N300 Q#1 Endocrine Flashcards
Hormones are carried by the blood to other sites in the body where their actions are exerted. Some hormones (e.g., ___ and ___ hormones) are not water soluble. Therefore these types of hormones are bound to plasma proteins for ____ in the blood. Hormones are____when bound to plasma proteins, they can be released when appropriate and ____ exert their action at the target tissue. Water-soluble hormones (e.g.,___ and ____) circulate freely in the blood and are not dependent on proteins for transport.
steroid and thyroid transport inactive immediately protein hormones, catecholamines (EPI and NE)
When ___ travels through the blood, it is a hormone and affects target tissues. When it travels across synaptic junctions, it acts as a ___
EPI, neurotransmitter
What are the 2 types of hormone receptors?
- Those that are ___ the cell (Ex?)
- Those that are in the ___ ____ Ex?
- The location of the receptor sites affects the mechanism of ____ for the hormone.
- within (steroid and thyroid)
- cell membrane (protein-type)
- action
Name the 4 feedback mechanisms for hormone regulation.
- Simple feedback
- Negative feedback
- Positive feedback
- complex feedback
Provide an example of simple feedback.
Blood levels of a particular substance
With negative feedback, a ___ responds by increasing or decreasing ___ of a hormone.
gland
secretion
For example, when blood calcium is low, PTH is secreted to raise calcium levels.
With positive feedback, the target organ is ___ beyond normal
increased.
For example, oxytocin is triggered by breast feeding; also enhances uterine contractions
____ feedback usually involves several glands. An example, with low T3 and T4, the ___ releases TRH which triggers the anterior pituitary to release more TSH.
Complex
hypothalamus
With circadian rhythms, ___ rise in the morning and decline toward evening. ___ hormones peak during sleep.
steroids
growth
The ___ produces hormones and works closely with the pituitary. It secretes many releasing and inhibiting hormones that act on the pituitary
hypothalamus
The hypothalamus contains ____, which receive input from the brainstem and limbic system. These neurons influence the limbic system, brainstem, and spinal cord. This creates a circuit to facilitate the coordination of the endocrine system, autonomic nervous system (ANS), and expression of complex behavioral responses, such as anger and feelings of fear and pleasure.
neurons
The Anterior pituitary secretes ___hormones. These are hormones that control the secretion of hormones by other glands. TSH stimulates the_____ to secrete thyroid hormones. ACTH stimulates the adrenal cortex to secrete ____. FSH stimulates secretion of ___and the development of ova in the female and sperm development in the male. LH stimulates ____ in the female and secretion of sex hormones in both the male and female.
tropic thyroid gland corticosteroids estrogen ovulation
The ___ is the master gland located under the hypothalamus and has an ___ and posterior part.
pituitary
anterior
The anterior pituitary releases ___ hormone which affects growth and development of skeletal muscles and long bones. Also has a role in protein, fat and ___ metabolism.
Growth
carbohydrate
The anterior pituitary secretes ____ which is responsible for breast development and lactation.
prolactin
The posterior pituitary is composed of nerve tissue that is an extension of the ___.
It releases ___ and oxytocin which are hormones produced in the _____ but travel down nerve tracts to the pituitary and are stored until released.
hypothalamus
ADH
hypothalamus
True or False: ADH causes retention of sodium and water.
False, water only.
ADH is regulated by fluid ___ and ____ concentration. ADH stimulates the ___ tubules to ___ water creating ____ urine.
volume, plasma
renal
reabsorb
concentrated
Oxytocin simulates the production of ___ by mammary ducts and contraction of ___ muscle. It is released by ___ of touch receptors in the nipples of lactating women.
milk
smooth
stimulation
_____ disorders cause an ___ of growth hormone. ____ occurs with excessive GH before closure of the epiphyses. ____ occurs with excessive GH after closure of the epiphyses.
Pituitary (anterior)
excess
Gigantism
Acromegaly
___ pituitary disorders can cause overproduction of ___. called “SIADH”. This causes fluid ___, dilutional ____ and concentrated urine. A deficiency of ADH causes diabetes insipidus where urine output is ____ and urine is ____. This a life threatening ____ causing _____.
Posterior ADH retention hyponatremia increased dilute dehydration hypernatremia
The thyroid glad produces stores and releases __ and ___. These hormones are responsible for body ___, increased ___ and require ___ for activity. Also stimulated by ___.
T3 and T4
metabolism, BP, iodine
TSH
Hyperthyroidism causes:
- diarrhea or constipation
- fatigue or energy
- Tachycardia or bradycardia
- weight gain or loss
- diarrhea
- fatigue
- tachycardia
- weight loss
Hypothyroidism causes:
- diarrhea or constipation
- fatigue or energy
- tachycardia or bradycardia
- weight gain or loss
- constipation
- fatigue
- bradycardia
- weight gain
The thyroid gland produces calcitonin in response to ____ levels of calcium. This ___ resorption of bone, ____ calcium in the bone and increases renal ___ of calcium. This is a ___ feedback mechanism.
high inhibits (reduces bone breakdown) increases excretion simple
The parathyroid is embedded behind the ___ and secretes ___. PTH ____ blood calcium levels. A complication of a thyroidectomy?
thyroid
PTH
increases
lose parathyroid
PTH ___ bone resorption and promotes ___ of calcium and ___ of phosphorus. Also activates Vitamin ___ which enhances intestinal ___ of calcium.
increases reabsorption excretion D absorption
The adrenal glands are ____ vascular and consist of the medulla and ___. The medulla releases ____ which have an effect on all body systems. __ is an example.
highly
cortex
catecholamines
Epinephrine
The adrenal cortex releases what 3 steroid hormones? provide an example.
Glucocorticoids (cortisol)
mineralcorticoids (aldosterone)
Androgens
Glucocorticoids effect ____ metabolism, have anti-____ action, ___ response and are released using ___ feedback (CRH hypothalamus and ACTH pituitary)
glucose
inflammatory
negative
- An example of a mineralcorticoid is ____. Mineralcorticoids are released in response to ___ volume and altered ___ levels.
- Aldosterone has what two primary functions?
- This has come influence from ___ since the adrenal cortex is involved.
1. Aldosterone fluid potassium 2. Retain sodium and water and excrete potassium 3. ACTH
____ syndrome is an excess of corticosteroids, effects are related to excess ____ and retention of sodium and water. This is a result of an adrenal ___ disorder
Cushings
glucocorticoids
cortex
____ disease results from a deficiency of corticosteroids (Adrenal Cortex disorder). Which steroids are reduced?
Addison’s
All 3: glucocorticoid, Aldosterone and androgen
____ results from excess epinephrine and blood sugar due to a tumor on the adrenal medulla. This causes severe ____ and the patient is at a high risk for stroke and heart attack.
Pheochromocytoma
hypertension
The pancreas has alpha cells that release ____ and beta cells that release ___.
alpha: glucagon
beta: insulin
What kinds of questions would be helpful to ask a patient having a suspected endocrine disorder?
Hydration Hair growth mood changes energy level weight gain cardiac palpatios
What should be focused on in the Physical Exam for a suspected endocrine disorder?
Thyroid enlargement Weight edema Urine input and output Labs skin turgor
Goiter is caused by a___ disorder. It is a hypertrophy and ___ of the thyroid. It is caused by excessive ___ stimulation from inadequate thyroid hormones. Goiter can also be caused by ___ or foods or drugs that suppress gland function.
thyroid
enlargement
TSH
goitrogens
What is the priority nursing diagnosis for a patient with goiter?
Airway
___: palpable deformity that is benign or malignant. A major sign of thyroid cancer is a hard ___ nodule on an enlarged gland. U/s, CT and MRI can be performed but the true test to determine if a nodule is cancerous is ____ via aspiration.
Nodules
painless
biopsy
____: inflammation of the thyroid, caused by ___, bacterial, ___ or autoimmune. Can lead to hypothyroidism (_____). usually thyroid levels are ____ but can become depressed. ___ is low then elevated.
Thyroiditis viral fungal Hashimoto's elevated TSH
_____: thyrotoxicosis s/s result from ____ T4, T3 or both. More common in ___ ages 20-__. Most common form is ____ disease which is an autoimmune disorder.
Hyperthyroidism excessive women 40 Graves
Manifestation of Hyperthyroidism include:
- diaphoresis or dry skin
- Tachycardia or bradycardia
- sunken eyes or exophthalmos
- increased or decreased T4, TSH
- diaphoresis from increased metabolic rate
- tachycardia (high HR and BP)
- exophthalmos (from high pressure behind eyes)
- increased T4 and decreased TSH
Thyrotoxic crisis or ____ ___ is life ___. manifestations include:
- bradycardia or sever tachycardia
- Heart failure or shock
- hypothermia or fever
- restlessness or somnolence
- seizures, delirium or coma
- NVD or constipation
Thyroid storm, threatening
- sever tachycardia
- Both HF and shock
- fever
- restlessness
- ALL
- NVD
How is thyroid storm treated?
reduce circulating hormones: RIT, antithyroid drugs
manifestations: Beta adrenergic blockers, sedatives, tylenol, oxygen
decreased effects of metabolic rate: insulin
Nutritional Therapy for hyperthyroidism includes food that are high in ___, protein and carbs,
___, anti-____ meds and daily weights, ___/__.
calories
vitamins
diarrheal
input/output
CAre related to manifestations of hyperthyroidism includes?
relaxation techniques, eye care, post-op care related to thyroidectomy
Post-op thyroidectomy care includes:
- ___: keep a tracheostomy tray at bedside.
- Assess for ___.
- Position: ____
- monitor ___ and ___ imbalance
- Diet: ___ as soon as tolerated.
- Airway (swelling obstruction)
- bleeding (back of neck)
- semi fowlers
- vital signs and calcium
- fluids
____ is hypothyroidism. Presents with ___, puffiness. Is life ___; observe for signs of hypoglycemia and ____.
Myxedema, edema
threatening
hyponatremia
True or false: cardiac issue is main concern for hyperthyroidism or hypothyroidism?
BOTH
treatment for hypothyroidism includes mechanical ____, IV ____ supplements, ____ fluids, IV ____ and monitoring for ____.
ventilation thyroid isotonic glucose heart failure
Nutritional Therapy for hypothyroidism includes foods:
- low in ___
- High in ____ (bc/ of slow GI tract and constipation)
- fluids but if in ___ decrease fluids
- calories
- fiber
- HF
Hypothyroidism requires nutritional therapy, patient ____ and thyroid hormone ____.
teaching, replacement
With hypothyroidism, with the TSH level be elevated or decreased?
elevated
_____: caused by overproduction of PTH by the parathyroid gland. Characterized by bone ____ and the development of renal ___ containing calcium.
With high calcium levels, concern should always be with ____ and kidney stones.
Hyperparathyroidism
decalcification
stones
bone fractures
Hyperparathyroidism manifests with ____ or asymptomatic. Diagnose using ___ levels, serum calcium and ____ levels, dexa scan, U/s and ECG. Manifestations include cardiac ____, lethargy and ___.
hypercalcemia PTH phosphorus arrhythmias constipation
Nursing care for hyperparathyroidism includes treatment for ____: fluids, limit ___ and meds. ___ are important to flush out stones, decrease broccoli and ___. Give ___.
hypercalcemia calcium Fluids Dairy Phosphorus
Nursing management of Hyperparathyroidism includes:
- safety due to ____
- ____ as tolerated
- PT
- fluids
- report s/s of ___ pain.
- strategies to relieve ____
- weakness
- ambulate
- back
- constipation
Hypoparathyroidism is due to inadequate ___. This is most commonly due to ____ with thyroid surgery.
PTH
removal of parathyroid
Hypoparathyroidism manifests with low ___. Treat acute ___, maintain normal serum ____ levels, provide calcium and Vitamin ___ supplements. Diarrhea or constipation?
serum calcium levels tetany calcium D diarrhea
Two signs for hypocalcemia (caused by hypoparathyroidism, low PTH and low calcium levels) are positive ____ and ____ sign (both indicate tetany).
Chvosteks sign: contraction of facial muscle with light tap on face by ear.
Trousseus sign: carpal spasm with inflated BP cuff over systolic for a few minutes.
nutrition for hypoparathyroidism should include a diet high in ___ and low in ____ (limit meats, poultry and cereals).
calcium
phosphorus
