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Adult III test 3

QuestionAnswer
The pituitary consists of two parts the anterior lobe (adenohypophysis) and posterior lobe (neurohypophypopysis)
lobe that accounts for 80% of the gland by weight anterior pituitary gland
the anterior pituitary gland is regulated by the hypothalamus through releasing and inhibiting hormones
the releasing and inhibiting hormones affect the secretion of six hormones from the anterior pituitary gland
hormones that control the secretion of hormones by other glands tropic hormones
stimulates the thyroid gland to secrete thyroid hormones Thyroid-stimulating hormone (TSH)
stimulates the adrenal cortex to secrete corticosteroids adrenocorticotropic hormone (ACTH)
has effect on all body tissues, affects the growth and development of skeletal muscle and long bones, affecting a persons size and height, also has numerous biologic actions, including a role in protein, fat, and carb metabolism growth hormone
is composed of nerve tissue and is essentially an extension of the hypothalamus the posterior pituitary gland
the hormones secreted by the posterior pituitary gland are actually produced in the hypothalamus
the major role of this hormone is regulation of fluid volume by stimulating reabsorption of water in the renal tubules, also called vasopressin, also a potent vasoconstrictor antidiuretic hormone
the most important stimulus to ADH secretion is plasma osmolality
will increase when there is a decrease in extracellular fluid or an in solute concentration plasma osmolality
the increased plasma osmolality activates osmoreceptors and these stimulate ADH release
When ADH is released the renal tubules reabsorb water, creating a more concentrated urine
when ADH release is inhibited, renal tubules do no reabsorb water, thus creating more dilute urine
is located in the anterior portion of the neck in front of the trachea the thyroid gland
the thyroid is regulated by TSH from the anterior pituitary gland
the three hormones produced and secreted by the thyroid gland are thyroxine (T4), triiodothyronine (t3), and calcitonin
the major function of the thyroid gland is the production, storage, and release of the thyroid hormones
is by far the most abundant thyroid hormone, accounting for 90% of thyroid hormone produced by the thyroid gland T4
much more potent and has greater metabolic effects, about 20% is secreted directly by the thyroid gland, and the remainder is obtained by peripheral conversion of T4 T3
necessary for the synthesis of thyroid hormones Iodine
t4 and t3 affect metabolic rate, caloric requirements, oxygen consumption, carbohydrate and lipid metabolism, growth and development, brain functions, and other nervous system activites
thyroid hormone production and release is stimulated by TSH from the anterior pituitary gland
when circulating levels of thyroid hormone are low, the hypothalamus releases ______, which in turn causes the anterior pituitary to release ______ TRH, TSH
High circulating thyroid hormone levels have an inhibitory effect on the secretion of both TRH from hypothalamus and TSH from anterior pituitary gland
is a hormone produced by C cells of the thyroid gland in response to high circulating calcium levels calcitonin
inhibits calcium reabsorption from bone, increases calcium storage in bone, and increases renal excretion of calcium and phosphorus, thereby lowering serum calcium levels calcitonin
while providing a countermechanism to parathyroid hormone, calcitonin does not play a critical role in calcium balance
an enlarged thyroid gland a goiter
in a person with a goiter the thyroid cells are stimulated to grow, which may result in an overactive thyroid (hyperthyroidism) or underactive thyroid (hypothyroidism)
a goiter that produces excess thyroid hormone is called a toxic goiter
a nontoxic goiter produces normal levels of thyroid hormone
the most common cause of goiter worldwide is a lack of iodine in the diet
In the US where most people use iodized salt, goiter is more often due to the overproduction or underproduction of thyroid hormone or to nodules that develop in the gland itself
foods or drugs that contain thyroid-inhibiting substances that can cause goiter goitrogens
in a person with a goiter, these levels are measured to determine whether a goiter is associated with hyperthyroidism, hypothyroidism, or normal thyroid funtions TSH and t4
a palpable deformity of the thyroid gland, may be benign or malignant a thyroid nodule
benign nodules are usually not dangerous but they can cause tracheal compression if they become too large
is the most common endrocrine related carcinoma thyroid cancer
the four main types of thyroid cancer include papillary, follicular, medullary, anaplastic
is the most common type, accounting for about 70% to 80% of all thyroid cancers. they tend to grow more slowly and spreads initially to lymph nodes in the neck papillary
makes up about 10% to 15% of all thyroid cancers, tends to occur in older patients, and first grows into the cervical lymph nodes, more likely to grow into blood vessels and spread to lungs and bones follicular
accounts for %5 to 10% of all thyroid cancers, more likely to occur in families and be associated with other endocrine problems medullary
is found in less than 5% of patients with thyroid cancer, the most advanced and aggressive thyroid cancer, least likely to respond to treatment anaplastic
the primary sign of thyroid cancer is the presence of a painless, palpable nodule or nodules in an enlarged thyroid gland
is often the first test used for presence of nodules ultrasound
CT, MRI, and ultrasound-guided fine-needle aspiration (FNA) are other diagnostic options
FNA is considered one of the most effective methods to identify malignancy
nursing care for a patient with thyroid cancer it is important to asses the patient for airway obstruction, bleeding, and manifestations of hypocalcemia (tetany)
is an inflammation of the thyroid gland that can have several causes thyroiditis
is thought to be caused by viral infection subacute granulomatous thyroiditis
is due to bacterial of fungal infections acute thyroiditis
with thyroiditis the patient complains of pain localized in the thyroid or radiating to the throat, ears, or jaw
other systemic manifestations of thyroiditis include fever, chills, sweats, and fatigue
can lead to hypothyroidism, and is a chronic autoimmune disease in which thyroid tissue is replaced by lymphocytes and fibrous tissue hashimoto's thyroiditis
is a form of lymphocytic thyroiditis with a variable onset silent painless thyroiditis
are initially elevated in subacute, acute, and silent thyroiditis but become depressed with time t4 and t3
in subacute, acute, and silent thyroiditis TSH levels are usually low and then elevated
in Hashimoto's thyroiditis, t4 and t3 are usually _____ and TSH levels are usually ____ low, high
if thyroiditis is bacterial in origin, treatment may include specific antibiotics or surgical drainage
NSAIDs are used in subacute and acute thyroiditis
may be used to treat cardiovascular symptoms related to hyperthyroid condition in thyroiditia propranolol and antenolol
nursing care of the patient with thyroiditis involves teaching about the treatment regimen and encouraging compliance with treatment
the patient with thyroiditis of an autoimmune origin is at risk for other autoimmune diseases such as addison's disease, pernicious anemia, premature gonadal failure, or graves disease
is hyperactivity of the thyroid gland with sustained increase in synthesis and release of thyroid hormones hyperthyroidism
refers to the physiologic effects or clinical syndrome of hypermetabolism that results from excess circulating levels of t4, t3, or both. thyrotoxicosis
hyperthyroidism and thyrotoxicosis occur together as in Grave's disease
hyperthyroidism occurs more in women than in men, with the highest frequency in persons age 20-40 years
is an autoimmune disease of unknown etiology marked by diffuse thyroid enlargement and excessive thyroid hormone secretion Grave's disease
in graves disease the patient develops antibodies to the TSH receptor, these antibodies attach to the receptors and stimulate the thyroid gland to release t3, t4, or both
graves disease may progress to the destruction of the thyroid gland causing hypothyroidism
nodular goiters are thyroid hormone secreting nodules that function independent of TSH stimulation and if these are associated with hyperthyroidism they are termed toxic
The clinical manifestations of hyperthyroidism are related to the effect of excess thyroid hormone
excess circulating thyroid hormone directly increases metabolism and tissue sensitivity to stimulation by the SNS
auscultation of the thyroid gland may reveal bruits, which is a reflection of increased blood supply
another common finding associated with hyperthyroidism is opthalmopathy, which is abnormal eye appearance or function
A classic finding in Grave's disease is exophthalmos, which is a protrusion of the eyeballs from the orbits
a type of infiltrative opthalmopathy that is due to impaired venous drainage from the orbit, which causes increased fat deposits and fluid in the retroorbital tissues exophthalmos
the upper lids are usually retracted and elevated, with the sclera visible above the iris in ophthalmopathy
When the eyelids do not close completely, the exposed corneal surfaces become dry and irritated, serious consequences such as corneal ulcers and eventual loss of vision
thyroid hyperfunction on the cardiovascular system systolic HTN, > rate and force of contractions, bounding rapid pulse, > cardiac output, cardiac hypertrophy, systolic murmurs, dysrhythmias, palpitations, A-fib (more common in older adult), angina
thyroid hyperfunction on the respiratory systems > RR and dyspnea on mild exertion
thyroid hyperfunction on the GI system > appetite&thirst, weight loss, >peristalsis, diarrhea, frequent defecation, >bowel sounds, splenomegaly, hepatomegaly
thyroid hyperfunction on the integumentary system war, smooth, moist skin, thin, brittle, nails detatched from nail bed, hair loss, clubbing of fingers, palmar erythema, fine silky hair, premature greying, diaphoresis, vitiligo, pretibial myxedema
thyroid hyperfunction on the musculoskeletal system fatigue, muscle weakness, proximal muscle wasting, dependent edema, osteoporosis
thyroid hyperfunction on the nervous system difficulty focusing eyes, nervousness, fine tremor, insomnia, lability of mood, delirium, restlessness, personality change of irritability, agitation, exhaustion, hyperreflexia tendon reflexes, depression, fatigue, apathy, lack concentration,stupor, coma
thyroid hyperfunction on the reproductive system menstrual irregularities, amenorrhea, < libido, impotence in men, gynecomastia in men, < fertility
thyroid hyperfunction on other systems intolerance to heat, elevated basal temp, lid lag, stare, eyelid retraction, exophthalmos, goiter, rapid speech
a patient in the early stages of hyperthyroidism may exhibit only weight loss and increased nervousness
also called a thyroid storm, is an acute, rare condition in which all hyperthyroid manifestations are heightened, considered a life threatening emergency, and caused by stressors thyrotoxic crisis
manifestations of thyrotoxic crisis are severe tachycardia, HF, shock, hyperthermia, restlessness, agitation, seizures, abdominal pain, N V D, delirium, and coma
treatment for thyrotoxic crisis is aimed at reducing circulating thyroid hormone levels and the clinical manifestations of this disorder by appropriate drug therapy
supportive therapy for thyrotoxic crisis is directed at managing respiratory distress, fever reduction, fluid replacement, and elimination or management of the initiating stressor
the two primary lab findings used to confirm the diagnosis of hyperthyroidism are < TSH levels and elevated t4 levels
The RAIU test is used to differentiate Grave's disease from other forms of thyroiditis
The overall goal in the treatment of hyperthyroidism is to block the adverse effects of thyroid hormones and stop their oversecretion
the three primary treatment options for the patient with hyperthyroidism are antithyroid medications, radioactive iodine therapy, and subtotal thyroidectomy
Drugs that are used to treat hyperthyroidism include antithyroid drugs, iodine and beta-adrenergic blockers
the first line antithyroid drugs and inhibit the synthesis of thyroid hormones, good results usually seen in 4-8 weeks pylthiouracil (PTU) and methimazole (tapazole)
indications for the use of antithyroid drugs include Grave's disease (young), hyperthyroidism (pregnancy), and the need to achieve a euthyroid state before surgery or radiation therapy
used with other antithyroid drugs to prepare the pt for thyroidectomy or for treatment of thyrotoxic crisis, inhibits the synthesis of T3 anf T4 and blocks release of these hormones into circulation, decreases the vascularity of the gland,not effective tx iodine
used for symptomatic relief of thyrotoxicosis that results from increased beta-adrenergic receptor stimulation caused by excess thyroid hormones beta-adrenergic blockers
treatment of choice for nonpregnant women, it damages or destroys thyroid tissue, thus limiting thyroid hormone secretion, effect not seen for 2-3 months, pt usually treated w/ antithyroid drugs before and during, >risk for hypothyroidism radioactive iodine therapy
indicated for individuals who had a large goiter causing tracheal compression, have been unresponsive to antithyroid therapy, or have thyroid cancer thyroidectomy
is the preferred surgical procedure and involves the removal of significant portion (90%) of the thyroid gland subtotal thyroidectomy
is a minimally invasive procedure, several small incisions are made through which a scope and instruments can be passed to remove thyroid tissue or nodules endoscopic thyroidectomy
postoperative complications of thyroidectomy include damage to parathyroid glands, hemorrhage, injury to laryngeal nerve, thyrotoxic crisis, and infection
nutritional therapy for hyperthyroidism high calorie diet (4,000-5,000 cal/day), six meals/day with >protein, >carbs, >minerals, and >vitamins
The overall goals that patient with hyperthryoidism will experience relief of symptoms, have no serious complications, maintain nutritional balance, cooperate with therapeutic plan
if exophthalmos is present there is a potential for corneal injury related to irritation and dryness, nursing inventions would be applying artificial tears, salt restriction, elevate pts head, dark glasses, tape eyes shut for sleep, teach pt to exercise intraocular muscles several times/day
results from insufficient circulating thyroid hormone as a result of a variety of abnormalities hypothyroidism
hypothyroidism can be two types primary or secondary
related to destruction of thyroid tissue or defective hormone synthesis primary
related to pituitary disease with decrease TSH secretion of hypothalamic dysfunction with decreased TRH secretion secondary
causes of primary hypothyroidism iodine deficiency, atrophy of gland, overtreatment of hyperthyroid, and drugs
causes of secondary hypothyroidism anterior pituitary gland or hypothalamus dysfunction
thyroid hypofunction on the cardiovascular system >cap fragility, <rate and force of contractility, varied changes in BP, cardiac hypertrophy, distant heart sounds, anemia, tendency to develop HF, angina, and MI
thyroid hypofunction on the respiratory system dyspnea and < breathing capacity
thyroid hypofunction on the GI system < appetite, N&V, weight gain, constipation, distended abdomen, enlarged, scaly toungue
thyroid hypofunction on the integumentary system dry, thick, inelastic, cold skin, thick, brittle nails, dry, sparse, course hair, poor turgor of mucosa, generalized interstitial edema, puffy face, decreased sweating, pallor
thyroid hypofunction on the musculoskeletal system fatigue, weakness, muscular aches and pains, slow movements, arthralgia
thyroid hypofunction on the nervous system apathy, lethargy, fatigue, forgetfulness, slowed mental processes, hoarseness, slow, slurred speech, prolonged relaxation of deep tendon muscles, stupor, coma, paresthesias, anxiety, depression
thyroid hypofunction on the reproductive system prolonged menstrual periods or amenorrhea, < libido, infertility
thyroid hypofunction on other systems >susceptibility to infection, >sensitivity to opiods, barbituates, anesthesia, intolerance to cold, <hearing, sleepiness, and goiter
patients with sever long standing hypothyroidism may display this, the accumulation of hydrophilic mucopolysaccharides in the dermis and other tissues myxedema
the mental sluggishness, drowsiness, and lethargy of hypothyroidism may progress gradually or suddenly to a notable impairment of consciousness or coma myxedema coma
myxedema coma can be precipitated by infection, drugs, exposure to cold, and trauma
for the patient to survive a myxedema coma vital functions must be supported and IV thyroid hormone replacement must be administered
the most common and reliable lab tests for thyroid function are TSH and T4
Serum TSH levels help determine the cause of hypothyroidism. serum TSH is ____ when the defect is in the thyroid and ____ when the defect is in the pituitary gland or hypothalamus. high, low
other abnormal labs are elevated with hypothyroidism cholesterol, triglycerides, anemia, increased creatine kinase
the overall treatment in a patient with hypothyroidism is restoration of a euthyroid state as safely and rapidly as possible with hormone replacement
the drug of choice to treat hypothyroidism levothyroxine (synthroid)
your assessment of the patient who is suspected of having hypothyroidism should include questions about weight gain, mental changes, fatigue, slowed and slurred speech, cold intolerance, skin changes, constipation, and dyspnea
the overall goals are that the patient with hypothyroidism will experience relief of symptoms, maintain a euthyroidstate, maintain a positive self-image, and comply with lifelong thyroid replacement therapy
teaching for a patient with hypothyroidism importance of replacement therapy, comfortable warm environment, prevent skin breakdown, avoid sedatives, minimize constipation
Thyroid preparations potentiate the effects of _______ and decrease the effect of ________ anticoagulants, digitalis compounds
the parathyroid glands secrete parathyroid hormone (PTH)
the major roll of the parathyroid gland is to regulate the blood level of calcium
PTH acts on bone, kidneys, and GI tract
in bone, PTH stimulates bone reabsorption and inhibits bone formation, resulting in the release of calcium and phosphate into the blood
in the kidney, PTH increases calcium reabsorption and phosphate excretion
PTH stimulates the renal conversion of vitamin D into its most active form
The active vitamin D then enhances the intestinal absorption of calcium
the normal function is when the serum calcium is low PTH secretion _____, when the serum calcium level rises, PTH secretion _____ increases, falls
is a condition involving an increased secretion of parathyroid hormone hyperparathyroidism
over secretion of PTH is associated with increased serum calcium levels
Excessive levels of circulating PTH usually lead to hypercalcemia and hypophosphatemia
the majjor manifestations of hyperparathyroidism include muscle weakness, loss of appetite, constipation, fatigue, emotional disorders, and shortened attention span
major signs of hyperparathyroidism include osteoporosis, fractures, and kidney stones
serious complications of hyperparathyroidism are renal failure, pancreatitis, cardiac changes, and long bone, rib, and vertebral fractures
in patients with hyperparathyroidism PTH levels are elevated
other lab tests for hyperparathyroidism include urine calcium, serum chloride, uric acid, creatinine, amylase, and alkaline phosphatase
the treatment objectives for hyperparathyroidism are to relieve symptoms and prevent complications caused by excess PTH
the most effective treatment for primary and secondary hyperparathyroidism is surgical intervention, leads to rapid reduction of high calcium levels
normal parathyroid tissue in the forearm or near the sternocleidomastoid muscle is usually done in surgical therapy for hyperparathyroidism autotransplantation
dietary measures for hyperparathyroidism include maintenance of high fluid intake and a moderate calcium intake
used in the treatment of hyperparathyroidism and are helpful is lowering calcium levels but do not treat the underlying etiology. they inhibit osteoclastic bone resorption and rapidly normalize serum calcium levels bisphosphonates (Fosamax)
these may also be given to patients with hyperparathyroidism to increase the urinary excretion of calcium diuretics
the major post operative complications for hyperparathyroidism are associated with hemorrhage and F&E disturbances
a condition of neuromuscular hyperexcitability associated with sudden decrease in calcium levels tetany
characterized by unpleasant tingling of the hands and around the mouth mild tetany
If tetany become severe what should be given IV calcium
nursing interventions for patients with hyperparathyroidism monitor I&Os, asses CA, K, phosphate, and mag levels frequently, asses Chvostek's and Trousseau's signs, and encourage mobility
a condition associated with inadequate circulating PTH, characterized by hypocalcemia resulting from a lack of PTH to maintain serum calcium levels hypoparathyroidism
The most common cause of hypoparathyroidism is iatrogenic, this may include accidental removal of the parathyroid glands
severe hypomagnesemia also leads to a suppression of PTH secretion
sudden decreases in calcium concentration cause tetany, characterized by tingling of the lips and extremities stiffness
abnormal lab findings in hypoparathyroidism include decreased serum calcium and increased serum phosphate levels
the primary management of hypoparathyroidism are to treat acute complications such as tetany, maintain a normal serum calcium, and prevent long-term complications
the patient with hypoparathyroidism needs instructions in the management of longer term drug therapy and nutrition
is used in chronic and resistant hypocalcemia to enhance intestinal calcium absorption Vitamin D
the inner part of the adrenal gland and consists of sympathetic postganglionic neurons, it secretes the catecholamines epinephrine, norepinephrine, and dopamine adrenal medulla
a rare condition characterized by a tumor of the adrenal medulla that produces excessive catecholamines pheochromocytoma
the mos dangerous immediate effect of pheochromocytoma is severe hypertension
if pheochromocytoma is left untreated it may lead to hypertensive encephalopathy, diabetes, cardiomyopathy, and death
besides hypertension other manifestations in pheochromocytoma are severe pounding headache, tachycardia w/ palpitations, profuse sweating, and unexplained abdominal or chest pain
the simplest and most reliable test for pheochromocytoma is the measurement of urinary fractionated metanephrines, as well as fractionated catecholamines and creatinine, usually done as a 24hr urine collection
the primary treatment for pheochromocytoma consists of surgical removal of the tumor
outer part of the adrenal gland, secretes more than 50 steroid hormones, which are classified as glucocorticoids, mineralocorticoids, and androgens adrenal cortex
regulate metabolism, increase blood glucose levels, and are critical in the physiologic response to stress glucocorticoids
the primary glucocorticoid is cortisol
regulate sodium and potassium balance mineralocorticoids
the primary mineralocorticoid is aldosterone
contribute to growth and development in both genders and to sexual activity in adult women androgens
refers to any one of the three types of hormones produced by the adrenal cortex corticosteroid
is a spectrum of clinical abnormalities caused by an excess of corticosteroids cushing syndrome
cushing syndrome causes pronounced physical changes such as weight gain
the clinical presentation is the first indication of cushing syndrome obesity, moon facies, purplish red striae, hirsutism in women, menstrual disorders in women, hypertension, and unexplained hypokalemia
the standard treatment is surgical removal of the pituitary tumor using the transphenoidal approach if the underlying cause is a pituitary adenoma
the best treatment for cushing syndrome is removal of the tumor
drug therapy can also be used for cushing synrdome and the goal for these drugs are to inhibit corticosteroid synthesis ketoconazole (Nizoral) and aminoglutethimide (Cytadren)
if cushing syndrome has developed during the course of prolonged administration of corticosteroids one of these alternatives may be tried gradual discontinue of therapy, reduction of dose, conversion to alternative day regimen
gradual tapering of the corticosteroids is necessary to avoid potentially life threatening adrenal insufficiency
the overall goals are that the patient with cushing syndrome will experience relief of symptoms, have no serious complications, maintain a positive self-image, actively participate in the therapeutic plan
because therapy for cushing syndrome has many side effects, the focus of assessment is on S/S of hormone and drug toxicity and complication conditions
on a cushing syndrome patient you was to continually assess and monitor vital signs, daily weight, glucose, and possible infection
another important focus on a cushing syndrome patient is emotional support because changes in appearance such as obesity, multiple bruises, hirsutism in women, and gynocomastia in men
primary cause of adrenocoritcol insufficiency may be from Addison's disease
secondary cause of adrenocorticol insufficiency may be from lack of pituitary ACTH secretion
In addison's disease all three classes of adrenal corticosteriods are reduced glucocorticoids, mineralocorticoids, and androgens
the most common cause of addison's disease in industrialized nations is autoimmune response
the manifestations for addisons disease have a very slow onset and include as primary features progressive weakness, fatigue, weight loss, anorexia, skin hyperpigmentation, a striking feature on pressure points, over joints, and in the creases
other frequent manifestations for addisons disease are orthostatic hypotension, hyponatremia, salt craving, hyprekalemia, N,V&D
patients with adrencorticoid insufficiency are at risk for acute adrenal insufficiency, a life threatening emergency caused by adrenocortical hormones or a sudden sharp decrease in these hormones addisonian crisis
addisonian crisis is triggered by stress, sudden withdrawal of corticosteroids, after adrenal surgery, following sudden pituitary gland destruction
manifestations of addisonian crisis include hypotension, tachycardia, dehydration, hyponatremia, hyperkalemia, hypoglycemia, fever, weakness, and confusion
a diagnosis of addison's disease can be made when cortisol levels are subnormal or fail to rise over basal levels with ACTH stimulation test
a failure of cortisol levels to rise in response to a ACTH stimulation test indicates primary adrenal disease
a positive response to ACTH stimulation indicates a functioning adrenal gland and points a probably diagnosis or pituitary disease
other abnormal findings in addison's disease include hyperkalemia, hypochloremia, hyponatremia, hypoglycemia, anemia, and increased BUN levels
the mainstay of adrencortical insufficiency is replacement therapy
the most commonly used form of replacement therapy, has both glucocorticoid and mineralocorticoid properties hydrocortisone
patient with addison's disease teachings names, dosages, and actions of drugs, S/S of underdosage and OD, conditions requiring > meds, course of action to take relative to changes is meds, prevention of infection, lifelong replacement therapy, lifelong medical supervision, medical ID device
a potent mineralocorticoid that maintains extracellular fluid volume, acts at the renal tubule to promote renal reabsorption of NA and excretion of K and H ions aldosterone
characterized by excessive aldosterone secretion hyperaldosteronism
the main effects of hyperaldosteronism are hypertension and hypokalemic alkolosis
elevated levels of aldosterone are associated with sodium retention and potassium elimination
sodium retention leads to hypernatremia, hypertension, and HA
potassium excretion leads to hypokalemia (causes generalized muscle weakness), fatigue, cardiac dysrhythmias, glucose intolerance, metabolic alkalosis (lead to tenany)
the preferred treatment for hyperaldosteronism is surgical removal of the adenoma
patients with bilateral adrenal hyperplasia are treated with a potassium-sparing diuretic (sprionolactone, amiloride [Midamor]) or aminoglutethimide (Cytadren) which blocks aldosterone synthesis
excessive secretion of GH in adults results in ____ a condition characterized by a thickening of bones and soft tissue acromegaly
Individuals experience enlargement of the hands and feet with joint pain that can range from mild to crippling
changes in physical appearance occur with thickening and enlargement of bony and soft tissues on the face and head
enlargement of the tongue results in speech difficulties and voice deepens from hypertrophy of vocal cords
is the most commonly performed with the transpehnoidal approach surgery on the pituitary gland
clinical manifestations of acromegaly enlarged pituitary gland, HA, visual disstrubances, slanting forehead, coarse facial features, protruding jaw, menstrual changes, sleep apnea
a rare disorder thainvolves a decrease in one or more of the pituitary hormones hypopituitarism
a deficiency is only one pituitary hormone is selective hypopituitarism
total failure of the pituitary gland results in a deficiency in all pituitary hormones panhypopituitarism
the most common hormone deficiencies associated with hypopituitarism involve GH and gonadotropins
causes of hypopituitarism include pituitary tumor, autoimmune disorders, infections, pituitary infarction, or destruction of pituitary gland
diagnosis of hypopituitarism include hormone levels, CT, and MRI
treatment for hypopituitarism is hormone replacement
is associated with a deficiency of production of or secretion of ADH or a decreased renal response to ADH diabetes insipidous
occurs when a lesion of the hypothalamus, infundibular stem, or posterior pituitary interferes with ADH synthesis, transport, or release central DI
is a condition in which there is adequate ADH, but there is a decreased response to ADH in the kidney, lithium is the most common drug induced nephrogenic DI
a less common condition, is associated with excessive water intake, psychiatric patients primary DI
DI is characterized by polydipsia, and polyuria
diagnosis of DI include dehydration and hypovolemia
treatment of Di iv fluids, DDVAP (desmopressin acetate), Pitressin, Diabinase, Tegretol, Thiazide diuretics, Indocin
occurs when ADh is released despite normal or low plasma osmolarity, abnormal production of ADH syndrome of inappropriate antidiuretic hormone (SIADH)
characterized by fluid retention, serum hypoosmolaity, dilutional hyponatremia, hypochloremia, concentrated urine, increased vascular volume, normal renal function
manifestations include vomiting, abdominal cramps, muscle twitching, and seizures
the diagnosis is made by simultaneously measurements of urine and serum osmolality
treatment is treating underlying cause, fluid restrictions, I&Os, and daily weights
Meds given Diuretics, hypertonic saline, demeclocycline (antibiotic)
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