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Endocrine System Flashcards

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1
Q

hormones produced by thyroid regulate

A

HR, BP, body temp, hunger, thirst, weight, growth

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2
Q

ADH antidiuretic hormone aka

A

vasopressin

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3
Q

goal of endocrine system

A

homeostasis

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4
Q

endocrine system consists of

A

body’s glands and their hormones

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5
Q

hormones travel via

A

bloodstream

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6
Q

endocrine and nervous relationship

A

work together for homeostasis

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7
Q

nervous sys response time and mechanism

A

quick response via neurotransmitters in central or peripheral nervous sys

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8
Q

endocrine sys response time and mechanism

A

slower response via hormones in blood stream

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9
Q

hypothalamus 2 types of hormones

A

releasing and inhibiting (after negative feedback) hormones

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10
Q

2 glands of endocrine sys that regulate hormones

A

hypothalamus and pituitary glands

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11
Q

small gland below the brain and behind the nose that regulates vital body functions

A

pituitary gland

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12
Q

pituitary gland 2 sides

A

anterior and posterior pituitary

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13
Q

hypothyroidism; what is it?

A

low levels of thyroid hormone

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14
Q

hypothyroidism causes

A

pituitary failure to secrete TSH (thyroid secreting hormone), hypothalamus failure to secrete TRH (thyroid releasing hormone), post thyroidectomy, radiation, age

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15
Q

hypothyroidism: 3 stages

A

hypothyroidism>myxedema>myxedema coma

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16
Q

myxedema population

A

women over 60, people with Hashimoto

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17
Q

myxedema cause

A

untreated or undertreated hypothyroidism

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18
Q

myxedema coma cause

A

long term neglect of hypothyroidism

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19
Q

myxedema coma clinical manifestations

A

hypoventilation, respiratory failure, hypothermia, coma

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20
Q

hyperthyroidism condition is

A

elevated levels of thyroid hormone

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21
Q

hyperthyroidism T3 and T4 levels? TSH level?

A

T3 and T4 high; TSH low as body adjusts stimulation down in response to already high thyroid levels

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22
Q

hyperthyroidism causes

A

cancer, Grave’s Disease, overtreatment of hypothyroidism

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23
Q

thyroid storm is a

A

complication of hyperthyroidism. aka = thyrotoxicosis

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24
Q

Grave’s Disease clinical manifestations

A

elevated T3 and T4, goiter, exophthalmos

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25
Q

Grave’s Disease treatment

A

lower thyroid hormone secretion or Thyroidectomy

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26
Q

hypothyroidism clinical manifestations

A

fatigue, sensitivity to cold b/c failure of thyroid hormones to regulate body temp, dry skin, high cholesterol

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27
Q

Addison’s Disease

A

adrenal gland insufficiency; adrenal cortex not secreting glucocorticoid/cortisol and mineralo corticoid/aldosterone

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28
Q

adrenal cortex releases/secretes 3 hormones

A

aldosterone, cortisol, sex hormones (androgen and estrogen)

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29
Q

adrenal cortex location and function

A

located on the outside of the adrenal gland, function is long term stress response

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30
Q

Addison’s Disease hormone levels

A

low cortisol, low aldosterone

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31
Q

Addison’s Disease secondary cause

A

chronic use of steroids medication (prednisone)

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32
Q

Addison’s Disease clinical manifestations

A

gradual onset, fatigue, weight loss, weakness, hypoglycemia

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33
Q

adrenal medulla stimulated by

A

brain/nervous sys via spinal cord

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34
Q

type of stimulation adrenal medulla receives from nervous sys

A

sympathetic nerves

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35
Q

adrenal medulla releases 2 catecholamines

A

adrenaline/epinephrine and noradrenaline/norepinephrine

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36
Q

sympathetic response “fight or flight” triggered by release of

A

epinephrine and norepinephrine

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37
Q

adrenal medulla vs adrenal cortex response time difference

A

adrenal medulla nervous stimulation so immediate response

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38
Q

adrenocorticotropin hormone (ACTH) released by

A

anterior pituitary gland. (posterior pituitary gland releases ADH

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39
Q

ACTH enters bloodstream and targets cells in

A

adrenal cortex

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40
Q

ACTH releases 3 hormones from adrenal cortex

A

mineralo corticoid/aldosterone, glucocorticoid/cortisol, sex hormones/androgen/estrogen

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41
Q

too high cortisol level in serum triggers what action?

A

negative feedback mechanism, cortisol alerts hypothalamus to stop releasing ACTH b/c inc level cortisol in circulation

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42
Q

kidneys/nephrons 3 primary functions

A

filter blood, reabsorbing and excrete via urine so role in BP

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43
Q

kidneys/nephrons 3 primary functions

A

filter blood, reabsorbing water and sodium back into blood and excrete via urine so role in BP

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44
Q

kidney reaction low BP

A

reabsorb water and sodium back into bloodstream; K+ will be reabsorbed into blood or urinated out depending on potassium level

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45
Q

aldosterone and low BP

A

aldosterone stimulates water and sodium reabsorption back into blood stream at distal convolated tubule of kidney

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46
Q

cortisol can cause hyperglycemia by

A

stimulating liver to begin glycogen synthesis, so glucose produced by gluconeogenesis process, induce insulin resistance, overreaction of glucose production and/or insulin resistance > hyperglycemia

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47
Q

cortisol effect on immune system

A

suppress immune system so risk for infection

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48
Q

why do cortisol and epinephrine stimulate glucose release into bloodstream?

A

the sympathetic response, “fight or flight” requires immediate glucose for large muscles and the brain

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49
Q

cortisol and epinephrine primary actions during sympathetic response

A

cortisol narrows arteries to increase circulation and epinephrine increases heart rate

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50
Q

hypofunction of adrenal cortex aka

A

Addison’s Disease

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51
Q

Addison’s and adrenal cortex hormones

A

cortisol/glucocorticoids lower
aldosterone/mineralo corticoid lower: Na+ excreted in urine
androgen/estrogen lower

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52
Q

Addison’s and negative feedback

A

no negative feedback to hypothalamus b/c low cortisol level, no inhibition of ACTH

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53
Q

Addison’s and the skin

A

hyperpigmentation (JFK) tan appearance b/c excess melanin

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54
Q

Addison’s, ACTH negative feedback and adrenal gland insufficiency

A

Addison’s condition low cortisol level so no negative feedback to hypothalamus to stop ACTH production, so ACTH excess which isn’t accepted by adrenal cortex so uses alternate pathway to produce melanin.

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55
Q

cortisol and inflammation

A

cortisol/steroids/hydrocortisone reduce inflammation by suppressing immune sys

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56
Q

2 types of bacteria

A

self/good especially in GI Tract, and non-self/bad foreign

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57
Q

autoimmune disease

A

body attacks itself aka good bacteria

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58
Q

Addison’s diagnostics: 3 tests

A

ACTH Stimulation Test, Serum Electrolytes levels, 24 hour cortisol urine test

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59
Q

ACTH Stimulation Test

A
  1. blood drawn from vein
  2. ACTH/cortrosyn injected into vein
  3. blood samples will show cortisol levels before and after ACTH stimulation
  4. normal results high cortisol level after ACTH/cortrosyn injection
  5. low levels indicate adrenal insufficiency/Addison’s
60
Q

Addison’s diagnostic Serum Electrolyte test

A

hyponatremia, hypoglycemia, increase potassium

61
Q

why serum electrolytes Na+ and glucose low in Addison’s?

A

adrenal insufficiency, adrenal cortex not accepting ACTH so not releasing alsosterone (so low sodium) and not releasing cortisol (so low glucose in blood)

62
Q

24 hour cortisol urine test

A

test for cortisol levels in urine over 24 hours; use for Addison and Cushing

63
Q

Addison’s expected 24 hour cortisol urine test results

A

low cortisol level in urine

64
Q

Addison’s 4 nursing interventions

A
  1. replace mineralo corticoids/aldosterone with Fludrocortisone
  2. replace glucocorticoids/cortisol with hydrocortisone
  3. monitor I/O, weigh daily, VS
  4. teach b/c hormone replacement may need to vary
65
Q

Addisonian Crisis caused by

A

low cortisol levels already pushed to crisis stage

  1. surgery
  2. trauma
  3. severe infection
  4. sudden withdrawal of cortisol/hydrocortisone/prednisone or dexamethasone
66
Q

Addisonian Crisis: 2 routes

A

kidney insufficiency/inability to accept ACTH/low cortisol/low aldosterone so:
1. cortisol route: liver function decrease>no gluconeogenisis>no glucose to increase energy>hypoglycemia
2. aldostrone route: kidney not reabsorbing water and sodium>hypovolemia>low BP
extreme crisis of hypoglycemia and hypovolemia can lead to coma

67
Q

Addison’s 4 nursing interventions

A
  1. replace hormones cortisol/hydorcortisone and aldosterone/fludrocortisone
  2. rehydrate with D5 NS
  3. replace glucose with Dextrose 50%
  4. if hyperkalemia, insulin with dextrose to shift K+ into cells/ICF from serum/circulatory sys/ECF
68
Q

Cushing Syndrome is

A

endocrine disorder that results from excess cortisol levels in the blood

69
Q

cortisol body levels circadian rhythms

A

cortisol peaks in morning “get up and go” and decline at night

70
Q

Cushing’s symptoms

A
  1. hyperglycemia
  2. muscle, skin, bone breakdown
  3. HTN
  4. electrolyte imbalance: increased Na+ and water, low K+ (K+ diluted by excess fluids)
  5. abnormal fat distribution
  6. moon face b/c high levels of cortisol
  7. buffalo hump
71
Q

Cushing’s Syndrome: 2 primary causes

A
  1. endogenous - high level cortisol made by body

2. exogenous - outside medications/steroids

72
Q

Cushing’s diagnostics: 4 tests

A
  1. hyperglycemia
  2. electrolyte imbalance: sodium. water, potassium
  3. 24 hour cortisol urine test (amt cortisol excreted in urine over 24 hours)
  4. Dexamethasone Suppression Test - low dose steroid should lower cortisol level
73
Q

Cushing’s surgery: 2 types

A
  1. adrenalectomy - tumor or adrenal gland too large

2. transsphenoidal hypophysectomy - pituitary

74
Q

Adrenalectomy nursing interventions: 4

A
  1. monitor for hemorrhage
  2. deep breathing, coughing
  3. hormone imbalances
  4. IV steroids
75
Q

catecholamines: 2 hormones

A

epinephrine and norepinephrine secreted by adrenal medulla

76
Q

pheochromocytoma is

A

overstimulation of sympathetic nervous sys by tumor on adrenal medulla, excess epi and nor

77
Q

pheochromocytoma symptoms

A

high basal metabolic rate (BMR), HTN, high HR, headache

78
Q

24 hour tests for adrenal insufficiency:3 types

A
  1. Addison’s - 24 hour cortisol urine test (adrenal cortex)
  2. Cushing’s - 24 hour cortisol urine test (adrenal cortex)
  3. Pheochromocytoma - 24 hour catecholamines urine test (adrenal medulla)
79
Q

hypothyroidism symptoms: 6

A
  1. low BMI basal metabolic index
  2. low GI motility, risk constipation, slow metabolic movement, less peristalsis
  3. low HR
  4. low energy, fatigue
  5. impaired neurologic function
  6. lipid metabolism abnormalities
80
Q

Hashimoto is

A

most common form of hypothyroidism

81
Q

hypothyroidism treatment

A

Levothyroxine sodium/Synthroid

82
Q

Levothyroxine nursing interventions: 4

A
  1. teach b/c levo will bind to products with iron and calcium so don’t take with food
  2. take on empty stomach, 1 hour before eating or 3 hours after eating
  3. check pulse daily
  4. s/s hyper/hypo thyroidism
  5. take in am b/c speeds up metabolism
83
Q

extreme, severe stage of hypothyroidism

A

myxedema coma

84
Q

myxedea coma symptoms: 4

A
  1. significant drop core body temp
  2. hypoxemia and hypercapnia decreased respirations, low cardiac output
  3. hypoglycemia
  4. hypotension
85
Q

pituitary gland lobes: 2

A

anterior and posterior

86
Q

posterior pituitary lobe produces

A

ADH

87
Q

anterior pituitary lobe produces

A

TSH - thyroid secreting hormone and ACTH which acts on adrenal medulla and cortex

88
Q

RAIU is

A

radioactive iodine uptake test

89
Q

thyroid gland and iodine relationship

A

thyroid gland needs iodine to secrete TSH/T3 and T4

90
Q

iodine sources: 2

A

seafood, table salt

91
Q

RAIU does what?

A

measures iodine uptake level in thyroid gland

92
Q

hyperthyroidism and RAIU

A

RAIU test results should be high in hyperthyroidism

93
Q

hypothalamus produces hormones: 2 types

A

ADH hormone and regulatory hormones

94
Q

hypothalamus regulatory hormones regulate?

A

pituitary gland hormones: ACTH and TSH (thyroid secreting hormone)

95
Q

hyperthyroidism symptoms: 5

A
  1. nervous, irritated
  2. hypercalcemia b/c thyroid hormones activate osteoclasts to release calcium from bone
  3. warm/moist skin b/c higher BMR and glucose/energy production warm body
  4. weight loss
  5. insomnia
96
Q

parathyroid and calcium

A

releases calcium into bloodstream when hypocalcemia

97
Q

ADH aka vasopressin function

A

regulate fluid volume

98
Q

ADH = Antidiuretic Hormone regulates: 2

A
  1. osmolality

2. volume of blood

99
Q

osmolality does what?

A

measures the concentration of dissolved particles (osmolality) in the blood.

100
Q

high osmolality (300+) and low blood volume, ADH reaction

A

ADH released, retain fluid to add water to offset high sodium

101
Q

low osmolality (less than 270) and high blood volume, ADH reaction

A

inhibit ADH, diuresis, fluid not retained

102
Q

ADH and the kidney/DCT/nephron

A

ADH increase water and reabsorption by the kidneys into the bloodstream/plasma, less urine output

103
Q

ADH and hemorrhage

A

release ADH to increase blood volume/water

104
Q

sodium level changes and mental status

A

sodium impacts brain and mental status so neuro assessment

105
Q

ADH disorders: 2

A

DI - Diabetes Insipidus

SIADH - Syndrome of Inappropriate ADH

106
Q

DI (Diabetes Insipidus) ADH level:

A

deficiency of ADH

107
Q

deficiency of ADH and water level

A

water being excreted, not held

108
Q

DI symptoms: 6

A
  1. low BP
  2. polyuria
  3. high HR, tachycardia
  4. orthostatic hypotension
  5. dry mucous membranes
  6. polydipsia, thirst because lost fluid
109
Q

DI and sodium level: blood and urine

A

hypernatremia, b/c less water in blood; urine dilute so low urine osmolality

110
Q

DI and urine specific gravity

A

low urine specific gravity, dilute urine, mostly water b/c sodium, glucose water urinated out

111
Q

SIADH (Syndrome of Inappropriate ADH) ADH level:

A

excessive release of ADH

112
Q

excess of ADH and water level

A

high water level

113
Q

SIADH symptoms:

A
  1. oliguria
  2. high BP, but not fluid volume overload (FVE)
  3. high HR, tachycardia
  4. no edema or dehydration
  5. weight gain b/c retain fluid
114
Q

SIADH and sodium

A

serum: hyponatremia b/c excess water offset salt
urine: high specific gravity

115
Q

hyponatremia brain risk

A

seizure

116
Q

SIADH and urine specific gravity

A

high b/c retaining water and urinate out particles with low percentage of water

117
Q

SIADH diet

A

fluid restriction

118
Q

DI urine specific gravity level

A

just above water, 1.01, water 1.00

119
Q

transsphenoidal approach to pituitary tumor

A

hypophysectomy

120
Q

transsphenoidal hypophysectomy path

A

removal of tumor on pituitary gland via nose/sphenoid cavity

121
Q

transsphenoidal hypophysectomy post op care

A
  1. nasal packing
  2. elevate HOB 15-30 degrees
  3. prevent intracranial pressure
  4. check for transferrin and glucose in drainage b/c likely CSF (cerebrospinal fluid)
  5. hormone replacement
  6. check eyesight
122
Q

anterior pituitary: 2 hormones

A
  1. TSH thyroid stimulating hormone

2. ACTH adrenocorticotropic hormone

123
Q

thyroid gland hormones: 2

A

T3 and T4

124
Q

if T3 and T4 are high, then TSH

A

low, inhibited

125
Q

thyroid gland primary functions

A

increase metabolism (growth, body temp), and increase energy required for increased metabolism (glucose needed)

126
Q

hypothyroidism effect on GI system

A

lower metabolism>slower peristalsis>slower food movement via tract>constipation risk

127
Q

SIADH and urine, concentrated or dilute?

A

concentrated b/c retain water, urinate particles (Na+)

128
Q

bulging eyes due to fluid accumulation behind eyes

A

Grave’s, hyperthyroidism, exophthalmos

129
Q

hyperthyroidism edema?

A

no edema, fluid retained by shifting between intracellular and extracelluar to maintain equilibrium

130
Q

hormone primarily responsible for metabolizing sodium

A

aldosterone

131
Q

ADH is affected by blood volume and blood osmolality?

A

true, ADH blood not urine

132
Q

thyroidectomy complication- 1

A

tetany, tingling aroung lips or muscular twitch b/c low calcium (procedure could have removed a parathyroid gland which raises calcium level if low.)

133
Q

parathyroid gland secretes

A

PTH, parathyroid hormone

134
Q

PTH, parathyroid hormone, function

A

regulates calcium and phosphorus by acting on bone

135
Q

PTY, parathyroid hormone, increases or decreases, bone resorption?

A

increases, resorption means returning to blood stream

136
Q

calcium normal range

A

8.5 to 10.5

137
Q

Grave’s/hyperthyroidism autoimmune?

A

yes

138
Q

Grave’s negative feedback?

A

yes, ample T3 and T4 in blood so TRH not produced but b/c autoimmune problem TSH keeps getting produced so more T3/T4>hyperthyroidism

139
Q

Grave’s assessment: 5

A
  1. goiter
  2. weight loss. high metabolism
  3. heat intolerance, unable to monitor body temp
  4. tachycardia, high metabolism
  5. anxious, irritable
140
Q

Grave’s risk factors:

A
  1. female
  2. family history
  3. stress
  4. thyroiditis = infection
141
Q

Grave’s and RAIU or Thyroid scan

A

high RAIU b/c high level of iodine so more T3 produced

142
Q

Grave’s medications: 3

A
  1. anti-thyroid drugs or PTU
  2. SSKI saturated solution potassium iodine
  3. Beta adrenergic blockers (lower sympathetic activity by adrenal gland receptors)
143
Q

Grave’s/hyperthyroidism surgery

A

thyroidectomy

144
Q

hypocalcemia/thyroidectomy post op

A

hypocalcemia - Trousseau and Chvostek

145
Q

beta blocker pre administration

A

HR and BP

Nursing 2 (9 decks)

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