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Stack #127253

a MCPHS- Provider I- Ch 42- Assessment & Management of Pts w/Endocrine Disorders

Other tissues which produce hormones GI mucosa, Kidneys, WBC's
Endocrine glands vs. Exocrine glands r/t Secretion Endo:secrete directly into bloodstream, Exo:secrete through ducts onto epithelial surfaces or into GI tract
Chemicals secreted by endocrine glands Hormones
Hormones regulate Organ function
Nervous system vs. Hormones r/t Action potential NS:rapid, H:slower
Hormone concentration vs. Hormone production Production increases, Concentration decreases, Inverse relationship
Mechanism which regulates hormone concentration in bloodstream Negative feedback
Peptide hormones vs. Protein hormones vs. Steroid hormones r/t Receptor sites Pep & Pro:receptor sites on cell surface, S:penetrate cell and interact w/intracellular receptors
Time r/t Steroid hormone action Hours
Common S/Sx r/t Endocrine imbalances Changes in energy level, Fatigue, Tolerance to heat and cold, Recent changes in weight, Changes in sexual function, Secondary sex characteristics
3 common diagnostic tests r/t Endocrine disorders Blood, Urine, Stimulation & suppression tests
Stimulation tests vs. Suppression tests Stimulation:determine gland response to stimulating hormones released by hypothalamus/pituitary gland, Suppression:determines if negative feedback mechanisms are intact
Secretes hormones that control secretion of hormones by other glands Pituitary
Controls pituitary Hypothalamus
Hormones secreted by posterior lobe of pituitary gland Vasopressin (ADH), Oxytocin
S/Sx r/t Hypopituitarism Extreme weight loss, Weight loss, Emaciation, Atrophy of all endocrine glands & organs, Hair loss, Impotence, Hypometabolism, Hypoglycemia
Acromegaly Excess growth hormone in adults
Gigantism vs. Dwarfism r/t Children G:oversecretion of growth hormone, D:insufficient secretion of growth hormone
Most common disorder r/t Posterior lobe dysfunction Diabetes insipidus
3 types of pituitary tumors Eosinophilic, Basophilic, Chromophobic
Eosinophilic vs. Basophilic vs. Chromophobic r/t Pathology E:Gigantism, B:Cushing's syndrome, C:Hypopituitarism
Hypophysectomy Removal of pituitary gland
Manifestations r/t Diabetes insipidus Polydipsia, Polyuria w/dilute urine, Inability to increase specific gravity/osmolality of urine
Manifestations r/t Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion Retain fluids, Na deficiency
Dilutional hyponatremia Na deficiency r/t SIADH
Essential for thyroid gland to synthesize its hormones Iodine
Thyroid hormone production w/in normal limits Euthyroid
Primary function r/t Thyroid hormones Cellular metabolic activity
Calcitonin function Reduce plasma level of Ca by increasing its deposition into bone
Pathology r/t Goiter Iodine deficiency causes goiter, Goiter causes oversecretion of thyroid hormone
Abnormal finding r/t Enlarged thyroid gland Bruit
Best screening test r/t Thyroid function Serum TSH function
Hypothyroidism vs. Hyperthyoidism r/t Values Hypo:value > 6.15, Hyper:value < 0.4
Current recommendations r/t TSH screening All adults 35+ and every 5 years after
T3 vs. T4 r/t Normal ranges T3:70 - 220, T4:4.5 - 11.5
Most common cause r/t Hypothyroidism Hashimoto's disease (autoimmune thyroiditis)
Most severe stage r/t Hypothyroidism/Hashimoto's Myxedema coma
S/Sx r/t Myxedema coma Hypothermia, Unconscious, Depressed respiratory drive, Progressive CO2 retention
Analgesic, sedative, anesthetic effects r/t Hypothyroidism Prolonged d/t altered metabolism and excretion
Heating pad & electric blanket usage r/t Myxedema coma Do not use d/t risk for peripheral vasodilation
Most commmon type r/t Hyperthyroidism Graves' disease
Most severe form of hyperthyroidism Thyoid storm
S/Sx r/t Thyroid storm High fever & Extreme tachycardia
Common precipating event r/t Thyroid storm Stress such as injury, infection, DKA et cetera
Management r/t Thyroid storm Hypothermia mattress, Humidified oxygen, IV fluids w/dextrose, Iodine administration
Cause r/t Acute thyroiditis Infection of thyroid gland
Aspirin r/t Subacute thyroiditis Avoided b/c it increases amount of circulating thyroid hormone
Synonym r/t Chronic thyroiditis Hashimoto's disease
Chronic vs. Acute thyroiditis r/t Pain & thyroid activity C:pain, pressure & fever are not normal, Thyroid activity is normal/low, A:pain, pressure & fever are normal, Thyroid activity is increased
Most common type of goiter Simple/colloid d/t Iodine deficiency in diet
Parathormone (parathyroid hormone) regulates Ca & phosphorus metabolism
Ca absorption r/t Increased parathormone Increased parathormone = Increased Ca absorption = Increased serum calcium levels
Characteristics r/t hyperparathyroidism Bone decalcification, Development of renal calculi
Secondary hyperparathyroidism occurs d/t Chronic renal failure
Management r/t Hyperparathyroidism Hydration, Mobility, Diet, Medication
Diet r/t Hyperparathyroidism management Nutritional needs met but avoid diets that restrict/excess Ca
Treatment r/t Acute hypercalcemic crisis Rehydration w/large volumes of IV fluid, Diuretics to excrete excess Ca, Phophate therapy to promote Ca deposition
Tetany General muscle hypertonia
Assessment/diagnostic findings r/t Hypoparathyroidism Positive Trousseau's & Chvostek's signs
Trousseau's sign vs. Chvostek's sign T:carpopedal spasm caused by occluding blood flow to arm for 3 minutes, C:sharp tapping of facial nerve causes twitch of mouth, nose & eye
Restricted foods r/t Hypoparthyroidism diet Milk products, egg yolk & spinach d/t high levels of phosphorus
Adrenal medulla vs. Adrenal cortex r/t Hormone secretion M:middle of gland which secretes catecholamines(epinephrine/norepinephrine), C:outer portion which secretes steroid hormones
Effects r/t Catecholamines Release free fatty acids, Increase basal metabolic rate, Elevate blood glucose levels
3 types of hormones released by adrenal cortex Glucocorticoids, Mineralocorticoids, Androgens
Increased glucocorticoids (hydrocortisone) r/t Blood glucose levels Increased blood glucose levels
Mineralocorticoids mainly effect Electrolyte metabolism
Mineralocorticoid pathology Act on renal tubule & GI epithelium, Increase Na absorption, Excrete K
Mineralocorticoid excretion r/t Angiotensin II Excreted as response to presence of Antiotensin II
Form of HTN cured by surgery Pheochromocytoma
Pheochromocytoma r/t Adrenal medulla Benign tumor found on medulla
Caused d/t inadequate adrenal cortex function Addison's disease
Most common cause r/t Adrenocortical insufficiency Corticosteroid therapy
S/Sx r/t Addison's disease Cyanosis & Signs of circulatory shock
Provide information regarding fluid status Orthostatic VS
Caused d/t excessive adrenocortical activity Cushing's syndrome
S/Sx r/t Cushing's syndrome Central obesity, Buffalo hump, Appearance of masculine traits
Serum Na vs. Serum K vs. Blood glucose r/t Cushing's vs. Addison's C:increased Na and glucose w/decreased K, A:decreased Na and glucose w/increased K
Diet r/t Cushing's syndrome Foods high in protein, Ca, Vitamin D
Manifestations r/t Aldosteronism Hypokalemia, Alkalosis, Increased serum bicarbonate, Inability to concentrate urine, Blood serum abnormally concentrated
Most prominent sign r/t Aldosteronism HTN
Created by: rpclothier