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Adult Health Nursing 2 > endocrinology > Flashcards

endocrinology Flashcards

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1
Q

Anterior Pituitary Gland Hormones

A 
Growth Hormone (GH) aka Somatotropin
Thyroid-stimulating Hormone (TSH)
Adrenocorticotropic Hormone (ACTH)
Prolactin
Lutenizing Hormone (LH) or Interstitial cell stimulating hormone (ICSH)
Follicle-stimulating Hormone (FSH)
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2
Q

Posterior Pituitary gland Hormones

A 
Antidiuretic Hormone (ADH)
Oxytocin
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3
Q

Thyroid Gland Hormones

A 
Thyroid Hormone (TH)
Calcitonin
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4
Q

Parathyroid Hormones

A

Parathyroid Hormone (PTH)

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5
Q

Adrenal Medulla Hormones

A

Catecholamines: epinephrine (adrenaline) & norepinephrine (noradrenaline)

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6
Q

Adrenal Cortex hormones

A

Mineralcorticoids: aldosterone
Glucocorticoids: cortisol & cortisone

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7
Q

Pancreas Hormones

A

Glucagon (alpha cells)
Insulin (beta cells)
Somatostatin (delta cells)
Pancreatic polypeptide (F cells)

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8
Q

Gonad hormones

A

Adrognes: testosterone, estrogen, progesterone

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9
Q

Acromegaly

A

Increased secretion of GH AFTER puberty and closure of epiphyseal plates. Often caused by pituitary tumor.

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10
Q

S/S and complications of Acromegaly

A 
S/S:
Forehead enlarges
Maxilla lengthens
tongue enlarges
voice deepens
overgrowth of hands and feet
Complications:
peripheral nerve damage
HA
HTN
CHF
seizures
visual disturbances
impaired glucose tolerance
diabetes
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11
Q

Tx for Acromegaly

A

Surgical removal of pituitary tumor or irradiation

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12
Q

Simmonds Disease

A

The profound and progressive depression of all bodily functions due to the complete or partial failure of anterior pituitary secretions (STH, ACTH, TSH, FSH, LH)

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13
Q

What is Diabetes Insipidus

Name 3 types of DI

A

Absence/deficiency of ADH causing non-reabsorption of fluids.
Neurogenic
Nephrogenic
Psychogenic

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14
Q

S/S of Diabetes Insipidus

A 
polyuria
polydipsia
constipation
dehydration
hypernatremia
hyperosmolality
dilute urine
low specific gravity
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15
Q

Tx for Diabetes insipidus

A

Treat underlying cause
IV hypotonic fluids
Increase oral fluids
Replace ADH (desmopressin acetate)

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16
Q

What is Syndrome of Inappropriate Diuretic Hormone (SIADH)

A

High levels of ADH in the absence of serum hypo-osmolality. Most often caused by malignant tumors

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17
Q

S/S of SIADH

A 
Water retention/weight gain
Decreased UOP
Increased USG
Serum osmolality low
Hyponatremia
HA
Change in LOC
muscle twitches
seizures
usually NO edema
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18
Q

Tx for SIADH

A 
Goal: restore fluid balance
IV hypertonic saline
Lasix
Restrict oral fluids to 1000 ml/day
Demeclocycline (used for side effect of diuresis)
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19
Q

Exocrine

A

A term applied to the external secretion of a gland; a term applied to glands whose secretion reaches an epithelial surface either directly or through a duct

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20
Q

Endocrine

A

An internal secretion; pertaining to a gland that secretes directly into the blood stream- endocrine glands secrete hormones directly into the blood stream to regulate body function

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21
Q

Negative Feedback

A

Controlled much as a thermostat in a house regulates temperature; sensors in the endocrine system detect changes in hormone levels and adjust hormone secretion to maintain normal body levels; when the sensors detect a decrease in hormone levels, they begin actions to cause an increase in hormone levels; when levels increase above normal, sensors cause a decrease in hormone production and release. Ex: When the hypothalmus or anterior pituitary gland senses increased blood levels of TH, they release hormones causing a decrease in the secretion of TSH which in turn prompts a decrease in the output of TH by the thyroid gland

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22
Q

Trophic hormones

A 
Act on (target) other glands.
Adrenocoticotrophic
Thyrotropin (aka Thyroid stimulating hormone)
Follicle stimulating hormone
Luteinizing hormone
Luteotropic (prolactin)
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23
Q

Adrenocorticotrophic

A

Stimulates the adrenal cortex to produce hydrocortisone (cortisol), aldosterone and other steroids

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24
Q

Thyrotropin (aka Thyroid stimulating hormone)

A

Controls the rate of iodine uptake, controls the secretion of thyroxine by the thyroid gland

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25
Q

Follicle stimulating hormone

A

Responsible for the development of graafian follicles in the ovary and for proliferation of sperm

26
Q

Luteinizing Hormone (interstitial cell stimulating hormone)

A

In females causes the follicle to atrophy and to undergo metamorphosis-corpusluteum, in male stimulates the production of testosterone

27
Q

Luteotropic Hormone (Prolactin)

A

Prepares the breats for lactation during pregnancy and stimulates milk production after the baby is born

28
Q

Glucocorticoids

A

General classification of adrenal cortical hormones that are primarily active in protecting against stress and in affecting protein and carbohydrate metabolism- most important glucocoricoid is cortisol (hydrocortisone)

29
Q

Mineralocorticoids

A

Steroid hormone that regulates the retention and excretion of fluids and electrolytes by the kidneys

30
Q

Euthyroid

A

Having a normally functioning thyroid gland

31
Q

Corticosteroids

A

Any of several steroid hormones secreted by the cortex of the adrenal gland or manufactured synthetically for use as a drug- classified according to their biological activity as glucocoticoids, mineralcorticoids and androgens- adrenal corticosteroids do not initiate cellular or exymatic activity but permit many biochemical reactions to proceed at optimal rates- used as replacement hormones in pts with adrenal insufficiency, common s/e of long term use include thinning skin, easy bruising, cataract formation, glucose intolerance, alterations in sleep cycles, osteoporosis and immune supression

32
Q

Urine specific gravity

A

A measure of the degree of concentration of a sample of urine.
Normal 1.010-1.025 (varies with hydration)
abnormal: Low= excessive fluid intake, impaired kidney concentrating ability. High= dehydration, hemorrhage, salt-wasting, diabetes mellitus and others

33
Q

Alkaline phosphatase

A

An enzyme present in bone, kidneys, intestine, plasma and teeth- it may be elevated in the serum in some diseases of the bone and liver and in some other illnesses

34
Q

Thyroid Stimulating Hormone (TSH) Normal level

A

0.2-5.4 mU/L

35
Q

Intermediate Portion (Pars Intermedia) Hormones

A

Melanocyte Stimulating Hormone (MSH)

36
Q

Melanocyte Stimulating Hormone (MSH)

A

Stimulates the synthesis of melanin–pigmentation of the skin. Melanin is between skin layers (middle)

37
Q

Antidiuretic Hormone (ADH; Vasopressin)

A

Increases water reabsorption in the renal tubules. Amount secreted is in proportion to the need. (ex. dehydration causes an increase in ADH)

38
Q

Oxytocin

A

Causes contractions of the pregnant uterus and milk ejection

39
Q

S/S of Simmonds Disease

A 
Extreme weight loss (thin and lots of imbalances)
Emaciation (exhausted and wasting away)
Atrophy of all organs (nothing works)
Hair Loss (FSH
Impotence (FSH)
Amenorrhea (FSH)
Hypometabolism (TSH)
Coma--->Death
40
Q

Growth Hormone (somatotropin)

A

Not a trophic hormone. Acts directly on body tissues.Responsible for body growth and orgtan regulation. Facilitates movement of amino acids into muscle cells. Stimulates epiphyseal plates. Increases concentration of glucose in blood by decreasing the consumption of glucose by tissues and prevents deposition of glucose in the liver

41
Q

Drawfism

A

Disorder of anterior pituitary gland. Decreased secretion of GH

42
Q

Giantism

A

Disorder of anterior pituitary gland. Increased secretion of GH BEFORE puberty and closure of epiphyseal plates. Often caused by pituitary tumors. Very tall stature and relatively proportionate

43
Q

Neurogenic Diabetes Insipidus

A

Results from disruption of hypothalmus and pituitary (trauma, radiation, cranial surgery) or possibly idiopathic

44
Q

Nephrogenic Diabetes Insipidus

A

Results from renal tubules not being sensitive to ADH. Genetic or r/t renal failure

45
Q

Psychogenic Diabetes Insipidus

A

Compulsive behavior of increased water consumption. May be seen in paranoid schizophrenics. Possibly due to damage to the thirst center.

46
Q

Pathophysiology of Diabetes Insipidus

A

Damage to pituitary or dysfunctional renal tubes>excessive amounts of diluted urine created> extreme thirst and water intake> if water loss not replaced> dehydration and hypernatremia> hyperosmolarity> possible cardiovascular collapse.

47
Q

Diagnosis of Diabetes insipidus

A

Lab test preformed when client is maximally hydrated as tolerated.
Urine specific gravity 287 mOm/kg
Low ADH level

48
Q

Causes of SIADH

A

Ectopic production of ADH by malignant tumors
Head injury (pituitary damaged)
Pituitary surgery
Medications (barbiturates, anesthetics, diuretics)

49
Q

Pathophysiolgy of SIADH

A

Failure of negative feedback mechanism which regulates the release and inhibition of ADH> ADH produced regardless of osmolality of blood> intracellular swelling> marked water retention & dilutional hyponatremia> decreased UOP and increased USG

50
Q

Nursing care r/t Pitressin/DDVAP

A

Desired response= decreased thirst & UOP
Assess VS, hx of cardiac dz, pregnancy
*may increase angina and uterine contractions in pregnancy
I&O
Avoid ETOH
S/E’s: Cough, chest tightness, SOB
Education: Report angina, irritation of nasal mucosa (if nasal spray), non-improved symptoms.
Report signs of fluid volume excess: weight gain, headache, listlessness

51
Q

Nursing care for SIADH

A

Close I&O monitoring
Fluid restriction
Low HOB (increases venous return to heart and increases atrial pressures and decreased amount of ADH produced)
Control thirst without giving fluids (small amounts of ice chips, Gum, mouth swabs)

52
Q

Nursing care for all Pituitary disorders

A

Assessment of abnormal growth and development (Appetite, weight, bone structure)
Nutrition imbalances
F&E imbalances
Abnormal neuromuscular function
Changes in libido and reproductive function
Changes in mental status & sleep patterns
Changes in body temp
Poor stress response
Goiter
Exophthalmos

53
Q

Nursing education for all Pituitary disorders

A 
Normal growth and development
Balanced, nutritious diet with proper amount of calories
Adequate intake of iodine
Weight loss PRN
Frequent healthcare provider visits
54
Q

Considerations of pituitary function in elderly

A

Decreased release of GH & increased sensitivity leads to decrease in lean body mass and increased blood glucose levels
Increased secreation of ADH leads to risk of dilutional hyponatremia
Increased risk of SIADH in general (non-modifiable risk factor)
May fail to recognize and respond to thirst

55
Q

Drugs that cause SIADH

A 
Oxytocin
Vincristine
Chlorapropamide
Anesthetics
Opiates (morphine, dilaudid)
Nicotine
Carbamazepine
56
Q

Hypophysectomy

A

Removal of the pituitary gland or a tumor on the pituitary gland

57
Q

Approaches for hypophysectomy

A

Transfrontal
Subcranial
Oronasal

58
Q

Most common approach for a hypophysectomy

A

Oronasal: incision made beneath the upper lip to gain access to the nasal cavity, then go up nasal cavity to remove

59
Q

Post Op care for hypophysectomy

A

Maintain nasal packing & reinforce dressing prn
DO NOT REMOVE DRESSING
Instruct pt to avoid blowing nose, try not to cough, no straining, no valsalva maneuver.
Frequent Oral care
Elevate HOB 30 degrees to improve venous drainage & drainage from surgical site
Check for hypocortisol

60
Q

Post-op complications of hypophysectomy

A 
DI
IICP (1st 24hrs)
Infection
CSF leak (rhinorrhea- check for for sugar) (1st 24hrs)
Seizures
Cerebral hemorrhage

Adult Health Nursing 2 (1 decks)

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