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EndocrineCH66
Interventions for clients with pituitary adn adrenal gland disorders
| Question | Answer |
|---|---|
| HYPOpituitarism | deficiency of one of more anterior hormones |
| Deficiencies of_______ and _______ are the most life threatening | ACTH and TSH |
| HYPOpituitarism (GH) | The lack of groth hormone causes short stature |
| HYPOpituitarism Etiology(causes) | Tumors, malnutrition, anorexia causing loss body fat, poor circulation to pituitary gland, radiation, cancer, trauma, infection, congenital defects |
| Low Growth Hormone (GH) | fractures, decreased muscle strength |
| Low Thyroid Stimulating Hormone (TSH) | < TSH levels, weight gain, cold intolerance, alopecia, hirsuitism, slowed cognition, lethargy |
| Low Adrenocorticotropic horomone (ACTH) | decreased cortisol levels,h/a, pale complexion, malaise, anorexia,hypoglycemia, hyponatremia |
| Low Anti-diuretic hormone (ADH) | Diabetes insipidus w/ increased urine output, hypovolemia, increased thirst and osmolarity of plasma |
| Pituitary tumors cause | diplopia(double vision), Head aches |
| HYPERpituitarism | oversecretion of hormones from pituitary tumors(adenoma) or enlarged pituitary |
| Hyperpituitarism Disorder- Gigantism | Increased GH before puberty , grow tall |
| Hyperpituitarism Disorder- Acromegaly | Increased GH after puberty, enlarged hands and feet, protruding lower jaw, enlarged heart, lungs, and liver |
| Hyperpituitarism labs | elevated PR>, ACTH, and GH most common |
| Causes of SIADH-Excess ADH | malignant tumors lungs, pancreas, leukemia, hodgkins disease, head injury, pituitary surgery, barbiturates, anesthetics, diuretics |
| SIADH causes/intervention | water retention and dilutional hyponatremia/restrict po fluids 500-600 ml/day |
| Diabetes insipidus causes | head trauma, radiation to pituitary, cranial surgery, renal failure, infection, CVA |
| Diabetes insipidus treatment | Hypotonic saline IV and giving ADH or Vasopressin |
| Adrenal Gland hyperfunctions | Cushings, hyperaldosteronism, and pheochromocytoma |
| Hyperaldosteronism | excess aldosterone, na retention, potasium excretion have htn, treated by adrenalectomy |
| Pheochromocytoma- | adrenal tumor causing hypertension/ surgery to remove |
| Cushings | too much ACTH from pituitary causes increase release of cortisol which is a glucocorticosteroid hormone from adrenal gland |
| additional causes of Cushings | long term steroid medications to treat asthma, allergic responses, autoimmune disorders, after organ transplants |
| Cushing manifestations | MUSCULO(weakness, wasting, prone fractures,osteoporosis), Moon face, buffalo hump |
| Skin/CNS | Stria, contusions, hirsutism, prone breakdown/Psychoses, depression |
| GI/CV | Ulcers & truncal obesity, GI bleeding/Hypertention |
| others | Renal calculi, elevated glucose, decreased K+, increase Na+ |
| Labs | Cortisol elevated, Decreased K and Ca, Elevated Glucose and Na, 24 hour urine for coritsol, Dexamethason Suppression test |
| Treatment (for cushings) | medication, radiation, surgery |
| ADDISON'S DISEASE | Adrenal gland cortex hypofunction |
| Cortex produces | aldostrone(mineralocorticoid) and cortisol (glucocorticoid) |
| Decrease ACTH causes | decrease production of steroids |
| Addison's disease is causeed by | autoimmune diseases that destroys cortex, abrupt withdrawal oflong term steroids, TB, CA, AIDS, Adrenalectomy, pituitary tumors, pituitary removal |
| In Addison's disease there is not enought | aldosterone secreted from adrenal gland |
| Aldosterone retains sodium and water, w/o enough... | Lose Na and water, retain K, hypovolemia, orthostatic hypotension, syncope, shock |
| Continue from ^above^ | Loss of Na- dizziness, confusion, seizuresCV- tachycardia, increas K= arrest/ decreased cortisol decreases glucose level |
| Manifestation of Addison's Disease | Skin- bronze or tan skin/ musculoskeletal- weakness & wasting/GI-Anorexia,N/V/D /Psychosocial- lethargic, depressed, confused to psychotic |
| Lab findings | Cortisol,Na,and glucose decreased/ BUN and K increased/ CT to check pituitary tumors/ EKG look T waves(k) |
| Treatment | Replace Cortisol: cortisone, hydrocortisone, prednisone, florinef, decadron, medrol, solu- medrol |
| What type of effects do these^ steroids have? | Anti-inflammatory and immunosuppresant effects. They mask symptoms of infection and increase glucose levels |
Created by:
letta
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