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Pit- Di And SIAD Flashcards

1
Q

Vasopressin is what hormone?

When is it secreted ? 2

A

Adh- hold on to water

Increase in osmolality Decrease in BP

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2
Q

Anterior pituitary- what growth hormone called what?

What happens when levels change in secretion ? 2

A

Somatotropin

Insufficient- childhood dwarfism
Over secretion- giant

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3
Q

Common occurrence in hyper secretion of pit with what?

A

With ATCH - cushings

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4
Q

What is panhypopituitarism ? 3

A

Results in Atrophy of thyroid adrenal cortex and gonads

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5
Q

What happens during posterior lobe dysfunction? What disease

A

Abnormally large amount urine secreted leads which is deficient vasopressin- diabetic insipidus

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6
Q

What causes destruction of pit gland3

What happens- 4

A

Trauma tumor vascular lesion

Weight loss, hair loss,impotence/amenorrhea, hypoglycemia, coma or death

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7
Q

6 treatment/diagn of pit tumor

Procedure/ meds

A 
Ct/ MRI head 
Radiation/ irradiation 
cryosurgery 
Brocriptine- inhibit prod. release hrmn 
Octreotide- (somatostatin) to shrink 
Hypohysectomy (transphenoidal)
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8
Q

Pre op management 5 (test and meds)

hypophysectomy

A

Endocrine testing - serum hormones
Rhinologic exam

Fundoscopix exam- look and back of eyes also check visual fields

Culture nasopharyngeal secret

Corticosteroids before and after

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9
Q

Post op hypophysectomy 4

(Meds care) PC

A

Preventing infection -antibiotic until nasal pack removed
Steroids -corticosteroid
Analgesics
Agent to control DI

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10
Q

Pit tumor
Nursing management 8
(What to look for test, teaching)

A 
Visual acuity - same place
Oral care-mouth, humidifier and rinse
Hob 30 d- 2 weeks post op 
No blowing bending straining 
I&O-USG (DI)
Cfs leak 
Menengitis 
Steroids for life if remove gland
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11
Q

Potential complications to hypophysectomy 3

A

Diabetes insipidus
Cfs leak
Menengitis

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12
Q

Reason for Visuals acuity test?

A

Count fingers

Decrease in visual acuity my indicate hemotoma

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13
Q

What happens from CSF leak in pit tumor

A

Pnd- acute attack of SOB awake from sleep

SwAllowing

Halo rings increase BG

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14
Q

Menengitis 2 ss?

A

Headache nuccal rigidity

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15
Q

3 causes of DI

A

Neurogenic-trauma ,irrigation, surgery

Nephrogenica inherited/renals not respond to adh

Drug induced

Can be transient- come and go

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16
Q

4 s/s of DI

Levels

A

Polydip- 4-30 l a day

Plolyuria - use- 1.001-1.005
5-20 L day nocturia

Dehydration

Fatigue

17
Q

Diagnostic for DI 4

Procedure lab levels

A

Fluid deprivation test - hold 8-12hrs or. Until 3-5 wt is loss- plasma during test- unable to increase USG DI

Vasopressin test - sq adh- increase USG of DI

Urine Chem go down

Serum chem go up

18
Q

Medical Management of DI 4

Meds 6

A
  1. Replace vasopressin - a. DDVAP (Desmode) intranasal b. (IM) ADH- tegretol stimulates
  2. Fluid replacement
  3. Is intracran path.
  4. Fluid conserve- clofibrate, chlorpropamide, thiazides diuretics, tegretol
19
Q

Nursing management DI

Monitoring and why 
Diet 5
Care 3
IV 
Teaching 4 pc, one complication
A
  1. Monitor -vs, uop, I&O, labs, wt, usg- meds expect Up 4hrs
  2. Diet- regular but no diuretic foods caffeine, adequate calories bulk food fiber, respond to thirst

3 skin and mouth Care , studied for poss lesions

  1. Iv replacement lytes
  2. Teaching- emergency ss- hypovolemia, circ. Collapse, unconscious, cns damage.caution meds CAD pts vasopressin - vasoconstriction
20
Q

SIADH what happens (hormones)

Who does it occurs in ? 3
Disorders happens in? 4
What meds causes it? 4

A

Excess ADH secretion- keeping fluid not exerting urine (hyponatremia)

Lungs- bronchogenic cancer, severe pneumonia, pneumothorax

Head Disorders- head injury, brain surg, tumor, infection

Meds- vincristine, tricyclics antidepressant, thiazides diuretix, nicotine

21
Q

Diagnostic procedure SIADH

A

Urine chemistry

Serum chemistry

22
Q

SIADH s/s

Three stages- 3 each

A
  1. Initially- headache, muscle cramp/weak, weight gain no edema
  2. As sodium decr (cerebral edema/ inc ICP)- personality change hostile, slow deep tend reflex, oliguria
  3. Serum sodium further drop- confusion, seizure, com death
23
Q

Nursing management SIADH

Fluids - 2
Meds- 2
Complications and fixes 4
Safety 2

A
  1. Fluids- restrict po (500-1000ml) 1st, flush NG tube NS
  2. Meds - democlocyline, lithium carbonate- block renal respond ADH
  3. Complications if severe hyponat/water intox (200-300ml hypertonic 3-5 NACL) for neuro compromise not raise to normal level.
    Heart failr- loop Diuretic
    Treatment may led to CPM- nerve damage NA change
  4. Safety-Neuro check 2hr/ seizure envmt/report neuro stat

Pituitary (1 decks)

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