Exam 4: All endrocrine Flashcards
Key functions: Adrenal Gland Cortex
- Glucocorticoids (important)
- Mineralcorticoids (important)
- Androgens
Key functions: Adrenal Gland Medulla
- Fight or flight (important
- Epinephrine (targets beta neurological receptors)
- Norepinephrine (acts on alpha receptors)
Transphenoidal hypophysectomy (TPH): Postoperative Care
- Monitor neurologic response (Monitor vision) - Elevate HOB - Assess for CSF leak (important) (postnasal drip) (Assess nasal drainage) - Assess for meningitis - Avoid activities that increase ICP (Coughing soon after surgery) (Avoid bending) (Avoid straining at stool) (Using a straw to drink) - Avoid toothbrushing - Numbness in the area of the incision - Decreased sense of smell - Hormone replacement (Vasopressin)
Diabetes Insipidus: Antidiuretic Hormone: Deficiency
- dilute urine
- risk of dehydration
Diabetes Insipidus: Central/Neurogenic and then nephrogenic medications
ADH replacement
- Desmopressin acetate (DDAVP) (important)
- Vasopressin (Pitressin) (monitor BP)
ADH stimulants
- Carbamazepine (Tegretol) (important)
Nephrogenic
- Thiazide diuretics (causes a paradoxical fluid retention) (important)
- Chlorpropamide (Diabinese)
Diabetes Insipidus: Nursing Interventions
- Monitor fluid and electrolyte balance
- Restore water balance (hypotonic fluids)
- Nutrition
(Restrict foods that promote diuretic effect)
(Add bulk foods, fruit juices if constipation develops) - Safety
- Skin care
- Teaching
Syndrome of Inappropriate ADH (SIADH): ADH
Excess of ADH
Syndrome of Inappropriate ADH (SIADH): Medications
- furosemide (important) (gets rid of water and keeps Na) - phenytoin (Dilantin) - Medications that increase renal water excretion demeclocycline (Declomycin) (important) (Decreases renal tubule response to ADH) - Vasopressin receptor antagonists
Syndrome of Inappropriate ADH (SIADH): Nursing Care
- Monitor fluid and electrolyte balance
Restore water balance - Lasix
- Restrict fluids, (ice chips, hard candy)
- Intravenous fluids (hypertonic only if NA is <120)
Prevent complications
- Neuro checks
- Sodium replacement slowly- prevent osmotic demyelination (Max of 12 meq/L per day
Increase levels by ~ 0.5 meq/L per hour
- Seizure precautions
- Monitor for crackles
Adrenal gland hypofunction (inadequate secretion of ACTH) : Addisonian crisis (acute adrenal insufficiency): symptoms
- rapid decrease in Na (important)
- Rapid increase in K
- Severe hypotension
Adrenal gland hypofunction (inadequate secretion of ACTH) : Addisonian crisis (acute adrenal insufficiency): Treatment
- # 1 fluids: Rapid infusion IVF 0.9% saline (important)
- Replace cortisol (important)
- Treat Decreased Na
- Treat increase K
- Treat decreased glucose
Adrenal gland hyperfunction: Hypercortisolism (Cushing’s disease/syndrome): Treatment
Cushings teaching
- fluid overload complications
Adrenal gland hyperfunction: Hyperaldersteronism: Assessment
- Hypokalemia (important)
- Hypertension
- Headache, fatigue, muscle weakness
- Nocturia
Adrenal gland hyperfunction: Hyperaldersteronism: Diagnosis/lab
- Decreased K
- Increase Na
- Metabolic alkalosis
- dehydration
- hypertension
Hypothyroidism: Diagnosis/Lab
- Decreased T3 and T4
- Increased TSH with primary
