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NUR 236 unit 2
| Question | Answer |
|---|---|
| Organs and Structures of the Endocrine System | Pituitary gland (anterior and posterior glands) Thyroid gland Parathyroid glands Adrenal glands Pancreas (beta cells) Ovaries and testes Pineal gland Thymus gland Heart |
| Does not produces hormones | posterior pituitary gland |
| Posterior pituitary gland function | stores and then releases oxytocin and ADH which are produced in the hypothalamus |
| anterior pituitary function | produces hormones that are secreted into the bloodstream as a result of “releasing hormones” from the hypothalamus |
| what does the thyroid gland secrete | the hormones thyroxine (T4), triiodothyronine (T3), and thyrocalcitonin |
| What is the Parathormone hormone produced and secreted by | parathyroid glands |
| released by the thyroid gland | Calcitonin, the balance to parathormone |
| What regulates plasma level of calcium | Parathyroid Glands |
| Known as "master gland" | Pituitary gland |
| What is oxytocin | Responsible for contractions |
| What is ADH | Responsible for water and salt balance |
| What does the adrenal gland (medulla) secrete | The adrenal medulla (middle portion) catecholamines (epinephrine and norepinephrine) |
| The hormones secreted by the adrenal cortex are called | adrenal corticosteroids - mineralocorticoids and glucocorticoids |
| What's the pancreas endocrine function | to produce the hormones insulin and glucagon |
| What are beta cells responsible for | producing and secreting insulin |
| secretes into the bloodstream | endocrine |
| secretes through a duct to the target tissues | exocrine |
| Is the pancreas endocrine or exocrine | BOTH |
| What releases glucagon | alpha cells, which stimulates the liver to change glycogen to glucose |
| Effects of Aging on the Endocrine System | Pituitary gland smaller Thyroid lumpy or nodular Hormones decrease or increase Blood glucose levels rise Thyroid hormone levels decrease |
| Endocrine system primary dysfunction | Hypersecretion and hyposecretion Tumors and inflammation Infection, mechanical damage, or autoimmune response |
| Endocrine system secondary dysfunction | Medications, trauma, hormone therapy Temporary or permanent |
| What is Goiter | an overgrowth of the thyroid (may be prevented by sufficient intake of iodine) |
| How to diagnosis goiter | Thyroid panel Parathyroid function—serum calcium and phosphate levels Adrenal gland function—electrolyte panels, glucose levels, hormone levels, and 12-lead electrocardiogram (ECG) |
| Why does goiter usually happen | lack of iodine |
| What keeps your thyroid healthy | Iodine (incorporate in diet) comes from seafood and iodized salt |
| A low level of what will stimulate release of parathormone | Calcium |
| Parathyroid Deficiency | muscle cramps, twitching of the muscles, and in some cases severe convulsions because of hypocalcemia. |
| prepares the body to meet stress or emergency situations and prevents hypoglycemia | Epinephrine |
| functions as a pressor (causing blood vessel constriction) to maintain blood pressure. | Norepinephrine |
| endocrine gland is either oversecreting or undersecreting hormone(s)—situations referred to as hypersecretion and hyposecretion | Primary endocrine dysfunction |
| occurs from factors outside the gland itself. Medications, trauma, hormone therapy, and other factors | Secondary endocrine dysfunction |
| Random blood glucose level for diagnosis of diabetes mellitus | greater than or equal to 200 mg/dL |
| Fasting blood glucose level for diagnosis of diabetes mellitus | greater than or equal to 126 mg/dL |
| Glucose tolerance test revealing postprandial glucose (GTT) | greater than or equal to 200 mg/dL 2 h after 75 g of glucose is administered (after meals) -Eat, given glucose, after 2 hr if greater than 200 |
| Diagnosis of Diabetes Mellitus | Glucose tolerance test Hemoglobin A1c (A 1c) test Healthy People 2030: Increase the proportion of adults with diabetes who have an A 1c test at least twice a year Fructosamine assay |
| Signs and symptoms of a pituitary tumors | Headache from the pressure of the tumor and visual disturbance—with possible blindness |
| FAST | Face: Sudden numbness or weakness on one side of the face Arms: Sudden numbness or weakness in one arm, especially if it's hanging down Speech: Sudden difficulty speaking, slurred speech, or trouble understanding speech Time: takes to get them out |
| What is a gland? | Organ that secretes hormones |
| Hormones the anterior pituitary gland secretes | Growth Hormone (GH) Thyroid-Stimulating Hormone (TSH) Adrenocorticotropic Hormone (ACTH) Follicle-Stimulating Hormone (FSH) Luteinizing Hormone (LH) Prolactin (PRL) |
| What are target cells | |
| removal of the pituitary gland | Hypophysectomy |
| a surgical procedure to remove tumors from the pituitary gland | Transphenoidal |
| Hormone prod by testes | testosterone |
| Hormone prod by ovaries | estrogen |
| lack of growth hormone | cretinism |
| a condition characterized by overgrowth of bone and soft tissues, most noticeably in the hands, feet, and face, caused by excessive secretion of growth hormone (most commonly by a pituitary tumor). | acromegaly |
| Measures blood glucose once a month for 3 months | A1c test |
| Measures blood glucose once a week for 3 weeks | Fructosamine assay |
| Pt hard to swallow could be | Thyroid issues |
| PT heart racing could be | hyperthyriodism |
| Thyroid should be | Non palpable |
| What does palpable mean? | Able to touch or feel |
| Transsphenoidal PT can't | brush there teeth |
| PT position for post transsphenoidal PT | Semi fowlers position |
| cretinism Signs and symptoms | big feet, face, forehead and no mensural cycle for women |
| Systemic symptoms of pituitary tumors | Personality changes, weakness, fatigue, and vague abdominal pain (KEY stand out) |
| How to diagnosis pituitary tumors | CT scan before MRI |
| TX for pituitary tumors | Hormone therapy Irradiation Surgery—hypophysectomy |
| Hypophysectomy Postoperative Nursing Management | Note any change in vision, mental status, level of consciousness, or strength Observe for symptoms of diabetes insipidus Nasal packing |
| Hyperfunction of the pituitary gland SS | Gigantism in children Acromegaly in adults |
| Hyperfunction of the pituitary gland TX | Removal of pituitary adenoma |
| Hypofunction of the pituitary gland etio and path | Most common cause is a tumor Autoimmune disorders, infections, or destruction of the pituitary gland Sheehan syndrome due to postpartum hemorrhage Decrease in growth hormone and gonadotropins |
| Hypofunction of the pituitary gland SS | With tumor: headaches, visual changes, anosmia, or seizures |
| Sheehan syndrome | death of the pituitary due to hemorrhage in labor |
| Hypofunction the pituitary gland TX | Hormone replacement Surgery and radiation Patient teaching |
| associated with brain tumors, head injury, neurosurgery, or central nervous system (CNS) infections | Central diabetes insipidus (DI) |
| caused by drug therapy (lithium) or kidney disease | Nephrogenic DI |
| caused by excessive water intake (sometimes associated with schizophrenia) | Dispogenic DI |
| Diabetes Insipidus SS | Diuresis Thirst, weakness, and fatigue, often from nocturia (urination at night) Deficient fluid volume Signs of shock and CNS manifestations |
| How to diagnosis diabetes insipidus | Complete history and physical examination Urine and plasma osmolality and urine specific gravity Water deprivation test |
| TX for diabetes insipidus | Replacement of fluid and electrolytes Hormone therapy Early detection Baseline vital signs and weight are to accurately document and monitor throughout therapy Strict (hourly) intake and output monitoring are essential |
| Syndrome of Inappropriate Antidiuretic Hormone (SIADH) | Excessive amounts of ADH are produced, resulting in fluid retention |
| SS Syndrome of Inappropriate Antidiuretic Hormone (SIADH) | Confusion, seizure, loss of consciousness, weight gain, and edema Hyponatremia, muscle cramps, and weakness Diminished urine output |
| Syndrome of Inappropriate Antidiuretic Hormone TX | Correct the underlying cause Restrict fluids to 500 to 1000 mL/day Administer sodium chloride, diuretics, and demeclocycline |
| Medication for SIADH | Tolvaptan (Samsca) |
| Hyperthyroidism | Primary hyperthyroidism—Graves’ disease or toxic goiter |
| Hyperthyroidism SS | Earlier Weight loss and nervousness Later weakness, insomnia, tremulousness, agitation, tachycardia, palpitations, exertional dyspnea, ankle edema, difficulty concentrating, diarrhea, increased thirst and urination, decreased libido, scanty menstruation |
| Methimazole (Tapazole) | main antithyroid drug used |
| Hyperthyroidism diagnosis | Heart rate while sleeping Electrocardiography, CT, or MRI |
| Caused by a sudden increase in the output of thyroxine due to manipulation of the thyroid as it is being removed during thyroidectomy | Thyroid Crisis (Thyroid Storm) |
| Thyroid Crisis (Thyroid Storm) SS | Temperature may rise to 106° F Pulse increases 200 beats per minute Respirations become rapid, and the patient exhibits marked apprehension and restlessness the patient can quickly passes from delirium to coma to death from heart failure |
| Thyroid Crisis (Thyroid Storm TX | Reduce the temperature Cardiac drugs to slow the heart rate Sedatives such as a barbiturates to reduce restlessness and anxiety |
| Congenital hypothyroidism | (cretinism) |
| Hypothyroidism SS | Children have delayed physical and mental growth Adults have decrease in appetite but an increase in weight because of a slow metabolic rate. Lethargic, sleepy, slurred speech |
| Thyroiditis | Inflammation of the thyroid Acute, subacute, or chronic Autoimmune thyroiditis (Hashimoto’s thyroiditis) |
| Thyroiditis SS | Painless enlargement of the thyroid gland Symptoms of hyperthyroidism |
| Thyroid Cancer SS | Thyroid nodule Voice changes, trouble breathing or swallowing Fatigue, depression, and weight changes |
| Most commonly caused by atrophy or traumatic injury to the parathyroid glands | Hypoparathyroidism |
| Hypoparathyroidism SS | Mild tingling, numbness, muscle cramps, and mental changes, such as irritability Chvostek sign Trousseau sign Tetany Convulsions, cardiac dysrhythmias, and spasms of the larynx |
| Hypoparathyroidism TX | calcium and vitamin D |
| Non cancerous tumor | adenoma |
| Excessive parathyroid hormone | Hyperparathyroidism A benign enlargement of the parathyroid glands (adenoma) or hyperplasia of two or more glands is the main cause |
| Hyperparathyroidism diagnosis | Serum calcium and phosphate Serum parathyroid hormone Serum albumin |
| A rare tumor of the adrenal medulla that secretes catecholamines | Pheochromocytoma |
| Pheochromocytoma SS | Tachycardia and severe hypertension Profuse diaphoresis, severe headache, palpitations, nausea, weakness, and pallor |
| Make sure the PT understands what you explained | Write it down |
| Pheochromocytoma pt management | Patient may be in hypertensive crisis and require close monitoring of vital signs and administration of IV antihypertensive medications |
| Excess Adrenocortical Hormone (Cushing Syndrome) cause | Excessive secretion of adrenocorticotropic hormone (ACTH) by the pituitary |
| Excess Adrenocortical Hormone (Cushing Syndrome) SS | Buffalo hump and moon face Enlarged abdomen with thin extremities Bruising after even minor traumas Impotence and amenorrhea Hypertension and weakness |
| Addison's disease | not enough ACTH (Adrenocorticotropic Hormone) |
Created by:
kaimcd