Endocrine System (Exam One) Flashcards
1
Q
Which glands are responsible for secreting hormones into the blood stream?
A
Endocrine glands
2
Q
List examples of the negative-feedback system within the body.
A
- Thermoregulation
- Blood sugar regulation
- Sweating
- Urination
3
Q
The Anterior Pituitary Gland is regulated by which gland?
A
Hypothalamus
4
Q
What hormones come from the Anterior Pituitary Gland?
A
- Thyroid stimulating hormone (TSH)
- Prolactin
- Follicle stimulating hormone (FSH)
- Luteinizing hormone (LH)
- Adrenocorticotropic hormone (ACTH)
- Growth hormone (GH)
5
Q
The Posterior Pituitary Gland is an extension of what?
A
Extension of hypothalamus
6
Q
Does the Posterior Pituitary Gland synthesize its hormones? Explain.
A
- No
- It only stores and releases hormones
7
Q
What gland stores and releases Antidiuretic hormone and Oxytocin?
A
Posterior Pituitary Gland
8
Q
What are tropic hormones?
A
Hormones that send messages to other glands and tell those glands to release their specific hormones
9
Q
What hormones are classified as tropic hormones?
HINT: FLAT
A
- Follice Stimulating Hormone (FSH)
- Luteinizing Hormone (LH)
- Adrenocorticotropic Hormone (ACTH)
- Thyroid Stimulating Hormone (TSH)
10
Q
What is the most common cause of hypo- and hyper-function of the anterior pituitary gland?
A
Tumors
11
Q
What is the main goal of the anterior pituitary gland?
A
Secrete tropic hormones
12
Q
Deficiencies of which hormone(s) is considered life threatening?
A
- Thyroid Stimulating Hormone (TSH)
- Adrenocorticotropic Hormone (ACTH)
13
Q
How does Thyroid Stimulating Hormone (TSH) work? Which gland does it act on?
A
- Stimulates the thyroid gland to release thyroid hormones (T3 and T4)
- Acts on the thyroid gland
14
Q
How does Adrenocorticotropic Hormone (ACTH) work? Which gland does it act on?
A
- Stimulates the adrenal cortex to release glucocorticoids (cortisol)
- Acts on the adrenal gland
15
Q
If there is a malfunction of the Anterior Pituitary Gland, what will happen with secretion of its hormones?
A
There will either be too little or too much of various hormones released
16
Q
Why would increased levels of Adrenocorticotropic Hormone be present in the body?
A
- During periods of stress, trauma, infection, illness, etc.
- ACTH is stimulating the adrenal cortex to release glucocorticoids (cortisol)
17
Q
Corticotropin-releasing hormone (CRH) stimulus the release of what hormone?
A
Adrenocorticotropic Hormone (ACTH)
18
Q
What tropic hormone is released to promote the release of cortisol from the adrenal cortex?
A
Adrenocorticotropic Hormone (ACTH)
19
Q
Hyperfunction of the growth hormone (GH) causes what disorder?
A
Acromegaly
20
Q
Acromegaly causes the overgrowth of what structures? Are the onset of symptoms rapid or slow?
A
- Overgrowth of soft tissues and certain bones (width)
- Develops slowly over time
21
Q
What type of skin changes occur in a patient with acromegaly?
A
- Thick skin
- Oily skin
- Increased sweating
22
Q
List the signs and symptoms of acromegaly.
A
- Abnormally large growth of hands, feet, nose, jaw, or brow
- Sweating
- Thick tongue/lips
- Oily skin
- Thick skin
- Hyperglycemia
- Type II DM
- Hoarse voice
- Weight gain
23
Q
Acromegaly is what type of gland disorder?
A
Anterior Pituitary Gland disorder
24
Q
Acromegaly is a secondary cause of __________.
A
Diabetes
25
Posterior pituitary gland disorders will result in the overproduction or underproduction of what hormone?
Antidiuretic Hormone (ADH)
26
What environment within the body will cause Antidiuretic Hormone (ADH) to be released?
- High serum osmolality
| - Dehydration
27
When will the release of antidiuretic hormone (ADH) be inhibited?
Low serum osmolality
28
What is the primary role of antidiuretic hormone (ADH) when it is released?
To conserve fluids through the kidneys
29
What is the normal range for serum osmolality?
280 - 295 mOsm/kg
30
What is the normal range for urine osmolality?
300 - 900 mOsm/kg
31
What is the normal range for specific gravity?
1.005 - 1.030
32
Describe the amount of solutes in the urine and urine characteristics if specific gravity is low.
- Less solutes in urine
| - Dilute urine
33
Describe the amount of solutes in the urine and urine characteristics if specific gravity is high.
- More solutes in urine
| - Concentrated urine
34
List situations in which serum osmolality will be decreased.
- Fluid volume overload
| - SIADH
35
List situations in which serum osmolality will be increased.
- Dehydration
- Ethanol ingestion
- Diabetes insipidus (DI)
- Renal tubular necrosis
- Severe pyelonephritis
36
Is urine osmolality or specific gravity more effective in determining urine concentration?
Urine osmolality
37
List a condition in which serum and urine osmolality may both be elevated?
Dehydration
38
What is the most common cause of Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
Hormone-secreting tumor (i.e. lung cancer)
39
When taking care of a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH), the nurse knows what would be a priority intervention?
- Fluid restriction
| - Daily weight
40
List signs and symptoms of Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
- Decreased urine output
- Concentrated urine
- Increased body weight
- Dyspnea on exertion
- Fatigue
- Increased thirst
41
A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is on a fluid restriction. What might the nurse give this patient instead?
- Hard candies
- Mouth swabs
- Sugarless gum
- Ice chips
42
Should the nurse restrict salt in a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH)? Why or why not?
- No
| - Patient is at higher risk for hyponatremia
43
List laboratory values that will be decreased in a patient suffering from Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
- Sodium
- Hemoglobin
- Hematocrit
- Chloride
- Serum osmolality
44
List laboratory values that will be increased in a patient suffering from Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Urine osmolality
45
If a patient has mild hyponatremia, the nurse should expect sodium laboratory values within what range?
125 - 134
46
List signs and symptoms of mild hyponatremia.
- Headache
- Muscle cramps
- Irritability
47
If a patient has severe hyponatremia, the nurse should expect sodium laboratory values within what range?
120 - 125
48
List signs and symptoms of severe hyponatremia.
- Muscle cramps
- Vomiting
- Cerebral edema
- Decreased LOC
- Headache
- Confusion
- Seizures
- Coma
49
What type of precautions should be initiated for a patient diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) who is severely hyponatremic?
Seizure precautions
50
List nursing management for Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
- I&O's
- Vital signs (blood pressure)
- Lung sounds
- Daily weights
- Position changes
- Seizure precautions
51
A patient diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) who has mild hyponatremia is allowed how many milliliters of fluid(s) per day?
800mL - 1000mL
52
A patient diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) who has severe hyponatremia is allowed how many milliliters of fluid(s) per day?
500mL
53
Sodium levels must be greater than _______ in order to administer lasix in a patient diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
>125 mEq/L
54
A patient arrives to the medical floor from the ED after being diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). What type of fluids does the nurse expect to be ordered for this patient?
Hypertonic saline (3%)
55
Improvement of Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is indicated by what laboratory values and/or signs and symptoms?
- Increased urine output
- Increased urine sodium
- Decreased specific gravity
- Decreased weight
56
Describe the etiology of Nephrogenic Diabetes Insipidus (DI).
Kidneys are resistant to antidiuretic hormone (ADH)
57
List causes of Diabetes Insipidus (DI).
- Pituitary tumor
- Head trauma
- Surgery
- Medication
58
List the signs and symptoms of Diabetes Insipidus (DI).
- Polyuria
- Polydipsia
- Dehydration
- Hypotension
- Tachycardia
- Hypovolemic shock
- Decreased LOC
- Death
59
List laboratory values that will be decreased in a patient suffering from Diabetes Insipidus (DI).
- Specific gravity
| - Urine osmolality
60
List laboratory values that will be increased in a patient suffering from Diabetes Insipidus (DI).
- Serum osmolality
| - Sodium
61
List signs and symptoms of hypernatremia.
- Irritability
- Mental dullness
- Confusion
- Lethargy
- Coma
62
A patient diagnosed with Diabetes Insipidus (DI) has a sudden change in mental status and level of consciousness. The nurse knows to do what as the priority intervention?
Notify the HCP!
63
List nursing management for Diabetes Insipidus (DI).
- Manage hydration
- Free access to fluids!
- I&O's
- Daily weight
- Monitor urine specific gravity
- Neurological checks
64
Improvement of Diabetes Insipidus (DI) is indicated by what laboratory values and/or signs and symptoms?
- Decreased urine output
- Decreased sodium level
- Increased specific gravity
- Increased weight
65
What type of education or teaching should be provided to a patient being discharged from the hospital with a Diabetes Insipidus (DI) diagnosis?
Monitoring I&O's at home
66
A patient diagnosed with Diabetes Insipidus (DI) one week ago was sent home with specific discharge instructions to monitor all intake and output. The patient begins to notice a fluctuation in their I&O's. What should the nurse instruct the patient to do?
Immediately notify HCP!
67
What medication is given for patients diagnosed with Diabetes Insipidus (DI)?
-Desmopressin Acetate (synthetic vasopressin)
68
What is a transsphenoidal hypophysectomy?
- Removal of pituitary gland or tumor through sinuses
| - Does not affect or harm brain tissue
69
What is the treatment of choice for a patient with a pituitary tumor?
Transphenoidal Hypophysectomy
70
What type of education should be provided to a patient before undergoing a transphenoidal hypophysectomy?
- Location of surgery
- Nasal packing in place for 2-3 days
- Will have to mouth breath
71
If a pituitary tumor is removed via transphenoidal hypophysectomy, what type of drug therapy will they require?
Lifelong hormone replacement therapy
72
How are pituitary disorder and tumors treated when surgery or radiation is unsuccessful, or surgery is not an option?
Medications
73
If a patient suffers from excessive growth hormone, what education should the nurse provide in relation to body image concerns?
Changes that have already occurred from excessive growth hormone (GH) will not reverse themselves
74
What type of activities should the nurse education a patient to avoid after undergoing a transphenoidal hypophysectomy?
- Blowing nose
- Coughing
- Bending over
- Straining with bowel movement
- Brushing teeth for 10 days
75
What exercises should be completed by all post-operation patients?
- Deep breathing exercises
| - Incentive spirometry
76
What is the priority nursing intervention for a patient who displays neurological or visual changes after a transphenoidal hypophysectomy?
Immediately notify HCP!
77
A patient who has had a transphenoidal hypophysectomy is at an increased risk for developing what other condition if bacteria comes in contact with the brain?
Meningitis
78
A post-op transphenoidal hypophysectomy patient is at an increased risk for developing what condition due to a lack of antidiuretic hormone (ADH)? How would the nurse monitor for this condition?
- Diabetes insipidus
| - Monitor urine output
79
List nursing interventions to decrease intra-cranial pressure for a post-op transphenoidal hypophysectomy patient.
- Elevate HOB
- Balance rest and activity
- Avoid brushing teeth for 10 days
80
What signs or symptoms might a patient display if they are suffering from a cerebrospinal fluid leak or epistaxis following a transphenoidal hypophysectomy procedure?
- Post nasal drip
- Frequent swallowing
- Frequent throat clearing
81
If the adrenocorticotropic hormone (ACTH) is removed, what is prescribed as replacement therapy?
Corticosteroids
82
If the thyroid stimulating hormone (TSH) is removed, what is prescribed as replacement therapy?
Levothyroxine
83
If the antidiuretic hormone (ADH) is removed, what is prescribed as replacement therapy? What type of therapy is prescribed based solely on symptoms?
- Vasopressin
| - Exogenous antidiuretic hormone (ADH)
84
Which endocrine gland can possibly be palpated? When should the nurse avoid palpating this gland?
- Thyroid gland
| - Avoid palpation in patient with uncontrolled hyperthyroidism
85
What hormone stimulates the thyroid to release T3 and T4?
Thyroid stimulating hormone (TSH)
86
In reference to the thyroid hormones, _____ is more potent than ______.
T3 is more potent than T4
87
What three hormones come from the thyroid?
- Triiodothyronine (T3)
- Thyroxine (T4)
- Calcitonin
88
Which thyroid hormone is the best indicator of thyroid function? This specific hormone accounts for _____ of hormones produced by the thyroid gland.
- T4
| - 90%
89
In order for T3 and T4 to be synthesized by the thyroid, what must be in the diet?
- Iodine
| - Protein
90
What biological system is responsible for the effects produced in hyperthyroidism and hypothyroidism?
Sympathetic nervous system
91
What do T3 and T4 do within the body?
- Regulate cellular respiration of glucose and fatty acids
- Control metabolism
- Growth and development
- Brain function
- Essential for life
92
Describe the etiology of hyperthyroidism.
Excessive synthesis and release of T3 and T4
93
List the signs and symptoms of hyperthyroidism.
- Heat intolerance
- Tachycardia
- Palpitations
- Hypertension
- Increased appetite
- Weight loss
- Frequent stools
- Nervousness
- Goiter
94
List the signs and symptoms of hypothyroidism.
- Fatigue/lethargy
- Mental dullness
- Bradycardia
- Hypoventilation
- Cold intolerance
- Constipation
- Weight gain
- Dry skin/hair
- Myxedema
95
What is the primary cause of hyperthyroidism?
Graves disease
96
Women are _____ more likely to develop Graves disease.
5 times
97
List precipitating factors of Graves disease.
- Insufficient iodine
- Smoking
- Infection
- Stress
- Genetics
98
List the signs and symptoms of Graves disease.
- Possible goiter
- Systolic hypertension
- Tachycardia
- Heat intolerance
- Hyperthermia
- Weight loss
- Exopthalmos
- Insomnia
99
What type of nursing interventions should be implemented for a patient diagnosed with Graves disease?
- Frequent clothing and bedding changes d/t excessive sweating
- High calorie diet
- Eye drops for exopthalmos
100
List nursing interventions for a patient diagnosed with Graves disease who has an increase in periorbital fluid.
- Elevate head of bed
| - Tape eyes shut using hypoallergenic tape
101
An acute thyroid storm occurs as a result from what?
Stressors
102
An acute thyroid storm may occur due to what surgical procedure?
Thyroidectomy
103
The signs and symptoms of hyperthyroidism and Graves disease will be more prominent or severe in a patient suffering from what condition?
Acute thyroid storm
104
Which specific beta blocker is the drug of choice when treating the signs and symptoms of hyperthyroidism or a thyroid storm?
Propranolol
105
A patient with a history of asthma is diagnosed with a thyroid storm. Which types of beta blockers are contraindicated in this patient? Which specific beat blocker will be prescribed to this patient instead?
- Non-selective beta blockers
| - Atenolol
106
What is the priority nursing intervention for a patient diagnosed with an acute thyroid storm or hyperthyroidism?
- Correct hyperthermia
| - Decrease body temperature
107
List medications that block thyroid synthesis or secretion.
- Porpylthiouracil (PTU)
| - Methimazole
108
Which medication prevents the thyroid gland from making hormones?
Methimazole
109
What education should the nurse provide to a patient who has received radioactive iodine therapy (RIT)?
- Avoid pregnant women and children for 7 days
- Flush toilet 2-3 times after use
- Do not prep food for others
- Launder clothing/bedding separate
110
A patient receiving radioactive iodine therapy (RIT) asks the nurse how long it will take before they start to feel better. What is the best response by the nurse?
May take 6 to 8 weeks to experience relief of symptoms
111
A patient receiving radioactive iodine therapy (RIT) should be educated on the signs and symptoms of what other disorder?
Hypothyroidism
112
A patient is post-op thyroidectomy. What supplies should the nurse have at bedside?
- Intubation
- Tracheostomy tray
- Oxygen
- Suction
- Calcium gluconate
113
List signs and symptoms of hypocalcemia.
- Dysrhythmias
- Decreased muscle tone
- Laryngospasms
- Numbness/tingling in hands, feet, lips
114
What sign or symptom is the first indicator of hypocalcemia?
Numbness or tingling in the lips
115
What medication is administered for a patient suffering from hypocalcemia?
IV calcium gluconate
116
Which hormone is responsible for calcium regulation?
Parathyroid hormone
117
What type of precautions or monitoring should the nurse place a post-op thyroidectomy patient on?
Cardiac monitoring
118
Why are CNS depressants avoided in patients with hypothyroidism?
Want to avoid slowing down the body system even further
119
What is the preferred route of medication administration for a patient with hypothyroidism? Why?
- IV
| - Metabolism is decreased so medications are given IV for better effects
120
List signs and symptoms of hypercalcemia.
- N/V
- Lethargy
- Weakness
- Fatigue
- Cardiac dysrhythmias
- Polyuria
- Constipation
121
List priority nursing interventions for patients with hypercalcemia.
Maintain safety when repositioning due to brittle bones
122
List the functions of aldosterone.
- Conserve sodium
- Secrete potassium
- Increase water retention
123
What is the result of too much cortisol in the blood?
Hyperglycemia
124
List instances in which cortisol is released.
- Stress
- Infection
- Trauma
- Inflammation
125
List causes of Cushing's syndrome.
- Chronic exposure to excess corticosteroids
| - Exogenous corticosteroid use
126
List the signs and symptoms of Cushing's syndrome.
- Hypertension
- Edema
- Hypernatremia
- Hypokalemia
- Hyperglycemia
- Increased urine glucose
- Purple/red straie
- Moon face
- Buffalo hump
- Muscle wasting
- Loss of bone mass
- Loss of collagen
- Male pattern hair growth in women
- Gynecomastia and impotence in men
127
Describe the affects that an adrenal cortex removal may have if only one adrenal cortex is removed and one adrenal cortex is not removed.
Remaining adrenal cortex may be overworked and unable to maintain balance
128
If a patient abruptly discontinues exogenous steroid use, what condition might this cause?
Addison's disease
129
Explain why steroid use causes immunosuppression.
Decreases function of leukocytes
130
List acute nursing interventions for a patient with Cushing's syndrome.
- Monitor vital signs
- Monitor I&O's
- Daily weight
- Serum electrolytes
- Glucose
- Monitor for infection
131
If the pituitary gland or adrenal gland is removed, and there is a lack of (ACTH), what is a priority nursing intervention?
Administer exogenous corticosteroids
132
During surgical intervention, will the nurse administer an increased or decreased amount of steroids? Explain.
- Increased amount
| - Want to account for increased stress, infection, illness
133
What percentage of the adrenal cortex is destroyed before signs and symptoms of Addison's disease arise?
90%
134
What hormone is affected if there is an adrenal insufficiency?
Increased levels of ACTH
135
Hypotension is a great threat and can kill a patient with what disease?
Addison's disease
136
Should a patient with Addison's disease increase or decrease their sodium intake?
Increased sodium intake
137
List signs and symptoms of Addison's disease.
- Weight loss
- Fatigue
- Hyponatremia
- Hyperkalemia
- Abdominal pain
- Diarrhea
- Headache
- Orthostatic hypotension
- Salt craving
- Bronze colored skin
138
Besides increasing corticosteroid administration during events of stress, what electrolyte should the nurse educate the patient on increasing? What electrolyte should the nurse educate the patient on decreasing?
- Increase sodium intake
| - Decrease potassium intake
139
What are the priority nursing concerns in a patient with Addisonian crisis?
- Hypotension
| - Hypovolemia
140
What is the leading cause of death in a patient with an Addisonian crisis?
Circulatory collapse
141
In an Addisonian crisis, when are higher doses of steroids required?
In the morning
142
What medications are administered during an Addisonian crisis?
- IV corticosteroids
- Hydrocortisone
- IV D5N5
- Normal saline bolus
143
What is the leading cause of adult blindness, renal disease, and non-traumatic limb amputation?
Diabetes mellitus
144
List the common signs and symptoms of diabetes mellitus type 1 and type 2.
- Polyuria
- Polydipsia
- Polyphagia
145
Which insulin(s) may be administered via IV?
Regular insulin only
146
Where on the body is insulin absorbed most quickly?
Abdomen
147
Is it okay for a patient to exercise if their blood glucose level is elevated?
Yes
148
The nurse should educate a patient to avoid working out if what is present?
Ketones in the urine
149
Describe the initial treatment of diabetic ketoacidosis.
- Establish airway
- Obtain BGL
- Establish IV access
- Draw labs
- Administer normal saline
- Administer insulin/insulin drip
150
List the onset, peak, and duration of NPH (Novolin N) insulin.
- Onset: 1.5 - 4 hr
- Peak: 4 - 12 hr
- Duration: 12 - 18 hr
151
List the onset, peak, and duration of regular (Novolin R) insulin.
- Onset: 30 min to 1 hr
- Peak: 2 - 5 hr
- Duration: 5 - 8 hr
152
List the onset, peak, and duration of long-acting (Detemir) insulin.
- Onset: 0.8 - 4 hr
- Peak: None
- Duration: 16 - 24 hr
153
List the onset, peak, and duration of short-acting (Aspart) insulin.
- Onset: 10 - 30 min
- Peak: 30 min - 3 hr
- Duration: 3 - 5 hr
