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Adult 300 > N300 Q#1 Endocrine > Flashcards

N300 Q#1 Endocrine Flashcards

1
Q

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.

A 
steroid and thyroid
transport
 inactive 
immediately
protein hormones, catecholamines (EPI and NE)
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2
Q

When ___ travels through the blood, it is a hormone and affects target tissues. When it travels across synaptic junctions, it acts as a ___

A

EPI, neurotransmitter

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3
Q

What are the 2 types of hormone receptors?

  1. Those that are ___ the cell (Ex?)
  2. Those that are in the ___ ____ Ex?
  3. The location of the receptor sites affects the mechanism of ____ for the hormone.
A
  1. within (steroid and thyroid)
  2. cell membrane (protein-type)
  3. action
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4
Q

Name the 4 feedback mechanisms for hormone regulation.

A
  1. Simple feedback
  2. Negative feedback
  3. Positive feedback
  4. complex feedback
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5
Q

Provide an example of simple feedback.

A

Blood levels of a particular substance

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6
Q

With negative feedback, a ___ responds by increasing or decreasing ___ of a hormone.

A

gland
secretion
For example, when blood calcium is low, PTH is secreted to raise calcium levels.

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7
Q

With positive feedback, the target organ is ___ beyond normal

A

increased.

For example, oxytocin is triggered by breast feeding; also enhances uterine contractions

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8
Q

____ feedback usually involves several glands. An example, with low T3 and T4, the ___ releases TRH which triggers the anterior pituitary to release more TSH.

A

Complex

hypothalamus

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9
Q

With circadian rhythms, ___ rise in the morning and decline toward evening. ___ hormones peak during sleep.

A

steroids

growth

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10
Q

The ___ produces hormones and works closely with the pituitary. It secretes many releasing and inhibiting hormones that act on the pituitary

A

hypothalamus

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11
Q

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.

A

neurons

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12
Q

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.

A 
tropic
 thyroid gland 
corticosteroids
estrogen 
ovulation
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13
Q

The ___ is the master gland located under the hypothalamus and has an ___ and posterior part.

A

pituitary

anterior

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14
Q

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.

A

Growth

carbohydrate

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15
Q

The anterior pituitary secretes ____ which is responsible for breast development and lactation.

A

prolactin

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16
Q

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.

A

hypothalamus
ADH
hypothalamus

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17
Q

True or False: ADH causes retention of sodium and water.

A

False, water only.

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18
Q

ADH is regulated by fluid ___ and ____ concentration. ADH stimulates the ___ tubules to ___ water creating ____ urine.

A

volume, plasma
renal
reabsorb
concentrated

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19
Q

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.

A

milk
smooth
stimulation

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20
Q

_____ disorders cause an ___ of growth hormone. ____ occurs with excessive GH before closure of the epiphyses. ____ occurs with excessive GH after closure of the epiphyses.

A

Pituitary (anterior)
excess
Gigantism
Acromegaly

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21
Q

___ 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 _____.

A 
Posterior
ADH
retention
hyponatremia
increased
dilute
dehydration
hypernatremia
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22
Q

The thyroid glad produces stores and releases __ and ___. These hormones are responsible for body ___, increased ___ and require ___ for activity. Also stimulated by ___.

A

T3 and T4
metabolism, BP, iodine
TSH

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23
Q

Hyperthyroidism causes:

  1. diarrhea or constipation
  2. fatigue or energy
  3. Tachycardia or bradycardia
  4. weight gain or loss
A
  1. diarrhea
  2. fatigue
  3. tachycardia
  4. weight loss
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24
Q

Hypothyroidism causes:

  1. diarrhea or constipation
  2. fatigue or energy
  3. tachycardia or bradycardia
  4. weight gain or loss
A
  1. constipation
  2. fatigue
  3. bradycardia
  4. weight gain
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25
Q

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.

A 
high
inhibits (reduces bone breakdown)
increases
excretion
simple
26
Q

The parathyroid is embedded behind the ___ and secretes ___. PTH ____ blood calcium levels. A complication of a thyroidectomy?

A

thyroid
PTH
increases
lose parathyroid

27
Q

PTH ___ bone resorption and promotes ___ of calcium and ___ of phosphorus. Also activates Vitamin ___ which enhances intestinal ___ of calcium.

A 
increases
reabsorption
excretion
D
absorption
28
Q

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.

A

highly
cortex
catecholamines
Epinephrine

29
Q

The adrenal cortex releases what 3 steroid hormones? provide an example.

A

Glucocorticoids (cortisol)
mineralcorticoids (aldosterone)
Androgens

30
Q

Glucocorticoids effect ____ metabolism, have anti-____ action, ___ response and are released using ___ feedback (CRH hypothalamus and ACTH pituitary)

A

glucose
inflammatory
negative

31
Q
  1. An example of a mineralcorticoid is ____. Mineralcorticoids are released in response to ___ volume and altered ___ levels.
  2. Aldosterone has what two primary functions?
  3. This has come influence from ___ since the adrenal cortex is involved.
A 
1. Aldosterone
fluid
potassium
2. Retain sodium and water and excrete potassium
3. ACTH
32
Q

____ 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

A

Cushings
glucocorticoids
cortex

33
Q

____ disease results from a deficiency of corticosteroids (Adrenal Cortex disorder). Which steroids are reduced?

A

Addison’s

All 3: glucocorticoid, Aldosterone and androgen

34
Q

____ 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.

A

Pheochromocytoma

hypertension

35
Q

The pancreas has alpha cells that release ____ and beta cells that release ___.

A

alpha: glucagon
beta: insulin

36
Q

What kinds of questions would be helpful to ask a patient having a suspected endocrine disorder?

A 
Hydration
Hair growth
mood changes
energy level
weight gain
cardiac palpatios
37
Q

What should be focused on in the Physical Exam for a suspected endocrine disorder?

A 
Thyroid enlargement
Weight
edema
Urine input and output
Labs 
skin turgor
38
Q

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.

A

thyroid
enlargement
TSH
goitrogens

39
Q

What is the priority nursing diagnosis for a patient with goiter?

A

Airway

40
Q

___: 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.

A

Nodules
painless
biopsy

41
Q

____: 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.

A 
Thyroiditis
viral
fungal
Hashimoto's
elevated
TSH
42
Q

_____: thyrotoxicosis s/s result from ____ T4, T3 or both. More common in ___ ages 20-__. Most common form is ____ disease which is an autoimmune disorder.

A 
Hyperthyroidism
excessive
women
40
Graves
43
Q

Manifestation of Hyperthyroidism include:

  1. diaphoresis or dry skin
  2. Tachycardia or bradycardia
  3. sunken eyes or exophthalmos
  4. increased or decreased T4, TSH
A
  1. diaphoresis from increased metabolic rate
  2. tachycardia (high HR and BP)
  3. exophthalmos (from high pressure behind eyes)
  4. increased T4 and decreased TSH
44
Q

Thyrotoxic crisis or ____ ___ is life ___. manifestations include:

  1. bradycardia or sever tachycardia
  2. Heart failure or shock
  3. hypothermia or fever
  4. restlessness or somnolence
  5. seizures, delirium or coma
  6. NVD or constipation
A

Thyroid storm, threatening

  1. sever tachycardia
  2. Both HF and shock
  3. fever
  4. restlessness
  5. ALL
  6. NVD
45
Q

How is thyroid storm treated?

A

reduce circulating hormones: RIT, antithyroid drugs
manifestations: Beta adrenergic blockers, sedatives, tylenol, oxygen
decreased effects of metabolic rate: insulin

46
Q

Nutritional Therapy for hyperthyroidism includes food that are high in ___, protein and carbs,
___, anti-____ meds and daily weights, ___/__.

A

calories
vitamins
diarrheal
input/output

47
Q

CAre related to manifestations of hyperthyroidism includes?

A

relaxation techniques, eye care, post-op care related to thyroidectomy

48
Q

Post-op thyroidectomy care includes:

  1. ___: keep a tracheostomy tray at bedside.
  2. Assess for ___.
  3. Position: ____
  4. monitor ___ and ___ imbalance
  5. Diet: ___ as soon as tolerated.
A
  1. Airway (swelling obstruction)
  2. bleeding (back of neck)
  3. semi fowlers
  4. vital signs and calcium
  5. fluids
49
Q

____ is hypothyroidism. Presents with ___, puffiness. Is life ___; observe for signs of hypoglycemia and ____.

A

Myxedema, edema
threatening
hyponatremia

50
Q

True or false: cardiac issue is main concern for hyperthyroidism or hypothyroidism?

A

BOTH

51
Q

treatment for hypothyroidism includes mechanical ____, IV ____ supplements, ____ fluids, IV ____ and monitoring for ____.

A 
ventilation
thyroid
isotonic
glucose
heart failure
52
Q

Nutritional Therapy for hypothyroidism includes foods:

  1. low in ___
  2. High in ____ (bc/ of slow GI tract and constipation)
  3. fluids but if in ___ decrease fluids
A
  1. calories
  2. fiber
  3. HF
53
Q

Hypothyroidism requires nutritional therapy, patient ____ and thyroid hormone ____.

A

teaching, replacement

54
Q

With hypothyroidism, with the TSH level be elevated or decreased?

A

elevated

55
Q

_____: 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.

A

Hyperparathyroidism
decalcification
stones
bone fractures

56
Q

Hyperparathyroidism manifests with ____ or asymptomatic. Diagnose using ___ levels, serum calcium and ____ levels, dexa scan, U/s and ECG. Manifestations include cardiac ____, lethargy and ___.

A 
hypercalcemia
PTH
phosphorus
arrhythmias
constipation
57
Q

Nursing care for hyperparathyroidism includes treatment for ____: fluids, limit ___ and meds. ___ are important to flush out stones, decrease broccoli and ___. Give ___.

A 
hypercalcemia
calcium
Fluids
Dairy
Phosphorus
58
Q

Nursing management of Hyperparathyroidism includes:

  1. safety due to ____
  2. ____ as tolerated
  3. PT
  4. fluids
  5. report s/s of ___ pain.
  6. strategies to relieve ____
A
  1. weakness
  2. ambulate
  3. back
  4. constipation
59
Q

Hypoparathyroidism is due to inadequate ___. This is most commonly due to ____ with thyroid surgery.

A

PTH

removal of parathyroid

60
Q

Hypoparathyroidism manifests with low ___. Treat acute ___, maintain normal serum ____ levels, provide calcium and Vitamin ___ supplements. Diarrhea or constipation?

A 
serum calcium levels
tetany
calcium
D
diarrhea
61
Q

Two signs for hypocalcemia (caused by hypoparathyroidism, low PTH and low calcium levels) are positive ____ and ____ sign (both indicate tetany).

A

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.

62
Q

nutrition for hypoparathyroidism should include a diet high in ___ and low in ____ (limit meats, poultry and cereals).

A

calcium

phosphorus

Adult 300 (5 decks)

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