pharm 2 Flashcards
1
Q
Anterior Pituitary =
A
adenohypophysis
2
Q
Posterior Pituitary =
A
neurohypophysis
3
Q
“Master Gland” regulates _____
A
numerous vital processes.
4
Q
Hormones regulate:
A
- Growth, metabolism
- Reproductive cycle
- Electrolyte balance
- Water retention or loss
5
Q
posterior pituitary regulates
A
ADH
Oxytocin
6
Q
example of ADH
A
vasopressin (Pitressin synthetic)
7
Q
ADH function
A
Regulates reabsorption of water by the kidneys
8
Q
ADH is secreted by pituitary when body ____
A
fluids must be conserved.
- -Water reabsorbed into the blood
- -Urine becomes concentrated
9
Q
ADH treats-
A
Diabetes insipidus (failure to secrete vasopressin)
10
Q
Vasopressin adverse reactions
A
- Tremors, sweating
- Nasal congestion
- Nausea, vomiting, abdominal cramps
- Water intoxication (toxicity, med. overdose)
11
Q
vasopressin:
Use cautiously in individuals with
A
history of: asthma, seizures, migraines, heart failure or vascular disease.
12
Q
Anterior pituitary regulates which hormones?
A
- Prolactin
- Lutenizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- Thyroid-Stimulating Hormone (TSH)
- Adrenocorticotropic Hormone (ACTH, corticotropin)
- Growth Hormone (GH)
13
Q
Influence the gonads (reproductive organs)
A
Gonadotropins (LH and FSH)
14
Q
Contributes to the growth of the body during childhood, mainly the muscles and bones
A
Growth Hormone (GH), also called Somatotropin
15
Q
Stimulates the adrenal cortex to produce and secrete adrenocortical hormones, especially the glucocorticoids
A
Adrenocorticotropic Hormone (ACTH)
16
Q
Stimulates the production of breast milk in the postpartum patient
A
Prolactin
17
Q
(ACTH) Corticotropin used to test —
A
adrenocortical function.
- Reactions may be multisystem (Display 43.2)
- Report symptoms of infection
- Monitor blood sugar
18
Q
In response to ACTH, the adrenal cortex secretes:
A
- Glucocorticoids (sugar)
- Mineralcorticoids (salt)
- Sex hormones (androgens)
19
Q
the adrenal glands are located:
A
on top of each kidney. (outer cortex, inner medulla)
20
Q
Glucocorticoids: Most prominent hormones
A
Hydrocortisone and cortisone
21
Q
Glucocorticoid functions
A
- Immune response
- Regulation of glucose, fat, protein metabolism
- Anti-inflammatory action
22
Q
glucocorticoid examples
A
Prednisone, cortisone, hydrocortisone
23
Q
glucocorticoid actions
A
- Enter target cells and bind to receptor sites
- –Some outcomes are desirable and some are not which lead to the adverse reactions
24
Q
glucocorticoids used to treat:
A
- Adrenocortical insufficiency (replacement therapy)
- Allergic reactions
- Systematic lupus erythematosus
- Dermatologic disorders
- Rheumatic disorders
- Shock
25
GLUCOCORTICOID ADVERSE REACTIONS: Fluid and electrolyte disturbances:
fluid and sodium retention, potassium loss, hypertension, hypocalcemia, shock
26
GLUCOCORTICOID ADVERSE REACTIONS: Musculoskeletal
muscle weakness, osteoporosis, fractures
27
GLUCOCORTICOID ADVERSE REACTIONS:
| Cardiovascular
thromboembolism, arrhythmias, CHF
28
GLUCOCORTICOID ADVERSE REACTIONS: GI
abdominal distention, nausea/vomiting, increased appetite and weight gain
29
GLUCOCORTICOID ADVERSE REACTIONS: Dermatologic
impaired wound healing, thin –fragile skin, bruising, increased sweating, itching
30
GLUCOCORTICOID ADVERSE REACTIONS: Neurological
convulsions, headache, vertigo, paresthesias, insomnia
31
GLUCOCORTICOID ADVERSE REACTIONS: Endocrine
amenorrhea, development of Cushings syndrome, increased s/s of diabetes
32
Mineralocorticoids
Aldosterone and Deoxycorticosterone
33
- Conserves sodium and increases excretion of potassium
- Controls salt and water balance
- Aldosterone most potent
- Deficiencies = loss of salt and water, and retention of potassium
Mineralocorticoids: Aldosterone and Deoxycorticosterone
34
Mineralocorticoids adverse reactions most often occurs when ----
the dose is too high, prolonged use, and d/c too rapidly.
35
- Edema, hypertension, heart failure, enlargement of the heart
- Increased sweating, allergic skin rash
- Hypokalemia, muscular weakness, headache, hypersensitivity
Mineralocorticoids adverse reactions
36
Admin of glucocorticoids (5-10) days can result in:
shutting off the pituitary’s release of ACTH (because of high levels in blood)
37
acute adrenal insufficiency
can result in circulation collapse
38
Abrupt discontinuation=
acute adrenal insufficiency
39
- Located in neck in front of trachea
- Secretes two hormones:
- -T4 (Thyroxine)
- -T3 (Triiodothyronine)
Thyroid Gland
40
____ is essential for manufacture of both T3 and T4
Iodine
41
TSH (Thyroid Stimulating Hormone) regulates the
manufacture of T3 & T4 by the thyroid gland
42
When the level of T3 and T4 in the blood is low,
the anterior pituitary gland secretes TSH which activates the cells of the thyroid to release stored T3 and T4
43
-Decrease in the amount of thyroid hormones manufactured and secreted
Ex = Myxedema (severe)
Hypothyroidism
44
-Increase in the amount of hormones manufactured and secreted
Ex = Grave’s disease, Tumors of thyroid
Hyperthyroidism
45
Rx with thyroid Hormones
Hypothyroidism
46
- Rx with Antithyroid drugs and radioactive iodine
| - Rx with thyroidectomy
Hyperthyroidism
47
S&S Hypothyroidism
- Decreased Metabolism
- Intolerance to cold, low body temp.
- Bradycardia, mod hypotension
- Lethargy
- Pale, cool dry skin, nails thick and hard
- Heavy menses, low sperm count
48
S&S Hyperthyroidism
- Increased metabolism, increased appetite, elevated temp,
- Weight loss despite increased appetite
- Tachycardia, mod hypertension
- Anxiety, nervousness
- Flushed warm moist skin
- Irregular or scant menses
49
- Influence every organ and tissue of body
- Contains both natural and synthetic hormones
- Primary goal: increase metabolic rate of tissues
- Used as replacement therapy when patient is hypothyroid : attempt at creating a “Euthyroid” state
thyroid hormones
50
Medication for Hypothyroidism
Levothyroxine (Synthroid) is the drug of choice
- -Inexpensive
- -Once a day dosage
- -Uniform potency
51
Thyroid hormone signs of therapeutic response:
- Weight loss
- Mild diuresis
- Increased appetite
- Sense of well being
- Increase in mental activity
- Decreased puffiness
52
- Vital Signs
- Weigh patient
- Observe for signs of therapeutic response
- Monitor for hyperglycemia in the diabetic patient
- Meds given once a day, early in morning before breakfast
- Dose adjusted based on blood levels (thyroid function tests)
- Monitor for signs of drug-induced hyperthyroidism
Nursing Process for Hypothyroidism
53
Replacement therapy is for:
life
54
take hypothyroid med ___
before breakfast in AM
55
Treated by:
- Anithyroid drugs
- Iodine solutions
- Thyroidectomy (partial or total)
Hyperthyroidism
56
Does not affect existing thyroid hormones
- Effect of meds may not be observed for 3-4 weeks
- Tapazole and PTU (propylthiouracil)
- May need surgery anyway
- Meds will reduce vascularity of thyroid gland decreasing risk of intra and post up bleeding
antithyroid medication
57
used because the thyroid gland has an affinity for iodine. Destroys hyperactive tissue without damaging cells outside thyroid gland
Radioactive Iodine –
58
decrease the vascularity of the thyroid gland by rapidly inhibiting the release of the thyroid hormones
Iodine solution --
59
decrease in the number of WBC’s (Neutrophils, basophils and eosinophils) = agranulocytosis
adverse reactions of tapazole and PTU
60
Metallic taste in mouth, swelling of parotid gland, burning of mouth
adverse reactions of strong iodine solution
61
sore throat, N,V, bone marrow depression
adverse reactions of radioactive iodine
62
antithyroid meds nursing process
- Obtain history of symptoms of hyperthyroidism
- -Vital signs
- -Weight
- -Symptoms
- If taking Iodine preparation, is patient allergic to iodine or seafood?
- Fever, sore throat, easy bruising, signs of infections (relationship to decreased blood cells)
- Assess for s/s of thyroid storm (thyrotoxicosis)
- -High fever
- -Extreme tachycardia
- -Altered mental state
- Monitor for difficulty swallowing large tablet
- Iodine drops added to juice to disguise taste (drink through straw to prevent teeth staining
- Observe for signs of hyperthyroidism
- Help develop time schedule for q 8 hour doses.
63
pt teaching for antithyroid meds
- Take meds as directed
- Notify provider of symptoms (sore throat, fever, bruising etc)
- Record weight twice a week; notify MD for sudden weight gain or loss
- Dilute iodine solution with juice
