Brainscape's Knowledge GenomeTM

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


See full index

NURS 3512 - Class 1-6 > Week 1 - Adrenal Disorders > Flashcards

Week 1 - Adrenal Disorders Flashcards

1
Q

what are the 3 main classifications of adrenal cortex hormones (corticosteroids)

A
  1. glucocorticoids (cortisol)
  2. androgens
  3. mineralocorticoids (aldo)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the main fnxn of glucocorticoids (3)

A
  • regulate metabolism
  • increase glucose
  • critical in stress response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the main fnxn of mineralocorticoids (aldo) (2)

A
  • retains Na
  • releases K
  • helps regulate BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the main fnxn of androgens

A
  • contribute to growth and development in both genders

- sexual desire & satisfaction in women

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

what are the two main disorders associated with the adrenal cortex

A
  • cushing’s

- addison’s

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

what is cushing’s syndrome

A
  • conditions caused by too excess lvls of corticosteroids (especially glucocorticoids)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what can cause cushing’s syndrome (4)

A
  • iatrogenic admin of prednisone
  • tumour of the adrenal cortex
  • other malignant growth that causes excess ACTH production (ex. lungs)
  • tumour of the pituitary gland
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is cushing’s DISEASE

A
  • when you have excess cortisol due to a tumour of the pituitary gland which then causes too much ACTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what effect does cushing’s have on body composition (5)

A

causes:

  • weight gain
  • “moon face”
  • “buffalo hump”
  • trunkal obesity
  • thin extremities & muscle wasting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what effect does cushing’s have on the skin and hair (5)

A

causes:

  • thin and fragile skin
  • purple striae
  • bruises and petchiae
  • acne
  • excessive body and facial hair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what effect does cushing’s have on fluids & electrolytes and glucose (4)

A
  • low K+
  • high Na+
  • water retention = increased BP
  • hyperglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what effect does cushing’s have on sexual characteristics (3)

A

in women:

  • amennorhea
  • hirsutism (start to have male characteristics)

in men:
- gynecomastia (development of breasts)

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

what effect does cushing’s have on bone’s

A
  • can cause osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does cushing’s impact the immune system (2)

A
  • causes increased suscpetibility to infection

- delayed wound healing

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

what effect does cushing’s have on personality and mood (3)

A
  • causes personality changes
  • depression
  • CNS irritability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how can cushing’s syndrome be diagnosed (3)

A
  • 24-hour cortisol urine sample
  • blood & urine for cortisol lvls
  • CT or MRI for tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the treatment goal for cushings

A
  • normalize hormone secretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how is treatment of cushings chosen

A
  • based off cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

if the underlying cause of cushings is a pituiatry tumour or adrenal gland, what is the treatment (3)

A
  • surgery
  • radiation
  • drug therapy to remove tumour or inhibit adrenal function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

if the underlying cause of cushings is prolonged corticosteroid use, what is the treatment (3)

A
  • tapered discontinuation of corticosteroid therapy
  • reduction of dosage
  • conversion to alternate day therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

why is it important to never dc corticosteroids abruptly?

A
  • may cause life-threatening adrenal insufficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

why is it important to offer emotional support to a pt with cushings? how can we offer this?

A
  • changes in appearance/emtional behavior are distressing

- reassure that once cortisol levels are restored they will look and feel normal again

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

what should you monitor for post-op (after tumour removal) for a pt with cushings (3)

A
  • electrolyte balance
  • hemorrhage
  • corticosteroid lvl
  • S&S of addison’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

why is it important to monitor electrolytes post-op for a pt with cushings

A
  • surgery can cause fluctuating hormones = unstable electrolytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

why is it important to monitor for hemorrhage post-op for a pt with cushings

A
  • bc the glands are very vascular = increased risk of hemorrhage
26
Q

why is it important to monitor corticosteroid lvls post-op for a pt with cushings?

A
  • corticosteroids may now be too low and require replacement
27
Q

what should you teach a pt with cushings post-op

A
  • to monitor for signs of addison’s disease
28
Q

what is addison’s disease

A
  • a condition caused by too little corticosteroid
29
Q

what can cause addison’s disease (3)

A

conditions that interefer w production of cortisol:

  • adrenal tissue autoimmune disease (destroys adrenal tissue)
  • pituitary disease
  • abruptly stopping prednisone
30
Q

describe the onset of addison’s disease

A
  • slow, insidious bc manifestations do not tend to become evident until 90% of the adrenal cortex is destroyed
31
Q

what effect does addison’s have on the skin and haor

A
  • hyperpigmentation

- changes in distribution of body hair

32
Q

what effect does addison’s have on BP

A
  • can cause postural hypotension
33
Q

what effect does addison’s have on body composition

A
  • weight loss
34
Q

what effect does addison’s have on an individual’s emotional characteristics (5)

A

can cause:

  • depression
  • irritability
  • fatigue
  • weakness
  • trouble coping w stressors (cortisol is imp for stress response)
35
Q

what effect does addison’s have on the GI tract (4)

A
  • nausea
  • vomitting
  • diarrhea
  • anorexia

r/t electrolyte imbalances

36
Q

what effect does addison’s have on electrolytes and blood glucose (3)

A
  • hyperkalemia
  • hyponatremia
  • hypoglycemia
37
Q

describe how addison’s can be diagnosed (4)

A
  • S&S
  • blood and urine for cortisol lvls
  • CT or MRI for tumours
  • electrolyte lvls
38
Q

what is the treatment goal for addison’s

A
  • normalize hormone secretion

- maintain fluid & electrolyte balance

39
Q

what is the treatment for addison’s (5)

A
  • replacement therapy –> hydrocortisone
  • NS replacement
  • 5% dextrose
  • electrolyte replacement
  • diet changes
40
Q

what is hydrocortisone

A
  • med that has both glucocorticoid and mineralocorticoid properties
41
Q

why is NS and dextrose used as treatment for someone w addison’s disease

A
  • reverse hypotension and electrolyte imbalances
42
Q

what should you monitor in a pt with addison’s (5)

A
  • fluid and electrolyte status
  • hyperkalemia
  • hyponatremia
  • hypoglycemia
  • dehydration
43
Q

what type of diet should someone w addison’s have (3)

A
  • high protein
  • high carb
  • make sure getting enough salt
44
Q

what is a complication of addison’s disease

A
  • addisonian crisis
45
Q

what is addisonian crisis

A
  • occurs when the pt has extremely low cortisol lvls
46
Q

what can trigger an addisonian crisis (4)

A
  • infection
  • surgery
  • trauma
  • physical activity
47
Q

what does addisonian crisis cause (4)

A
  • hypotension
  • tachycardia
  • severe dehydration
  • shock
48
Q

what is the treatment for addisonian crisis (2)

A
  • high-dose hydrocortisone treatment

- shock management

49
Q

what 4 things should the nurse discuss during discharge teaching for a pt with addison’s

A
  • self dose adjustments for corticosteroids
  • medical alert bracelet
  • emergency kit
  • S&S of cortisol excess and deficiency
50
Q

when might glucocorticoid dosages need to be adjusted? why?

A
  • during times of physiological stress to avoid addisonian crisis
    ex. surgery, running a marathon
51
Q

when are glucocorticoids taken in a pt with addisons

A

2/3 of dose in morning

1/3 in evening

52
Q

when are mineralocorticoids taken in a pt with addisons

A

in morning

53
Q

describe the teaching for a pt with addison’s regarding the emergency kit

A
  • carry at all times

- teach pt and family how to use

54
Q

what does the emergency kit for addison’s contain

A
  • IM injection of glucocorticoid - solucortef
55
Q

in cushing’s syndrome, the pt has an increasded risk for infection. list nursing interventions for this (10)

A
  • monitor for systemic and local signs of infection
  • provide private room
  • maintain asepsis for pt at risk
  • screen all visitors for communicable diseases
  • monitor WBC, absolute granulocyte count, and differential
  • obtain culture samples as indicated
  • inspect skin & mucous membranes for redness, warmth, drainage
  • teach pt and family how to avoid infections
  • teach pt and family about signs and symptoms
  • teach pt and family about signs and symptoms of infection and when to report them
56
Q

weight gain is associated with cushing’s. what nursing interventions can be used to allow the pt to maintain low-calorie diet that meets nutritional needs & attain a weight appropriate for their height (4)

A
  • determine, w dietician, number of cals and types of nutrients needed to help correct effects of excess cortisol
  • instruct pt about nutritional needs
  • monitor caloric and dietary intake
  • monitor trends in weight gain & loss
57
Q

what type of diet would a pt with cushing’s have (6)

A
  • high protein
  • low fat
  • low carbs
  • low sodium
  • high K
  • high calcium
58
Q

what nutritional counseling can be given to a pt with cushing’s (4)

A
  • discuss pt’s knowledge of food groups
  • discuss pt’s perception of the needed diet modication
  • evaluate progress of dietary modification goals at regular intervals
  • provide referral/comsultation with other members of the health care time
59
Q

pts with cushing’s may experience situational low self-esteem due to alteration in body image.
what are some nursing interventions to help the pt report increased acceptance of appearance and use self-care methods to improve appearance (5)

A
  • encourage pt to identify strengths
  • reinforce personal strengths the pt identifies
  • make positive statements about the pt
  • encourage increased responsibility for self
  • provide reassurance about the pt’s condition (that changes will resolve with hormonal balance)
60
Q

pts with cushing’s have an increased risk of altered skin integrity.
what are some nursing interventions to help the pt experience no skin impairment & maintain intact skin? (5)

A
  • observe extremities for color, warmth, swelling, pulses, texture, edema, ulcertaions
  • monitor for sources of pressure and friction
  • monitor skin for rashes & abrasions
  • monitor skin & mucous membranes for discoloration, bruising, breakdown
  • document skin or mucous membrane changes
61
Q

what are some topical treatments to maintain intact skin in a pt with cushing’s

A
  • provide support to edematous areas to promote circulation

- use devices on bed that protect the pt

NURS 3512 - Class 1-6 (47 decks)

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