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Adult Health 3 > Endocrine System > Flashcards

Endocrine System Flashcards

1
Q

What causes acromegaly?

A

overproduction of growth hormone

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2
Q

Acromegaly most often occurs because of a ______

A

benign growth hormone-secreting pituitary adenoma

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3
Q

Excessive growth hormone causes an overgrowth of soft tissues and bones in the _____, ____, and _____

A

hands, feet, face

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4
Q

Due to tongue enlargement, ___ and ____ occur

A

voice deepens; sleep apnea

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5
Q

What happens to the skin with acromegaly?

A

becomes thick, leathery, oily with acne outbreaks

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6
Q

What happens with GH and insulin?

A

glucose intolerance turns into diabetes mellitus

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7
Q

What are people with acromegaly prone to?

A

cardiovascular disease, diabetes mellitus, colorectal cancer

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8
Q

Diagnostic studies for acromegaly

A

1GF-1 levels, OGTT, MRI, CT with contrast

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9
Q

What is the primary nursing goal for acromegaly?

A

return GH to normal level

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10
Q

What is the treatment of choice for acromegaly?

A

hypophysectomy

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11
Q

What is the primary drug for acromegaly?

A

octreotide - adminsitered 3 times weekly

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12
Q

define panhypopituitarism

A

total failure of the pituitary gland resulting in deficiency of all pituitary hormones

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13
Q

What is the usual cause of pituitary hypofunction?

A

pituitary tumor

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14
Q

Early manifestations of hypopituitarism

A

headaches, visual changes, loss of smell, nausea and vomiting, seizures

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15
Q

What is the treatment for hypopituitarism

A

surgery or radiation therapy with lifelong hormone replacement

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16
Q

What medication is used for long-term hormone therapy in adults with GH deficiency

A

somatropin

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17
Q

What are the mild to moderate side effects of somatropin?

A

fluid retention with swelling in the feet and hands, myalgia, joint pain, headache

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18
Q

When should GH be administered?

A

daily in the evenings

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19
Q

When is hormone therapy contraindicated?

A

phlebitis, pulmonary embolism, breast cancer, prostate cancer

20
Q

What should a nurse do after a pituitary surgery?

A

Assess the patient for the formation of a hematoma compressing the optic nerve

21
Q

What are common postoperative complications after pituitary surgery?

A

CSF leaks, epistaxis

22
Q

Post pituitary surgery, a glucose level greater than _____ indicates CSF leakage from an open connection with the brain

A

30 mg/dL

23
Q

What do complaints of persistent and severe generalized or supraorbital headache post pituitary surgery indicate?

A

CSF leakage into sinuses

24
Q

After pituitary surgery the patient’s HOB should be at a ____ degree angle at all times

A

30

25
Q

Advise the patient to avoid tooth brushing for at least ___ days to protect the suture lines post pituitary surgery

A

10

26
Q

How do you assess for DI post pituitary surgery

A

report urine output > 200 mL/hr for more than 3 consecutive hours or a specific gravity level less than 1.005; elevated sodium levels, extreme thirst

27
Q

How do you treat DI?

A

desmopressin acetate

28
Q

How will sodium levels less than 125 mEq/L exhibit?

A

headache, vomiting, decreased LOC

29
Q

Clinical manifestations of SIADH

A

low urine output, increased body weight, thirst, dyspnea on exertion, fatigue

30
Q

Diagnostics for SIADH

A

sodium less than 134, urine specific gravity greater than 1.025

31
Q

What drugs can cause SIADH

A

carbamazepine, chlorpropamide

32
Q

What is the treatment with SIADH that has a sodium level greater than 125?

A

fluid restriction of 800-1000 mL/day

33
Q

what medication can be used to promote diuresis?

A

furosemide - sodium must be at least 125

34
Q

What drug blocks the effect of ADH on the renal tubules and dilutes the urine?

A

demeclocycline

35
Q

How should HOB be with SIADH

A

flat or elevated no more than 10 degrees

36
Q

What is given with SIADH that has severe hyponatremia?

A

3% NaCl

37
Q

When correcting severe hyponatremia the level should not increase by more than _____ in the first 24 hrs

A

8-12 mEq/L

38
Q

What can happen if you quickly increase sodium levels with SIADH

A

osmotic demyelination syndrome

39
Q

What is the fluid restriction with severe hyponatremia

A

500 mL/day

40
Q

What are manifestations of DI

A

polydipsia, polyuria, low specific gravity

41
Q

Diagnostics for DI

A

water deprivation test, measure ADH after desmopressin is given

42
Q

What is the treatment for central DI

A

fluid and hormone therapy

43
Q

What is given with acute DI

A

IV hypotonic saline or dextrose 5%

44
Q

What is the hormone replacement of choice for central DI

A

desmopressin

45
Q

what medications help decrease thirst associated with central DI

A

chlorpropamide and carbamaepine

46
Q

Treatment measures for nephrogenic DI

A

low-sodium diet, thiazide diuretics, indomethacin

Adult Health 3 (4 decks)

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