med surg exam 3 study guide
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| age related changes) pituitary gland | becomes smaller
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| age related changes) thyroids becomes | more lumpy or nodular and metabolism gradually declines around age 20
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| age related changes) hormones such as aldosterone, renin, calcitonin, growth hormone, estrogen, prolactin, and testosterone. | decrease with age.
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| age related changes) levels remain unchanged but decreased glucose tolerance may occur causing greater risk for hyperglycemia and type 2 diabetes | blood glucose
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| age related changes) increase with age | FSH,LH,ADH,norepinephrine.
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| age related changes) hypoglycemia | is experience more quickly and may progress to dangerously low levels before s/s are obvious.
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| age related changes) thyroid disorders | twice as common, decrease in ability to adapt to stress and respond to environmental changes as readily due to change in amount of hormones secreted.
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| age related changes) hormone replacement therapy | must be done cautiously to avoid overdose due to decreasing liver and kidney functions.
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| function of the thyroid | regulates the manner/rate @ which the tissues utilize food/natural chemicals for the production/utilization of energy into body heat and muscular energy.
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| function of the thyroid | regulates body metabolism, blood calcium levels, energy levels, excess fats, hormones, 02, and weight loss.
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| function of the parathyroid | production and secretion of parathormone. a hormone that is critical to calcium and phosphorus balance.
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| function of the adrenal gland | two small structures one atop each kidney consisting of two distinct regions.
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| adrenal cortex (outer layer) | secretes a variety of steroid hormones (glucocor0ticoid, mineralocorticoids, and androgens.
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| adrenal medulla (inner layer) | part of the sympathetic branch of the ANS. prepares the body to take immediate and vigorous action through release of adrenaline (epinephrine) and norepinephrine
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| function of the pituitary gland located at the base of the brain | consist of three lobes, anterior, posterior, and intermediate.
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| anterior pituitary gland | 80% of the pituitary by weight, releases or influences other glands to release LH, and FSH,PRL,ACTH,GH, and TSH.
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| posterior pituitary gland | releases oxytocin and ADH or vasopressin
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| intermediate pituitary gland | releases melanocyte-stimulating hormone which stimulates the growth of melanocytes(cells that produce a dark pigment called melanin)
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| function of pancreas as endocrine gland | secretes internally to produce the hormones insulin and glucagon.
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| function of pancreas as exocrine gland | secretes outwardly through a duct-beta cells secrete insulin
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| function of beta cells | produces and secretes insulin needed for the cells of the body to be able to utilize glucose as fuel.
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| function of islet cell antibodies | produces by immune system, attack and destroy the islet cells as though they were foreign substances. the beta cells on the islet of Langerhans are destroyed by this autoimmune reaction resulting in no production of insulin.
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| role of glucocorticoids | essential to the metabolic systems for proper utilization of carbs, proteins, and fats, primary glucocorticoid is cortisol or hydrocortisone acts to increase glucose levels in the blood. helps to counteract the inflammatory response.
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| role of mineralocorticoids | affect electrolytes, especially sodium, potassium, and chloride primary mineralocorticoids is aldosterone which promotes conservation of water by action on the kidneys to retain sodium in exchange for potassium which is excreted in the urine.
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| 3 general causes responsible for endocrine disorders | overproduction of endocrine hormones, underproduction of endocrine hormones, effects of drugs such as steroids.
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| general goals for the patients with an endocrine disorder | balance between I and O, normal bowel pattern w/in 2 weeks. regain and maintain weight w/in normal limits w/in 6 months. acknowledge need for patience until therapy improves the symptoms
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| s/s hypo-parathyroidism | mild tingling, muscle cramps, and mental changes, decreased serum calcium levels, bone resorption, and calcium and phosphate in urine, increased serum phosphate levels, and neuromuscular irritability possibly progressing to tetany.
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| cause of hypo-parathyroidism | atrophy or traumatic injury to the parathyroid glands.
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| diagnosis of hypo-parathyroidism | clinical signs and lab data, EEG, CT scan, x-rays, serum calcium, phosphate, magnesium, vitamin D, and urine cyclic adenosine monophosphate (cAMP)
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| treatment of hypo-parathyroidism | measures to raise serum calcium levels to normal range, oral or parenteral administration of calcium salts in the acute phase, parathormone replacement therapy, vitamin D in massive doses to enhance absorption of calcium from the small intestine, oral adm
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| nursing management of hypo-parathyroidism | electrolyte replacement and teaching patient to eat foods high in calcium but low in phosphorous, that therapy is lifelong, and to wear a medic alert bracelet.
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| s/s hyperparathyroidism | dehydration, confusion, lethargy, anorexia, nausea, vomiting, weight loss, constipation, thirst, freq urination, hypertension, decreased serum phosphate levels, bone resorption, calcium and phosphate in urine
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| cause of hyperparathyroidism | benign enlargement of the parathyroid glands (adenoma), hyperplasia, of two or more glands, parathyroid tumor, congenital enlargement, neck trauma, or irradiation, vitamin D deficiency, CHF, hypocalcemia, or lung, kidney, or GI tract cancers
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| Diagnosis of hyperparathyroidism | radiologic and laboratory screening procedures and testing for serum calcium and phosphate levels.
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| treatment of hyperparathyroidism | infusion of isotonic sodium chloride and diuretic agents to promote excretion of excess calcium in the urine. surgical removal major portion of the parathyroids for pt's who have severe systemic disorders
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| nursing management for hyperparathyroidism | accurate measuring of I&O every 2-4 hours, daily weight, monitoring of serum electrolytes, ongoing assessment for electrolyte imbalance and possible continuous cardiac monitoring.
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| primary focus/treatment for hospitalized patient with addisonian crisis | closely monitor vital signs and immediate fluid replacement therapy, IV hydrocortisone along with sodium, fluids and dextrose until BP becomes stable.
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| simple goiter | thyroid enlargement not accompanied by s/s of hyperthyroidism.(commonly causes by inadequate dietary intake of iodine)
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| hyperthyroidism | caused by overproduction of thyroid hormone.
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| s/s of thyroid storm | sudden and extreme elevation of all body processes, temp may rise to 106 or more, pulse increase to as much as 200 BPM, respirations become rapid, marked apprehension/restlessness, w/out relief patient quickly passes from delirium/coma then death/heart fa
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| preoperative nursing care thyroidectomy | inform charge nurse or surgeon of any unexpected emotional outburst(poss/ineffective control of the thyroid gland signaling thyroid crisis postoperatively)
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| post op complications thyroidectomy | hypoparathyroidism can result if the parathyroid glands are accidentally removed during a total thyroidectomy (positive chvostek's sign and complaints of muscle cramps resulting from low calcium blood levels)
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| post op nursing care thyroidectomy | keep patient comfortable with analgesics and offer clear fluids and monitor vital signs.
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| postoperative nursing care/transsphenoidal hypophysectomy | semi-fowler position, closely monitor vital signs and neuro status, monitor for diabetes insipidus, nasal drip pad in place due to nasal packing, no brushing teeth, cough, sneeze, blow nose or bend forward. encourage hourly deep breathing exercise.
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| too much parathormone (excessive) | leads to elevated calcium levels in the blood (hypercalcemia) and calcium deposition in cartilage.
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| too little parathromone (deficiency) | abnormally low calcium levels in the blood (hypocalcemia)
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