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adult health nursing > Lecture 8 Endocrine > Flashcards

Lecture 8 Endocrine Flashcards

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1
Q

what hormones come from the posterior pituitary?

A

ADH
oxytocin

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2
Q

what hormones come from the anterior pituitary?

A

GH
ACTH
TSH
FSH and LH
prolactin

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3
Q

what controls the pituitary gland?

A

hypothalamus

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4
Q

what hormones are insufficient in hypopituitarism

A

TSH
GH
ADH

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5
Q

what causes diabetes insipidus?

A

hypopituitarism of the posterior pituitary because ADH is low

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6
Q

what are the clinical manifestations of DI

A

weight loss
polyuria w/ low spec gravity and low osmolarity
extreme thirst
hypovolemia
hypernatremia
low BP

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7
Q

what are the diagnostic tests for DI?

A

urine osmolarity - normal is 200-800
specific gravity - normal is 1.005-1.025

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8
Q

how is DI treated?

A

desmopressin
fluid replacement
identify and correct underlying cause

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9
Q

what condition comes from hyperpituitarism?

A

SIADH
increased ADH

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10
Q

what can cause SIADH

A

pituitary tumor is most common

lung cancer, pneumonia, pneumothorax, tumors, head injury, medications

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11
Q

clinical manifestations of SIADH

A

weight gain
oliguria
increased spec gravity and osmolarity
hypervolemia
hyponatreamia

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12
Q

diagnosing SIADH

A

urine specific gravity and urine osmolarity

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13
Q

how is SIADH treated?

A

reverse the cause
restrict fluid
diuretics
hypertonic fluids for severe hyponatremia

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14
Q

what to monitor for SIADH

A

s/s of fluid overload
daily weights, I/Os
s/s of hyponatremia and neuro status

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15
Q

how is pituitary tumor diagnosed?

A

MRI
CT
pituitary hormone labs

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16
Q

what kind of tumors are common in the pituitary?

A

benign, slow growing tumors

17
Q

treating pituitary tumors

A

meds - octreotide, bromocriptine
radiation
surgery - hypophysectomy

18
Q

Hypophysectomy care

A

avoid increased ICP
oral care every 4 hours but no tooth brush until healed
humidifier
head of bed elevated

19
Q

what hormones does the thyroid produce?

A

T4 - thyroxine
T3 = triiodothyronine
calcitonin

20
Q

what is the function of the thyroid

A

control the metabolism

21
Q

what is the function of calcitonin

A

responds to high calcium in blood, puts calcium back into the bones

22
Q

how do thyroid hormones get to the bloodstream?

A

they are synthesized with iodine
they are bound to binding hormones - TBG, transthyretin, albumin
then released into bloodstream

23
Q

what is the path of hormones involved in thyroid function?

A

hypothalamus releases TRH
anterior pituitary releases TSH
thyroid releases T3 and T4

24
Q

hypothyroidism hormone levels

A

T3 and T4 are low
TSH is high in response to low T3 and T4

25
Q

what causes hypothyroidism?

A

hashimoto disease - immune system attacks thyroid
radiation
thyroidectomy
medications - amiodarone and lithium

26
Q

clinical manifestations of hypothyroidism

A

fatigue, lethargy, sluggishness
weight gain w anorexia
cold intolerance
dry skin, nails, hair
weakness
constipation
irritable

27
Q

hypothyroidism complications

A

respiratory muscle weakness
ACS

28
Q

what is myxedema

A

severe hypotension
respiratory depression
hypothermia
lethargy
coma

29
Q

hypothyroidism treatment

A

levothyroxine, lifelong med therapy
levothyroxine increases effects of warfarin and sedative effects of opioids

30
Q

what causes hyperthyroidism

A

grave’s disease = autoimmune
excess iodine
inflammation
tumors

31
Q

hyperthyroidism hormone levels

A

increased T3 and T4
decreased TSH

32
Q

clinical manifestations of hyperthyroidism

A

goiter
nervous, anxious, tremors
arrhythmias, tachycardia
heat intolerance
increased appetite and weight loss
diarrhea
increased BP
sweating
exopthalmos

33
Q

thyrotoxicosis - thyroid storm

A

fever
tachycardia
abdominal pain
decreased alertness
elevated BP
diarrhea

34
Q

treating thyroid storm

A

decrease body temp - ice packs, tylenol
hydrocortisone
humidified O2
IV fluid with dextrose
digoxin or propranolol for arrhythmias

35
Q

treating hyperthyroidism

A

methimazole, propylthiouracil
beta blockers
radioactive iodine
thyroidectomy

36
Q

hyperthyroidism nursing interventions

A

tele for thyroid storm
heart failure manifestations
small frequent meals, high calorie and protein
daily weights
avoid coffee, spice, alcohol

37
Q

thyroid cancer stats

A

3x more common in women
is 90% of all endocrine cancers

38
Q

thyroidectomy care

A

monitor airway w trach kit at bedside
notify provider at first sign of resp distress
monitor for hematoma
monitor hypocalcemia r/t parathyroid injury
semi-fowler w pillows supporting neck
avoid turning and talking too much

adult health nursing (10 decks)

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