Week 12 Flashcards
What are the major endocrine glands?
Hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas
These glands are responsible for hormone secretion and regulation.
What are some hormones secreted by the endocrine system?
Insulin, cortisol, thyroid hormones (T3, T4), aldosterone, growth hormone, oxytocin
Hormones are chemicals that act on specific tissues.
What are the two types of feedback mechanisms in the endocrine system?
Negative feedback loop, positive feedback loop
These mechanisms regulate hormone secretion.
What is a positive feedback loop?
Increases target organ action causing another gland to release a hormone that stimulates further release
Example: Oxytocin during childbirth.
What is a negative feedback loop?
The gland responds to an increase or decrease in the secretion of that hormone
Example: PTH/calcium regulation.
What are some clinical manifestations of hypothyroidism?
Myxedema, weight gain, fatigue, cold intolerance
Hypothyroidism is characterized by low thyroid hormone levels.
What are some clinical manifestations of hyperthyroidism?
Weight loss, heat intolerance, exophthalmos, goiter
Grave’s disease is a common cause of hyperthyroidism.
What is the purpose of the hypothalamus in the endocrine system?
Regulates hormone secretion from the pituitary gland
It acts as the master regulator of the endocrine system.
What are the two parts of the pituitary gland?
Anterior pituitary, posterior pituitary
The anterior pituitary produces tropic hormones while the posterior stores and releases ADH and oxytocin.
What is SIADH?
Syndrome of Inappropriate Antidiuretic Hormone secretion
Characterized by excessive water retention and low sodium levels.
What is diabetes insipidus?
Condition resulting from too little ADH, leading to increased urine production
Can result in hypernatremia due to excessive water loss.
What is Cushing Syndrome?
Condition caused by excessive corticosteroid levels
Often results from a tumor or prolonged steroid use.
What is Addison’s Disease?
Condition caused by insufficient corticosteroid production
Results in symptoms like fatigue, weight loss, and low blood pressure.
What does TSH stand for?
Thyroid-stimulating hormone
It regulates the production of thyroid hormones.
What is the significance of T3 and T4 levels?
They indicate thyroid function; high levels indicate hyperthyroidism and low levels indicate hypothyroidism
More specialized measurements than TSH.
What can cause a goiter?
Iodine deficiency, changes in thyroid hormone production, medications
Can occur in both hypothyroidism and hyperthyroidism.
What is the role of the pancreas in the endocrine system?
Secretes insulin and glucagon to regulate blood glucose levels
Dysfunction can lead to diabetes mellitus.
What are the assessment components for the endocrine system?
Past medical history, vital signs, weight changes, subjective and objective assessments
Includes head-to-toe assessments for signs of endocrine disorders.
What is the function of the adrenal cortex?
Produces cortisol, aldosterone, and adrenal androgens
Cortisol is involved in stress response and metabolism.
What are the common diagnostics used in assessing the endocrine system?
Blood tests, urinalysis, radiographic studies (CT, ultrasound)
These tests help evaluate hormone levels and gland function.
What is the most common cause of issues with the pituitary gland?
Tumor growth
Tumors can affect hormone production from both anterior and posterior glands.
True or False: The endocrine system is ductless.
True
Endocrine glands release hormones directly into the bloodstream.
Fill in the blank: The _______ is known as the master regulator of the endocrine system.
hypothalamus
It influences the pituitary gland’s hormone secretion.
The endocrine system plays a role in:
- reproduction
- growth and development
- sexual reproduction
- maintaining homeostasis
- responding to emergency demands
Glands:
Endocrine
- secrete into blood
Exocrine
- excreting it into a duct
target tissue
Hormones
Chemical substances synthesized and secreted by a specific organ or tissue
- secretion in small amounts at variable but predictable rates
- circulation through the blood
- binding to specific receptors
Diagnostics blood tests for endocrine
- TSH
- T3, T4
- Calcium
- PTH
- phosphate
- aldosterone
- blood glucose
- HbA1C
- amylase
- cortisol
- lipase
Pituitary Gland
located under the hypothalamus
anterior pituitary (2/3 of the gland, 80% by weight)
- tropic hormones (ATCH, gonadotroic hormones)
- prolactin, TSH, GH
Posterior pituitary
- ADH
- oxytocin
Hypopituitarism
- tumour is a common cause
- trauma, surgery can also damage gland
- can influence all hormones secreted (anterior and posterior)
ADH imbalances
Too much ADH
- syndrome of inappropriate anti diuretic hormone (SIADH)
- too much water is retained = hyperbole is and hyponatremia
Too little ADH
- diabetes insipidus
- increased urine production = hypernatrimua
Acromegaly
- excessive secretion of GH
- generally caused by a tumour of the anterior pituitary gland
- overgrowth of bones
- enlargement of tissues in hands, feet and face
- treated with surgery and/or radiation therapy
- diagnostics: CT/MRI for tumour presence
The hypothalamus is..
The master regulator
- the control of the whole system
What physical assessments might a nurse expect to find in a patient with increased T3 and T4 levels?
- Bulging eyeballs
- Sweating
- Tachycardia
These findings are indicative of hyperthyroidism.
Which nursing diagnosis may be appropriate for a patient with hypothyroidism?
- Risk for altered nutritional status r/t anorexia
- Risk for body image changes r/t weight loss
- Risk for emotional changes r/t nervousness
- Risk for hyperthermia r/t impaired temperature regulation
- Risk for fluid imbalance r/t diarrhea
These diagnoses reflect potential complications associated with hypothyroidism.
What is an adverse effect of Synthroid in a patient with hypothyroidism?
- Tachycardia
Tachycardia can occur due to excessive thyroid hormone replacement.
When should levothyroxine sodium (Synthroid) be administered for hypothyroidism?
In the morning on an empty stomach
This enhances absorption and efficacy of the medication.
What is the primary purpose of the endocrine system?
Regulation of bodily functions through hormones
The endocrine system maintains homeostasis and coordinates complex processes.
List the major glands of the endocrine system.
- Hypothalamus
- Pituitary gland
- Thyroid gland
- Parathyroid glands
- Pancreas
Each gland has specific functions and hormone production.
What hormones are produced by the thyroid gland?
- Thyroxine (T4)
- Triiodothyronine (T3)
These hormones are crucial for regulating metabolism.
What role does iodine play in the endocrine system?
Necessary for the synthesis of thyroid hormones
Iodine deficiency can lead to thyroid dysfunction.
What is the function of parathyroid hormone (PTH)?
Regulates blood calcium levels
PTH increases serum calcium through bone resorption and renal reabsorption.
What are the common causes of acute pancreatitis?
- Gallbladder disease
- Alcohol (ETOH)
These are the most prevalent factors leading to acute inflammation of the pancreas.
What are some clinical manifestations of acute pancreatitis?
- LUQ or epigastric pain
- Nausea/vomiting
- Hypotension
- Tachycardia
- Jaundice
Symptoms may vary in severity and presentation.
What lab findings are indicative of acute pancreatitis?
- Dramatic increase in amylase/lipase
These enzymes are elevated significantly during acute episodes.
What is the mechanism of action of metformin?
Increases insulin sensitivity and decreases hepatic gluconeogenesis
Metformin is commonly used in managing Type 2 diabetes.
What symptoms are associated with hypoglycemia?
- Shaky
- Sweaty
- Dizzy
- Hunger
- Headache
- Pallor
These symptoms arise due to low blood sugar levels.
What treatment is recommended for hypoglycemia?
Consume 15-20 grams of glucose or simple carbohydrates
Followed by rechecking blood glucose after 15 minutes.
What is the primary function of the pancreas?
- Produces digestive enzymes (exocrine)
- Regulates blood glucose levels (endocrine)
The pancreas plays a dual role in digestion and metabolism.
What could cause hyperparathyroidism?
- Parathyroid tumor
This condition results in excessive secretion of parathyroid hormone.
What are the primary functions of T4 and T3?
- Affect metabolic rate
- Influence caloric requirements
- Regulate oxygen consumption
- Impact carbohydrate and lipid metabolism
- Support growth and development
- Affect brain function and nervous system activity
These hormones have widespread effects on bodily functions.
What is the difference between acute and chronic pancreatitis?
- Acute: sudden inflammation, often related to gallbladder disease or alcohol
- Chronic: prolonged inflammation leading to scar tissue development
The duration and underlying causes differentiate the two forms of pancreatitis.
Fill in the blank: The major function of the thyroid gland is the production, storage, and release of thyroid hormones: _______ and _______.
thyroxine (T4), triiodothyronine (T3)
These hormones play critical roles in metabolism.
Parathyroid glands regulate..
Serum calcium
Which is influenced by
- bone (primary reservoir for calcium (99%)
- kidneys (regulating ca+ excretion)
- GI tract (absorbs dietary calcium)
PTH function
Increases serum calcium via
- resorption of bone
- reabsorption of Ca+ in the kidney
Thyroid gland
- major function is the production, storage and release of thyroid hormones (thyroxine (T4) and tridothyronine (T3))
- iodine is necessary for the synthesis of thyroid hormones
- calcitonin is a hormone productive by the thyroid gland in response to high circulating calcium levels to help tone down serum calcium
Parathyroid glands
Four small oval structures usually arranged in pairs behind each thyroid lobe.
- excrete PTH (parathyroid hormone) which regulates the blood level of calcium
- helps to increase serum calcium
Too much PTH secretion =
Hyperparathyroidism
- r/t elevated resorption of calcium by the bone
- can be caused by parathyroid tumour
- results in serum hypercalcemia/hypercalcuria
Too little PTH secretion =
Hypoparathyroidimsm
- results from parathyroid gland destruction
- natural atrophy of the gland is rare
- results in serum hypocalcemia
Pancreas
- has both endocrine and exocrine function
Exocrine
- digestive enzymes (protein, lipase, amylase)
-secrete substances into ducts
Endocrine
-glucagon, insulin
- are ductless and secrete substances directly into bloodd
Pathophysiology of pancreatitis
- acute vs chronic inflammation
- acute: gallbaladder disease and ETOH
- chronic: prolonged inflammation with scar tissue development (ETOH is common but there are other functions)
Clinical manifestations of pancreatitis
- LUQ or epigastric pain with retroperitoneal radiation
- pain aggravated by eating
- nausea/vomiting/hypotension (in acute)
- jaundice
Diagnostics for pancreatitis
- amylase/lipase (dramatic increase in acute pancreatitis, no elevation or mild elevation in chronic pancreatitis)
- abdominal U/S or CT primarily used
Collaborative care/ nursing management for pancreatitis
- pain and symptom relief (N/V reduction)
- vital sign normalization (if shock present), hydration
- reduce pancreatic secretions (acute cases may require NPO)
- BGM monitoring
- treat or prevent infection
Chronic pancreatitis
- persistent, chronic inflammation of pancreas
decreased function of exocrine pancreas - difficulties with digestion and absorption of nutrients
- abdominal pain (worse with eating)
- steatorrhea
- unintentional weight loss
Obstructive pancreatitis
R/t biliary disease and cholelithiasis
Non-obstructive pancreatissis
Inflammation/sclerosis of the head of pancreas and pancreatic duct
Diagnostics for chronic pancreatitis
- none to mild elevation in lipase/amylase
- bilirubin elevated (if common bile duct obstructed)
- ALP elevated
- Mild increased WBC
- Stool (check for high fat content)
- MRI, CT, US, MRCP
Management of pancreatitis
- bland diet, low fat, no alcohol use
- pancreatic enzyme replacement
- diabetes management
- manage bile duct obstructions
Insulin
- stimulates liver and muscle cells to store glucose in the form of glycogen (when the body does not need the glucose)
- stimulates fat cells to form fats from fatty acids and glycerol
- stimulates liver and muscle cells to make protein from amino acids
- inhibits the liver and kidney cells form making glucose intermidate compounds of metabolic pathways
Glucagon
- stimulates the liver and muscles to break down stored glycogen (glycogenolysis) and release the glucose
- stimulates breakdown of fat and protein into glucose
What is pre-diabetes
- also called impaired glucose tolerance (IGT)
- blood glucose levels that are higher than normal but not yet high enough to be diagnosed with diabetes
- no clear symptoms of prediabetes
- some people may have some of the symptoms or even problems of diabetes already
- 6 million Canadians have iGT
Drink factors for T2DM
- overweight or obese
- gestational diabetes
- family hx
- metabolic syndrome (high cholesterol, triglycerides, low HDL, high LDL, high blood pressure)
- older people
HbA1C
Glycated hemoglobin
