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Endocrine System

The primary Function of the Endocrine System Regulate the body's internal environment. Hormones regulate growth, reproduction/sex differentiation, metabolism and f&E balance.
The Exocrine Glands vs. Endocrine Glands Exocrine secrete substances through ducts to epithelial surface. Endocrine is ductless and secrete substances directly into the blood
Hypothalamus located in the brain. Controls the pituitary function. Regulates temp, fluid volume & growth; Resonds to pain, pleasure,hunger and thirst.
Pituitary Gland "The Master Gland" has 2 parts. Ap and Pp. Ap has 6 hormones and Pp releases ADH(Anti Diuretic Hormone)and Oxyocin (for labor).
Thyroid Gland Sits on either side of the trachea. Needs an adequate supply of iodine in order to secrete (T4) Thyroid hormone and (T3)triiodothyronine which releases meatabolism. Secretes Calcitonin which decreases ca
Adrenal Glands Sits on Kidneys. Secretes Corticosteroids. Maintains normal salt and water balance. Secretes Catecholamines: Epinepherine and noepinephrine. (flight/flight)
Corticosteroids are hormones of the Adrenal Glands that are split into two groups. Glucocortoid and Mineralcorticoids. Glucocorticoids have an anti-inflammatory response and affect emotions. Cortisol raises B/S
Parathyoid Gland Secretes PTH. Increases Ca levels in plasma and decreases phosphorus levels. PTH target kidneys to increase phosphate excretion
Thymus Gland 2 hormones are Thymosin, and Thymin. Located in the mediastinum beneath the sternum. More active in children and atrophy at puberty.
Pancreas Located mostly in the Left Upper Quaqdrant behind the stomache. Primary organ involved in DM. acini cells secrete digestive enzymes into the duodenum. islets of Langerhans Release insulin and Glucagon into the bloodstream
Pancreas Hormones Function Produces hormones needed for the meabolism of carbs, proteins & fats. Hormones inc. Insulin, Glucagon & Somatostatin maintain blood glucose levels. Somatostatin causes hypoglycemic effect by interfering with release of the GH and glucagons
Insulin Primary funcion is to regulate blood glucose levels
Glucagon Primary function is to decrease glucose oxidation and to increase blood glucose
Healh Assessment on a Pt with possible Endocrine Disorder Ask about Energy level, ADL's, urination, thirst salt cravings, increased appetite, diarrhea or constipation, sensitivity to heat or cold, weight loss or gain
When doing a physical exam on pt Assess: face(can be yellow/bronze) Skin (can be scaly) Nails(can be blue, white, clubbing) Hair( dry, brittle, thinning, apolecia) Adventitious lung sounds(abnormal lung sounds)
Common lab test with Endocrine System TSH(Thyroid stimulating hormone), T3,T4, Serum Ca(thyroid)FBS(fasting blood sugar) hA1c(b/s over 3mths) 2hr oral GTT(glucose/pancreas) Thyroid scan, RAI uptake test (checking thyroid)
Anterior Pituitary Disorders Hyperpituitarism- Increase in GH. Gigantism is a result it patients if occurs in children before the epiphysis closes. Afterwards called Acromegaly (signs inc proruding forehead, c/o muscle weakness, diff chewing/swallowing
Anterior Pituitary Disroders Cont. Hypopituitarism- Decrease in GH. Resulting in dwarfism A tumor is usually the cause.
DX AND TX OF GIGANTISM Serum levels of GH, xray for tumor, hypophysectomy(Gland Removal)Bromocriptine=a dopemine receptor agonist for acromegoly. CNS=H/A, depression, confusion. CV= orto b/p, shock, MI, dysrhythmias
POSTERIOR PIT DISORDERS SIADH May see bruising, can be caused by tumor. too much ADH is secreted resulting in increased fluid retention. fluid overloads the bloodstream. temp. inc of ADH can be caused by meds(i.e TCA's, head trauma)
TCA's TCA meds that cause increase of ADH in Pp such as Amitriptyl_ine, Nortriptyl_ine, Doxepin, Desipram_ine
Symptoms of SIADH wt gain without edema, Hyponatremia c ^bp, h/a, muscle weakness. Excessive circulating fluid affects the brain causing cerebral edema, lethargy, seizures, coma, even death. Dk yellow urine, sp>1.030, dec. urine output, anorexia.
Nursing Care for SIADH Lasix(diuretic), Hypertonic solution D5.9NS, D5.45NS to counteract hyponatremia, Declomycine(antibiotic), monitor I&O, LOC, wt., seizure precautions
Demeclocycline (Declomycin) It is widely used in the treatment of hyponatremia(low blood sodium concentrate) due to SIADH when fluid restriction alone has been ineffective.
Diabetes Insipidus(DI) A Pp disorder where not enough ADH is secreted. Kidneys are not absorbing enough h2o resulting in excessive urine output. cause by tumor ,intake of glucocorticoid meds, alcohol ingestion, tx c ADH replacement therapy SIADH s/e may appear
Sympoms of DI 3-15L if urinary output in a 24hr period. Polydipsia(thirst), urine looks like water, tachycardia, dec.b/p, dry skin, sp<1.005, weakness,poor skin turgur, dry mucous membanes.
The difference between DI an DM Polydipsia is a symptom for both. DI is caused by lack of ADH while DM is caused by lack of insulin
DX & TX of DI urine sp gravity<1.005, tumor scan, water deprivation test. TX inc. ADH replacement c Vasopressin(IV/IM/SC) Desmopressin(DDAVP) a nasal spray. Na restriction. 0.45% Hypotonic solution to get fluid from intra vasc. to cells.
Water Deprivation Test used to determine if a pt has DI as opposed to other causes of polydipsia. The pt has to stop intake h20 completely to determine cause of thirst. It measures chg. in body wt, urine output, urine comp. ^levels ind SIADH, dec. levels is DI.
Oxytocin Disorders hyposecretion of oxytocin is treated wit Pitocin to induce contractions during labor
Nursing Care for DI pt. Mainain F&E balance, I&O, signs of dehydration, monitor LOC q4hr, DI pt. requires Hypotonic D0.45%
Nursing DX fluid volume excess(r/t SIADH AMB I&O) Fluid volume deficit(r/t DI AMB polyuria, dry mucous membranes)
THYROID DISORDERS Hyperthyroidism-(Graves Disease)Excessive production of thyoid hormone. Oversecretion of T3&T4.thyrotoxic crisis(storm) caused by tumor, Auto-immune disorder
Symtoms of Hyperthyroidism Tachycardia, ^b/p, heat intolerance, nervousness, emotional liablity, buldging eyes(EXOPHTHALMOS). Inc. Appetite, wt.loss, diarrhea, sweating.
DX & TX of Hyperthyroidism labs T3,T4; dec. TSH, thyroid scan to check for urine, TX inc.Tapazole(an anti-thyroid) Iodine meds(to suppress release of thyroid hormones)Beta-blockers(Proponolol to relieve thyrotoxicosis problems assoc c. thyroid called Thyrotoxicosis(thyroid storm)
Created by: Meagan2828