Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing 2 Exam 3 > Unit 10 Endocrine > Flashcards

Unit 10 Endocrine Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

How do hormones travel?

A

Through the blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the endocrine system consist of?

A

body’s glands & their systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The Hypothalamus is the link between what two systems?

A

Nervous and Endocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What hormone releasing gland is “In Charge” and stimulates organs?

A

The pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of hormones does the pituitary gland release?

A

Tropic hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The pituitary gland releases what hormones and what are the target organs?

A
  1. Antidiuretic hormone ADH, Vasopressin (Kidneys)
  2. Thyroid stimulating hormone TSH (Thyroid)
  3. Adrenocorticotropic ACTH (Adrenal Gland)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the the function of ADH?

A

Regulation of fluid volume by stimulating reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What two things are regulated by ADH?

A
  1. Osmolality (substances in body fluids)

2. Volume of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If you have increased osmolality and decreased blood volume, what happens regarding ADH?

A

Stimulates ADH release which results in fluid being retained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

With decreased osmolality and increased blood volume, what will happen regarding ADH?

A

ADH release is inhibited which results in fluid not being retained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q 
Name the following electrolyte values:
Urine specific gravity
Na
K
Ca
Mg
Cl
P
A 
Urine specific gravity 1.010-1.025
Na: 135-145
K: 3.5-5.0
Ca: 9-11
Mg: 1.8-3
Cl: 96-106
P: 3.0-4.5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the ADH disorders?

A

Diabetes Insipidus (DI) - deficiency of ADH

Syndrome of Inappropriate ADH (SIADH)- excessive release of ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are interventions for DI and SIADH?

A 
Strict I&Os
Urine specific gravity 
Urine & Serum osmolality  Q4hr
Weigh daily
Educate family
With DI---fluid replacement
With SIADH---Fluid Restriction & Neuro assess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is hypopituitarism or hyperpituitarism autoimmune?

A

hypopituitarism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

For Diabetes Insipidus (DI) state whether the following will increase or decrease or whatever corresponds.

Urine output:
Urine specific gravity:
Urine osmolality:
Serum osmolality:
PT's weight:
Blood Pressure:
Medical treatment:
Nursing Diagnosis:
A 
Urine output:  >250mL/hr
Urine specific gravity: will be dilute 
Urine osmolality: decreased (think why)
Serum osmolality: Increased (think why)
PT's weight: decreased (poor skin turgor)
Blood Pressure: decreased 
Medical treatment: DDAVP desmopressin synthetic ADH synthetic ex: vasopressin 
Nursing Diagnosis: FVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

For Syndrome of Inappropriate Diuretic Hormone (SIADH) state whether the following will increase or decrease or whatever corresponds.

Urine output:
Urine specific gravity:
Urine osmolality:
Serum osmolality:
PT's weight:
Blood Pressure:
Medical treatment:
Nursing Diagnosis:
A 
Urine output:  decreased
Urine specific gravity: > 1.025
Urine osmolality: increased 
Serum osmolality: decreased
PT's weight: increased
Blood Pressure: increased
Medical treatment: Fluid restriction, Hypertonic solutions 3% saline
Nursing Diagnosis: FVE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can very low sodium induce?

A

Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a transsphenoidal hypophysectomy?

A

Surgery to remove usually tumors (mostly benign) by pituitary gland through either nasal passageway or upper oral mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the post-op care for a transsphenoidal hypophysectomy?

A
  • Nasal packing 3-4 days
  • Elevate HOB 15-30 degrees
  • Prevent increased ICP (inter cranial pressure)
  • Monitor for CSF (cranial fluid)
  • Replace necessary hormones
  • Assess for pain (HA and graft site)
  • Check visual acuity
  • Frequent oral care
  • Monitor urine output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What could indicate CSF leak?

A

dark yellow ring on mustache dressing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What test is confirmatory for CSF leak?

A

Postive beta transferin test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What hormones are released from the Thyroid Gland?

A

T4-thyroxine

T3-tri-iodothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What happens if T3/T4 levels are high?

A

TSH is inhibited by the pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What happens if T3/T4 levels are low?

A

TSH is released by the pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the function of T4/T3?

A

Increases metabolism & energy requirements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What hormone does the parathyroid gland release

A

PTH- parathyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does PTH do?

A
  • regulates calcium and phosphorus metabolism by acting on bone, kidney, and intestinal tract
  • increases bone reabsorption thus increases the release of calcium from the bone into the blood stream
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most common type of Hyperthyriodism?

A

Grave’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe Grave’s disease.

A
  • Autoimmune

- Abnormal immune system releases abnormal antibodies that mimic TSH, causing an overproduction of T3 and T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Is Grave’s Disease more common in women or men?

A

Women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Is Grave’s Disease curable?

A

No, but it is treatable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is Goiter?

A

Enlarged thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What can be assessed in Grave’s Disease?

A
  • Goiter
  • Weight loss
  • Heat Intolerance
  • Thin, brittle hair
  • Easy fatigue
  • Tachycardia/palpations
  • Anxious/nervous/irritable
  • Insomnia/difficulty concentrating
  • +thrill (feel)
  • +bruit (hear)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is Exophthalmos and why does this happen?

A

Exophthalmos means bulging eye’s seen in Grave’s Disease because of increased deposit of fatty fluids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What gland senses levels T3 and T4?

A

Pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

In Grave’s Disease, describe what happens with T3/T4 levels, TSH, and RAIU, and why.

A
  • T3/T4 levels will be increased because of the overproduction of the thyroid gland, which will decrease TSH because the pituitary gland will detect high levels of T3/T4.
  • RAIU (Radioactive iodine uptake) will be increased because Iodine is necessary for the synthesis of the thyroid.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is important to stop ingesting before a PT does a Thyroid scan?

A

Iodine because it could show a false positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What 3 categories of medication are given for Grave’s Disease, and what is/are the specific medication(s) for each?

A

> Anti-thyroid meds

  • propylthiouracil (PTU)
  • methimazole

> Iodines
-saturated solution of potassium iodine (SSKI)

> Beta adrenergic blockers
-propranolol

39
Q

What is the side effect of anti-thyroid medications propylthiouracil (PTU) and methimazole?

A

Agranulocytosis- severe and dangerous leukopenia (lowered white blood cell count), most commonly of neutrophils causing a neutropenia in the circulating blood

40
Q

What does propylthiouracil (PTU) do and how long does it take to work?

A

blocks thyroid hormone production and it takes a couple weeks

41
Q

What does SSKI do and how must it be taken?

A

Saturated solution of potassium iodine (SSKI) decreases size of thyroid (it is short acting) and it is drinken through a straw because it can stain teeth.

42
Q

Describe Radioactive Iodine Therapy (RAI) what is it used for?

A

Helps shrink thyroid. Takes about 6-8 weeks and 80% of PT’s become hypothyroid. Used for the treatment of Grave’s Disease (hyperthyroidism).

43
Q

What is thyroid storm?

A

an exacerbation of symptoms of Grave’s Disease

44
Q

What are Interventions for Grave’s Disease?

A

Radioactive Iodine Therapy (RAI)
Supportive Eye Care
Cardiac assessments
Surgery

45
Q

What is a thyroidectomy?

A

removal of part or all of thyroid

46
Q

What are post-op complications of Thyroidectomy?

A

Hypocalcemia
Laryngeal nerve damage
Hemorrhage
Airway obstruction (swelling post-op)

47
Q

What are Trousseau’s and Chvstek’s signs and what do they indicate?

A
  • Trousseau’s sign is a carpo-pedal spasm/flexion of wrist and hand indicating hypocalcemia.
  • Chvstek’s sign is the twitching of the facial muscles in response to tapping over the area of the facial nerve indicating hypocalcemia.
48
Q

What decreases in Hypothyroidism or what becomes abnormal/impaired?

A

The following decrease with hypothyroidism:

  • BMR (basal metabolic rate)
  • GI motility (constipation happens)
  • HR
  • Energy leading to more fatigue
  • Impairment of neurologic function
  • Abnormalities in lipid metabolism
49
Q

What is the most common type of Hypothyroidism?

A

Hashimoto

50
Q

What lab finding are decreased or increased in Hypothyroidism and why?

A
  • Decreased T3/T4
  • Decreased RAIU (Iodine is necessary for synthesis of thyroid and with hypothyroidism you have less production of anything to do with the thyroid directly)
  • Increased TSH because pituitary senses low T3/T4
51
Q

What is the treatment for Hypothyroidism?

A

Levothyroxine sodium

52
Q

Explain all the treatment details of Levothyroxine.

A
  • Levothyroxine sodium is taken on an empty stomach
  • Lifelong
  • Taken early in the morning because it increases HR and metabolism (imagine if you took it at night)
  • Couple of months until Levothyroxine sodium brings PT back to normal levels
  • Check pulse daily and signs and symptoms of hypo/hyper-thyroidism
53
Q

What is Myxedema Coma, what are clinical manifestations of it, and what usually causes it?

A

Myxedema Coma is a complication of hypothyroid like thyroid storm for Grave’s Disease and causes:

  • hypotension, hypoglycemia, hypoxemia, hypercapnia (too much CO2 in blood), and significant drop in body temp.
  • Usually caused when PT stops taking Rx, is sick, or is at end stage
54
Q

How is Myxedema Coma treated in priority order?

A

Airway is most important, so the order is as followed:

O2, replace sugar, IV fluids, Give Levothyroxine

55
Q

Where are the Adrenal glands located and what do they consist of?

A

Sides of the kidneys and are made up of the Adrenal Cortex (90%) and Adrenal Medulla (10%).

56
Q

How is the pituitary gland divided?

A

30% posterior, 70% anterior

57
Q

What hormones are excreted by the Adrenal Cortex, what do they do and what are the collectively known as?

A

Aldosterone (mineralo corticoid) - maintenance of extracellular fluid volume by holding onto sodium (Na) getting rid of potassium (K)

Cortisol (glucocorticoids)- metabolism of carbohydrates and protein

Androgens & Estrogens - sexual development of males and females

Collectively known as “steroids”

58
Q

What are the hormones released by the Adrenal Medulla known as and what two are they?

A

Known as Catecholamines and they are epinephrine and non-epinephrine.

59
Q

The adrenal medulla and its hormones are described as acting as what?

A

Fight or flight, the autonomic system

60
Q

Hypo-function of Adrenal Gland is known as what?

A

Addison’s Disease.

61
Q

What are the primary and secondary reasons for Addison’s Disease?

A

Primary: Adrenal Gland not producing enough hormones because of surgery, tumor, etc.
Secondary: Pituitary problem

62
Q

What is the purpose of Adrenocorticotropic hormone (ACTH)?

A

Its key function is to stimulate the production and release of cortisol from the adrenal cortex of the adrenal gland.

63
Q

What is the purpose of TSH?

A

TSH stimulates the thyroid to make the hormones T3/T4

64
Q

PTs with hypo-function of Adrenal gland are at risk for developing what disease?

A

Tuberculosis

65
Q

Describe what Addison’s disease is considered.

A

Mostly auto-immune and gradual

66
Q

In hypo-function of Adrenal Gland (Addison’s Disease) what is there a decrease of?

A

Decrease of aldosterone, glucocorticoids (cortisol), and androgens.

67
Q

Decrease in Aldosterone leads to what?

A

Decrease in Aldosterone leads to:

An increase in Na+ excretion which lowers BP leading to hypotension and and increase in K+ leading to hyperkalemia.

68
Q

Describe the connection of Addison’s Disease to the pituitary gland with ACTH.

A

There is no inhibition of ACTH because of the decreased cortisol which means there is no negative feedback of ACTH.

69
Q

What is physically observed with people who have Addison’s Disease?

A

Hyper-pigmentation, Bronze skin-ONLY IN PRIMARY ADDISON’s because in secondary pituitary doesn’t release MSH.

70
Q

What are the 3 diagnostic evaluations of Addison’s Disease and details regarding them?

A

ACTH simulation test- Intramuscular, Cortisol levels decrease (in primary adrenal insufficiency)

Serum electrolytes: Na decreases, Potassium Increases, Glucose decreases. (think about why, you don’t have enough aldosterone)

24 hr urine free cortisol levels- decreased

71
Q

What are the interventions for Addison’s Disease and explain.

A

-Replace glucocorticoids
>hydrocortisone PO, IV

-Replace mineralocorticoids
>fludrocortisone acetate

-Monitor I&O, weight QD, VS

-Teaching is important
>teach to eat salty diet
>to always wear medical alert bracelet (to not be mistaken for diabetic since symptoms are similar)
>take steroids in the morning with food to protect stomach

72
Q

What is Addison’s crisis?

A

Extremely low levels of cortisol and aldosterone because of the adrenal glands hypo-functioning (Addison’s Disease) leading to extremely low sugar, low fluid volume, shock and then if not treated brain coma/death.

73
Q

What are the interventions for Addison’s Crisis?

A
  • Treat dehydration with D5 NS
  • Replace steroids hydrocortisone/fludrocortisone
  • Replace glucose with Dextrose 50%
  • For hyperkalemia, insulin with dextrose (to shift K into cells)
74
Q

What could be the causes of Cushing’s Syndrome (cortisol excess)?

A
  • Adrenal tumor

- Long term high dose oral steroids

75
Q

What is the difference between Cushing’s syndrome and Cushing’s Disease?

A

Cushing’s Disease is caused by the pituitary releasing to much ACTH -possibly because of a tumor, and

Cushing’s syndrome is excess cortisol secretion that doesn’t depend on stimulation from ACTH and is associated with disorders of the adrenal glands

76
Q

What are the clinical manifestations of Cushing’s Syndrome (Cortisol excess)?

A
  • Hyperglycemia
  • Tissue wasting
  • Weakness
  • Poor wound healing
  • Electrolyte imbalance (decreased K, increased Na)
  • Hypertension
  • Abnormal fat distribution (Moon face)
  • Increased BP
  • Increased susceptibility to infection (steroids are anti-inflammatory and could mask infection.
  • Increased androgen production (increased acne, facial hair)
  • mental changes such as memory loss & poor concentration
77
Q

What are the diagnostic evaluations for Crushing’s syndrome?

A
  • Hyperglycemia
  • Electrolyte imbalance Na increased, K decreased
  • 24 hr urine free cortisol levels increased
  • Dexamethasone(steroid) suppression test
78
Q

What is the Dexamethasone suppression test for and describe it.

A

Screening test for Crushing’s syndrome:

-Given at night. Pituitary should normally slow down, if cortisol level increased abnormal.

79
Q

What are interventions that can be done for Crushing’s Syndrome?

A
  1. ) Surgery
    a. Adrenalectomy (if adrenal problem)
    b. Transsphendial hypophysectomy (if pituitary problem)
  2. ) Radiation
  3. ) Medications
80
Q

What is needs to be done regarding discontinuation of steroids?

A

They need to be tapered off to prevent Addison’s Crisis.

81
Q

What are the two types of adrenalectomys?

A

Open and laparoscopic

82
Q

What is the post-op care for an adrenalectomy?

A
  • Monitor for hemorrhage (Vitals signs)
  • Deep breathing, coughing, and incentive spirometer is needed. Pre-meditate so that they can, otherwise they’ll be in too much pain too do so.
  • Monitor for hormone imbalances
  • IV steroids
  • Discharge teaching about lifetime steroid replacement needed if adrenal glands removed bi-laterally.
83
Q

What can an excess of Catecholamine hormones be from?
And what does this mean?

A

Pheochromocytoma and it means overstimulation of sympathetic nervous leading to hyper metabolic state.

84
Q

What is a Pheochromocytoma?

A

Usually benign tumor on adrenal medulla.

85
Q

What are the signs and symptoms of Pheochromocytoma?

A
  • Severe HPN
  • Pounding headache
  • Palpitations
  • Profuse sweating
  • Nervousness
86
Q

What are the 5 H’s (s and s) to Pheochromocytoma

A

Hypertension, Headache, Hyperhydrosis, Hypermetabolism, Hyperglycemia

87
Q

What are the 3 diagnostic evaluations for Pheochromocytoma and which is the most reliable?

A

> 24 hr Urinary Catecholamine and Metanephrine Test
-most reliable

> VMA (vanillymandelic acid) 24 hr urine

> MRI/CT (for tumors)

88
Q

What is tetany?

A 
neuromuscular irritability (tetany)
muscle spasms caused by hypocalcemia
89
Q

What is an euthyroid ?

A

having a normally functioning thyroid gland.

90
Q

What is dilutional hyponatremia?

A

decreased serum sodium concentration associated with loss of sodium from the circulating blood through the gastrointestinal tract, kidney, skin, or into the “third space.” Accompanied by hypovolemic and hypotonic state.

91
Q

What is thyrotoxicosis?

A

Overactive thyroid

92
Q

Name 2 Anti-thyroid medications

A

propylthiouracil (PTU)

methamazole (Tapazole)

93
Q

Name the Mineralocorticoid and the replacement Rx.

A

aldosterone; fludrocortisone (Florinef)

94
Q

Name the Glucocorticoid and the replacement Rx.

A

cortisol; hydrocortisone

Nursing 2 Exam 3 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions