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Adult Health Nursing II > Exam 6 > Flashcards

Exam 6 Flashcards

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1
Q

Structures of the Endocrine System

A 
Pineal gland
Hypothalamus
Pituitary gland
Thyroid and parathyroid glands
Thymus
Adrenal glands
Pancreas
Ovaries/Testes
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2
Q

Pineal Gland

A

Hormones: Melatonin

Functions: Regulates our sleep cycles

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3
Q

Hypothalamus Hormones

A 
Corticotropin releasing hormone
Thyrotropin releasing hormone
Growth hormone releasing hormone
Gonadotropin releasing hormone
Prolactin releasing factor
Somatostatin
Prolactin inhibiting factor
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4
Q

Functions of the Hypothalamus

A

Releases hormones that stimulate the release of other hormones from the pituitary

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5
Q

Anterior Pituitary Hormones

A 
Growth hormone (dwarfism, gigantism)
Thyroid stimulating hormone
Adrenocorticotropic hormone
Follicle stimulating hormone
Lutenizing hormone
Melanocyte stimulating hormone
Prolactin
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6
Q

Posterior Pituitary Hormones

A 
Antidiuretic hormone (increase is SIADH, decrease is diabetes insipidus)
Oxytocin
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7
Q

Thyroid Gland

A

Hormones: T3 and T4, calcitonin

Functions: regulate metabolism, decreases serum calcium and phosphorus levels

Iodine is necessary for proper thyroid function

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8
Q

Parathyroid Gland

A

Hormones: parathyroid hormone

Functions: increases serum calcium and phosphorus

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9
Q

Thymus Gland

A

Hormones: thymosin

Functions: helps to train our immune system so it can recognize self from non-self

Can contribute to myasthenia gravis

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10
Q

Adrenal Medulla Hormones

A

Epinephrine

Norepinephrine

Pheochromocytoma is a tumor in the adrenal gland that stimulates excessive release of norepinephrine and epinephrine

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11
Q

Adrenal Cortex Hormones

A

Corticosteroids (cortisol), androgens, mineralcorticoids (aldosterone)

Cushing’s: too much cortisol

Addison’s/Adrenal Insufficiency: too little cortisol

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12
Q

Pancreas

A

Hormone: insulin

Functions: helps with uptake of sugar into the cells

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13
Q

Ovary

A

Hormones: estrogen and progesterone

Functions: aid in the development of women’s secondary sex characteristics, help prepare uterus for implantation of the egg, aid in fetal development

Polycystic ovarian syndrome

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14
Q

Testes

A

Hormones: testosterone

Functions: help to develop secondary sex characteristics in men

Disease Processes: erectile dysfunction, infertility

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15
Q

Diagnostic Tests for Endocrine Disorders

A

Labs: blood levels of hormones

Radiologic: x-rays, radiologic studies, CAT scans, MRIs

Urine: helps to assess cortisol levels

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16
Q

Clinical Manifestations of Hyperthyroidism

A

Weight loss, excess hunger, bounding pulse, goiter, brittle nails, sweating, elevated heart rate, excess fatigue, exophthalmos, hypertension, hair loss, menstrual irregularities, diarrhea

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17
Q

Diagnostic Tests for Hyperthyroidism

A

TSH levels
Free T3 and T4 levels
Radioactive iodine uptake study

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18
Q

Treatments for Hyperthyroidism

A

Radioactive iodine (will not know results for 2-3 months)
Medications (PTU, methimazole, potassium iodine, propanolol)
Surgery

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19
Q

Dietary Instructions for Hyperthyroidism

A 
No caffeine
Increase caloric intake to up to 4,000-5,000 calories/day
6 small meals per day
Do not limit carbs/protein
Watch fiber and spice intake
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20
Q

Equipment Needed for Post-Op Thyroidectomy

A

Oxygen
Suction
Tracheostomy kit
Calcium gluconate

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21
Q

Post-Op Interventions for Thyroidectomy

A 
Elevate HOB 30 degrees
Avoid flexion of the neck
Monitor the airway/monitor for hemorrhage
Monitor for hypocalcemia
Monitor Chvostek's/Trousseau's signs
22
Q

Discharge Teaching for Thyroidectomy

A 
Watch for signs/symptoms of infection/hemorrhage
Watch for signs of hypothyroidism
Check hormone levels
Adequate intake of iodine
Smoking cessation
23
Q

Clinical Manifestations of Hypothyroidism

A

Fatigue, constipation, feeling cold, difficulty concentrating, puffy face, angina, heart failure, decreased appetite, menstrual irregularities, increased sensitivity to sedation, increased number of infections

24
Q

Diagnostic Tests for Hypothyriodism

A

Blood tests (TSH will be elevated or decreased)

T4 will be decreased

25
Q

Treatment of Hypothyroidism

A

Levothyroxine taken entire life, reduce caloric intake until medication has taken full effect, may take 4-6 weeks to see improvement in symptoms

Increase fiber/fluids/activity

26
Q

Cushing’s Syndrome

A

Overproduction of ACTH or corticosteroids

Commonly caused by exogenous administration of corticosteroids

27
Q

Clinical Manifestations of Cushing’s Syndrome

A

Moon face, striae, truncal obesity, hypertension, thin extremities, buffalo hump, increased weight, hyperglycemia, hirsutism, acne, delayed wound healing, mood changes

28
Q

Diagnostic Tests for Cushing’s Syndrome

A

Blood sugar, ACTH levels, cortisol levels, potassium levels (watch for hypokalemia)

29
Q

Addison’s Disease

A

Primary adrenal insufficiency

Adrenal glands are not producing the hormones (mineralcorticoids, glucocorticoids, androgens) and ACTH is increased

Idiopathic

30
Q

Clinical Manifestations of Addison’s Disease

A

Nausea, vomiting, diarrhea, hyponatremia, cardiac dysrhythmias due to hyperkalemia, hypotension, tachycardia, dehydration, hypoglycemia, weakness

31
Q

Diagnostic Tests for Addison’s Disease

A

Serum electrolytes
ACTH and cortisol levels
CBC
Blood sugars

32
Q

Treatment of Addison’s Disease

A

Hydrocortisone replaces glucocorticoids (2/3 in the morning, 1/3 in the late afternoon)

Fludrocortisone replaces mineralcorticoids (daily in the morning)

33
Q

Patient Teaching about Medication for Addison’s Disease

A

Teach how/when to take medications

Increase dosage when under stress

34
Q

Lifestyle Modifications for Addison’s Disease

A

High protein, high carb, increase salt

35
Q

Acromegaly

A

Growth hormone excess in adults

36
Q

Symptoms of Acromegaly

A

Excessive sweating, hyperglycemia, heart issues, increased body hair, joint pain, misaligned teeth, tongue enlargement

37
Q

Diagnostic Tests for Acromegaly

A

Growth hormone levels

38
Q

Transsphenoidal Hypophysectomy

A

Removal of the pituitary by going through the sphenoid sinuses

39
Q

Post-Op Interventions for Transsphenoidal Hypophysectomy

A

HOB at least 30 degrees, monitor pupil reaction, do not strain/increase ICP, monitor for clear drainage and spinal headache, monitor LOC, watch urine output and make sure it isn’t greater than 200mL/hour for greater than 3 hours or specific gravity less than 1.005

40
Q

Treatment for Diabetes Insipidus

A

Vasopressin to replace ADH

Fluid replacement

41
Q

Clinical Manifestations of Polycystic Ovarian Syndrome

A

Weight gain, obesity, excessive hair growth, irregular menses, difficulty with conception, migraines, acne, insulin resistance, impaired glucose tolerance tests, elevated lipid levels, sleep apnea

42
Q

Diagnostic Tests for Polycystic Ovarian Syndrome

A 
Glucose tolerance test
Blood sugar levels
Ultrasound
Insulin levels
Pelvic exam
Hormone levels
Lipid levels
43
Q

Treatment Options for Polycystic Ovarian Syndrome

A

Hysterectomy with bilateral salpingo-oophorectomy
Birth control (Clomid/Clomiphene)
Metformin (helps with insulin resistance, stimulates ovulation, helps with weight loss)
Spironolactone

44
Q

Medication Education for Polycystic Ovarian Syndrome

A

Metformin takes 2-4 months to be effective
Need to monitor blood sugars
Don’t skip medications

45
Q

Lifestyle Modifications for Polycystic Ovarian Syndrome

A

Exercise
Drink water
Well-balanced meals
Limit sugar intake

46
Q

Clinical Manifestations of SIADH

A

Confusion, unsteadiness, headache, bounding pulse, weight gain, decreased serum sodium, decreased serum osmolality

47
Q

Treatment for SIADH

A 
ADH antagonist
Restrict fluids to 800-1000 mL/24 hours
Monitor serum sodium and serum potassium
Diuretics
Intake and output measurements
Daily weight measurements
Steroids to reduce ICP
48
Q

Surgically Induced Thyrotoxicosis

A

Thyroid levels elevated after a thyroidectomy–expected reaction

49
Q

Signs and Symptoms of Hypocalcemia

A

Numbness around the mouth
Tingling in the tips of the fingers
Restlessness

Common after thyroidectomy

Notify the physician, elevate HOB, monitor respiratory status, breathe into a paper bag

50
Q

Clinical Manifestations of Pheochromocytoma

A

Atrial fibrillation, high blood pressure, vertigo, nausea, vomiting, diarrhea, anxiety, pallor, diaphoresis, headaches

51
Q

Diagnostic Tests for Pheochromocytoma

A

Full work-up to rule out hyperthyroidism

Plasma metanephrin level

24 hour urine for catecholamines

MRI

52
Q

Treatment for Pheochromocytoma

A

Surgical removal of the tumor

Adrenalectomy

Adult Health Nursing II (22 decks)

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