low potassium and calcium
- high glucose and BP
- delayed healing
- infection
Conns syndrome
Hyperaldosteronism
- sodium retention: hypernatremia, HTN, headache, no edema
- potassium excretion
- hypokalemia acidosis, muscle weakness, fatigue
- assess F&E and BP; surgery
Pheochromocytoma
Tumor of adrenal medulla
- severe HTN
- profuse sweating, headache, tachycardia with chest pain
- surgery, monitor VS, cardiac, BP, and glucose
