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hormonal regulation
pathophysiology NUR 304
| Question | Answer |
|---|---|
| What are the three major types of hormones | protein hormones, steroid hormones, and tyrosine derivatives |
| Define protein hormones | aka polypeptide hormones. made of chains of amino acids |
| What is an examples of a protein hormone? | ADH; antidiuretic hormone; which decreases BP. it is a secondary messenger on the cell wall |
| Define steroid hormones | derived from lipids |
| What is an example of a steroid hormone? | reproductive hormones: testosterone and estrogen. its a primary messenger because it can enter a cell |
| Define tyrosine derivative hormones | amine hormones derived from amino acid |
| What is an example of tyrosine derivative hormone? | epinephrine; which regulates our fight or flight |
| What does our hypothalamus do? | produce several releasing and inhibiting hormones that act on the pituitary gland, stimulating the release of pituitary hormones |
| What are the hormones that are produced in the hypothalamus? | corticotropin releasing hormone, dopamine, growth hormone releasing hormone, somatostatin, gonadotropin releasing hormone, thyrotropin releasing hormone. |
| What are the hormones that are produced from the anterior pituitary gland? | ACTH: adrenocorticotropic hormone, TSH: thyroid stimulating hormone, FSH: follicle stimulating hormone, LH: luteinizing hormone, GH: growth hormone, PL: prolactin |
| What are the hormones that are produced from the posterior pituitary gland? | ADH: vasopressin and oxytocin |
| Define ACTH | adrenocorticotropic hormone. aka corticotropin. stimulates the release of corticosteroids |
| Define GH | growth hormone. triggers growth |
| Define TSH | thyroid stimulating hormone. that stimulates the thyroid gland |
| Define FSH | follicle stimulating hormone. stimulates graafian follicles and seminiferous tubules |
| Define LH | luteinizing hormone. stimulates production of androgens (testosterone) and rupture of follicles to release ovum |
| Define PL | prolactin. stimulates milk secretion |
| Define ADH | antidiuretic hormone. aka vasopressin. decreases diuresis by controlling renal function |
| Define OT | oxytocin. stimulates contraction of uterus and letdown in lactating females. helps bond in relation to newborn baby |
| What is the pituitary gland known as? | the master gland |
| What is the size of the pituitary gland? | the size of a pea |
| What is the size of the hypothalamus? | the size of a grape |
| Define hypopituitarism | growth hormone (GH) deficiency. inhibits somatic growth |
| What is the diagnosis for GH deficiency? | family hx, growth patterns, definitive diagnosis based on radioimmunoassay of plasma GH levels, hand x rays to evaluate growth potential vs. ossification, and the endocrine studies to detect deficiencies. |
| What is GH replacement? | biosynthetic GH injections. other hormone replacements as needed. thyroid extract, cortison, testosterone or estrogens and progesterone |
| What is the prognosis for GH deficiency? | GH replacement successful in 80% of patients. response varies based on age, length of treatment. frequency of dose, dosage, weight, and GH receptor amount. growth rate of 3.4-4 cm/year before treatment to 8/9 cm/year after treatmetn |
| What are some client concerns for GH deficiency? | family support needs, child's body image, preparing child for daily injections, treatment is very expensive |
| Define creutzfeldt-jakob disease | rare neurodegenerative condition reported in some patients after receiving human GH from cadavers. does not occur in biosynthetic GH. blood banks will not accept donation from former human GH recipients b/c of risk of infection. aka "mad cow disease |
| Define acromegaly | excess Gh after epiphyseal closure. reach heights of 8 feet or more. vertical growth and increased muscle. weight generally in proportion to height |
| What are some CM of acromegaly | visual field defects. prominent supraorbital ridge. large nose & jaw. teeth separated or lacking. spade shaped hands & feet. arthrosis. peripheral neuropathy. sexual dysfunction. cardiomegaly. HTN. abnormal glucose tolerance. galactorrhea. |
| How can we manage acromegaly? | radiologic and endocrine studies. surgical treatment to remove tumor, radiation and radioactive implants, hormone replacement therapy after surgery , early identification with excessive growth rates, early treatment, emotional support, body image concerns |
| What is the principle disorder of the posterior pituitary gland? | diabetes insipidus |
| Define diabetes insipidus | results from hyposecretion of ADH. produces uncontrolled diuresis. primary and secondary causes |
| What are the primary causes of diabetes insipidus? | familial or idiopathic |
| What are the secondary causes of diabetes insipidus? | trauma, tremors, CNS infection, and aneurysm |
| What are some CM of diabetes insipidus | POLYURIA AND POLYDIPSIA. enuresis. |
| What are some CM of diabetes insipidus in infants? | irritability relieved with feedings of water but not milk. dehydration often occurs |
| What are some client teachings for diabetes insipidus? | instruct parents in difference between mellitus and insipidus. daily hormone replacement of vasopressin. DDAVP, nasal spray or IV meds, requires treatment for life |
| Define SIADH | syndrome of inappropriate antidiuretic hormone. TOO MUCH ADH. produced by hypersecretion of the posterior pituitary. fluid retention and hypotonicity. |
| What are some CM of SIADH? | fluid retention. hypotonicity. anorexia. nausea. vomiting. irritability. personality changes |
| How can we treat SIADH? | accurate I & O. observe for signs of fluid overload. seizure precautions. administer ADH antagonizing meds. observe and administer sodium as needed. |
| How does the thyroid hormone regulate? | basal metabolic rate |
| What are the two types of hormones secreted by the thyroid? | thyroxin (T4) and triiodothyronine (T3) |
| What is the normal range for sodium; Na? | 135-145 |
| What is the normal glucose range? | 70-115 |
| What is the normal range for hemoglobin? | 12-17 |
| What is the normal range for WBC? | 4-10 |
| What is the normal range for hemacrit? | 36-52 |
| What is the normal range for calcium Ca2? | 8.4-10.2 |
| What are some CM for hypothyroidism? | decelerated growth. constipation. sleepiness. dry skin. sparse hair. periorbital edema. hypertrophy of the thyroid gland. muscle weakness and aches. anorexia. slow speech. |
| How can we treat hypothyroidism? | oral thyroid hormone replacement. |
| Define graves' disease | aka hyperthyroidism. enlarged thyroid gland & exophthalmos. bulging eyes, eyelid retraction. redness of the eyes. |
| How is graves' disease diagnosed? | increased levels of T3 and T4, with suppressed TSH |
| Define hypoparathyroidism | deficient production of PTH |
| What are some CM of hypoparathyroidism? | dry scaly skin with eruptions. brittle hair. thin nails laryngeal stridor. headache. seizures. depression. confusion. POSITIVE CHVOSTEK AND OR TROUSSEAU SIGNS. |
| Define cushing syndrome | a characteristic group of manifestations caused by excessive circulating free cortisol |
| What are some CM of cushing syndrome? | personality changes. hyperglycemia. moon face. CNS irritability. increased susceptibility to infection. NA fluid retention (edema). thin extremities. fat deposits on face and back of shoulders. Gi distress. thin skin. osteoporosis. bruises and petechiae. |
| What can cause cushing syndrome? | excessive or prolonged steroid therapy |
| Is cushing syndrome reversible? | yes. once steroids are discontinued |
| What is addison disease? | chronic adrenocortical insufficiency. occurs as a result of neoplasms or lesion of adrenal glands |
| What are some CM of addison disease? | fatigue. malaise. weakness. anorexia. postural dizziness. syncope. weight loss. hyperpigmentation. hypotension. thinning of axillary and pubic hair. vitiligo. nausea. vomiting. abdominal pain. diarrhea. constipation. decreased libido. |
| Define type 1 diabetes mellitus | characterized by total or partial deficiency of the hormone insulin. most common endocrine disorder in childhood. peak incidence in early childhood. cannot be prevented |
| Define type 2 diabetes mellitus | the body does not create enough insulin or develops insulin resistance. can be prevented through lifestyle modifications. |
| What is the level of HbA1c of a diabetic? | >/= 6.5 |
| What is the level of HbA1c of a prediabetic? | 5.7-6.4 |
| What is the level of HbA1c of a normal person? | 5.7 |
| What is the fasting plasma glucose of a diabetic? | >/= 126 |
| What is the fasting plasma glucose of a prediabetic? | 100-125 |
| What is the fasting plasma glucose of a normal person? | </= 99 |
| What is the oral glucose tolerance test of a diabetic? | >/= 200 |
| What is the oral glucose tolerance test of a prediabetic? | 140-199 |
| What is the oral glucose tolerance test of a normal person? | </= 139 |
| Define MODY | transmitted as autosomal dominant disorder with formation of structural abnormal insulin with decreased biologic activity |
| What are some causes of type 1 DM? | believed to be autoimmune diseases arising when a person with a genetic predisposition is exposed to a participating event such as a viral infection |
| Define diabetic ketoacidosis (DKA) | when glucose is unavailable for cellular metabolism. the body breaks down alternative sources of energy. common complication of type 1 DM. ketones are released, and they are elliminated with urine (ketonuria) or by the lungs (acetone breath |
| Define ketones | in the blood. strong acids that lower serum pH and produce ketoacidosis |
| When does kussmaul breathing occur? | in metabolic acidosis. resulting from respiratory system's attempt to eliminate excess CO2 increased depth and rate |
| What are the long term complications of DM? | microvascular complications. neuropathy and retinopathy. macrovascular disease, neuropathy |
| What are some treatments for type 1 DM? | insulin therapy. glucose monitoring (80-120). lab measurement of hemoglobin a1c. urine testing for ketones |
Created by:
keiondraharden
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