Exam 3 - alterations in regulation and metabolism Flashcards
what is the feedback mechanism?
- body sends message to hypothalamus
- hypothalamus stimulates the pituitary
- pituitary sends to primary
- primary releases hormone
what is the complex feedback mechanism
Cns receives stimulus
Hypothalamus releases
Inhibiting factor or
Releasing factor which travels to
Pituitary gland. when then sends hormone to
Target tissue
what gland can override others?
pituitary
what are the endocrine glands
pitutary thyroid parathyroid adrenals gonads pancreas hypothalamus
what does the thyroid control
metabolism and growth
what does the parathyroid control
calcium and phosphorus metabolism
what does the adrenals control
sodium, electrolyte balance, reproduction, immune, fight or flight
what does the hypothalamus control
hormones are releasing factors or inhibiting
what are the types of endocrine disorders?
primary seconday tertiary ectopic hypofunction hyperfunction
what is a primary endocrine disorder?
problem with gland itself in releasing or creating hormone
what is a secondary endocrine disorder?
problems with pituitary and releasing factors
tertiary endocrine disorder
problems with cellular receptors or cells themselves
ectopic endocrine disorder
tumor (other than normal site of hormone production)
intolerance to heat tremor sweating weight loss increase in appetite palpitations nervousness exopthalmia decrease in fluids and sex drive
hyperthyroidism (systems speed up except wt loss)
what is the autoimmune version of hyperthyroidism?
graves disease
what labs should be looked at for thyroid disorders?
t3, t4, TSH
if the thyroid is the problem(primary), what should the labs look like?
TSH would be decreased and t3 and t4 would be increased
nurse interventions for hyperthyroidism
increase calories
o2
cool down
treatment that stops t3 and t4 production
radioactive iodine
high fever disaphoresis restlessness agitation tachy, dysrhytmia and tremor CHF delirium coma
thyroid storm!
what causes a thyroid storm
acute stress
infection
surgery
how should you treat a thyroid storm symptoms?
sedation, cooling, steroids, IV fluids
what are the meds you should administer in a thyroid storm
strong iodine solutions
propylthiouracil
inderal (propranol) beta block
NO ASPIRIN
myxedema
mucousy edema - hard to get rid of
hypothyroidism
deficient t3 and t4 release
what is the treatment of hypothyroidism
levothyroxine
how should you take levothyroxine?
on an empty stomach
bradycardia hair dry and course and sparse cold intolerance fatigue weight gain anorexia lifelong treatment
hypothyroidism
what is the autoimmune version of hypothyroidism
hashimoto’s
what should be done if hypothyroidism exacerbates
support airway o2, iv fluid and levothyroxine hyponatremia hypoglycemia COMA
what type of labs should be tested in an assessment of a patient with hypothyroidism?
cholesterol levels
elderly thyroid medication therapy
smaller doses
smaller increments at longer intervals
cinacalet
suppresses PTH secretion
hyperparathyroidism
elevation of serum calcium levels and excessive secretion of phosphorus by kidneys
symptoms of hyperparathyroidism
asymptomatic
may not realize until kidney stones
what are we worried about with hyperparathyroidism?
osteoporosis
fall risk
cause of hypoparathyroidism
damage to parathyroid glands during thyroid surgery
nerve and muscle excitation muscle spasms hyperreflexia clonic tonic convulsions paresthesia
hypoparathyroidism
what should we do in the case of hypoparathyroidism?
give calcium
hyper function of the adrenals
cushing’s disease
what is conn’s disease
hyper secretion of mineral corticosteroids
what is cushing’s disease
hyper secretion of ACTH,
leading to stimulated adrenal glands
increase in cortisol
moon face buffalo hump and fat pads truncal obesity broad purple striae bruising slow wound healing thin limbs muscle wasting excessive hair growth in women decreased inflammatory response
cushing’s
what type of CV issue may you see in cushings
hypertension
what may you see in cushing’s disease related to glucose?
glucose intolerance
addison’s disease
hypo function of the adrenal glands - aldosterone and cortisol
what is the treatment of addisons
lifelong corticosteroids
hypoglycemia nausea vomitting diarrhea weight loss muscle weakness fatigue headache sweating mood changes tanning of skin folds bluish mucous membranes hypotension vitiligo hyperkalemia hyponatremia
addisons
when does the treatment of addisons change?
corticosteroid doses should be increased in periods of stress
addisonian crisis
severe hypotension and volume depletion
severe electrolyte abnormalities
hypoglycemia
inability to respond to stress
how to treat addisonian crisis
iv fluids
iv steroids
electrolyte replenish
how does one get addisonian crisis
does not adjust dosage
mental status changes and muscle weakness in people with addisons disease is primarily causes by
hypoglycemia
pheochromocytoma
tumor on adrenals
manifestations of pheochromocytoma
sweating hypertension headaches palpitations chest pain stroke
treatment of pheochromocytoma
surgery and removal
metabolic syndrome
fat syndrome (pancreas)
high bp
central obesity
insulin resistance
pituitary dwarfism
hypo pituitary and growth hormone
gigantism in children and acromegaly in adults
hyper pituitrary growth hormone
acromegaly
hands feet and mandible over grown
growth plates build up - bone
what is something growth hormone monitors?
glucose!
