a MCPHS- Provider I- Ch 42- Assessment & Management of Pts w/Endocrine Disorders
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| Other tissues which produce hormones | GI mucosa, Kidneys, WBC's
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| Endocrine glands vs. Exocrine glands r/t Secretion | Endo:secrete directly into bloodstream, Exo:secrete through ducts onto epithelial surfaces or into GI tract
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| Chemicals secreted by endocrine glands | Hormones
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| Hormones regulate | Organ function
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| Nervous system vs. Hormones r/t Action potential | NS:rapid, H:slower
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| Hormone concentration vs. Hormone production | Production increases, Concentration decreases, Inverse relationship
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| Mechanism which regulates hormone concentration in bloodstream | Negative feedback
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| Peptide hormones vs. Protein hormones vs. Steroid hormones r/t Receptor sites | Pep & Pro:receptor sites on cell surface, S:penetrate cell and interact w/intracellular receptors
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| Time r/t Steroid hormone action | Hours
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| Common S/Sx r/t Endocrine imbalances | Changes in energy level, Fatigue, Tolerance to heat and cold, Recent changes in weight, Changes in sexual function, Secondary sex characteristics
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| 3 common diagnostic tests r/t Endocrine disorders | Blood, Urine, Stimulation & suppression tests
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| Stimulation tests vs. Suppression tests | Stimulation:determine gland response to stimulating hormones released by hypothalamus/pituitary gland, Suppression:determines if negative feedback mechanisms are intact
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| Secretes hormones that control secretion of hormones by other glands | Pituitary
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| Controls pituitary | Hypothalamus
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| Hormones secreted by posterior lobe of pituitary gland | Vasopressin (ADH), Oxytocin
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| S/Sx r/t Hypopituitarism | Extreme weight loss, Weight loss, Emaciation, Atrophy of all endocrine glands & organs, Hair loss, Impotence, Hypometabolism, Hypoglycemia
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| Acromegaly | Excess growth hormone in adults
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| Gigantism vs. Dwarfism r/t Children | G:oversecretion of growth hormone, D:insufficient secretion of growth hormone
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| Most common disorder r/t Posterior lobe dysfunction | Diabetes insipidus
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| 3 types of pituitary tumors | Eosinophilic, Basophilic, Chromophobic
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| Eosinophilic vs. Basophilic vs. Chromophobic r/t Pathology | E:Gigantism, B:Cushing's syndrome, C:Hypopituitarism
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| Hypophysectomy | Removal of pituitary gland
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| Manifestations r/t Diabetes insipidus | Polydipsia, Polyuria w/dilute urine, Inability to increase specific gravity/osmolality of urine
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| Manifestations r/t Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion | Retain fluids, Na deficiency
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| Dilutional hyponatremia | Na deficiency r/t SIADH
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| Essential for thyroid gland to synthesize its hormones | Iodine
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| Thyroid hormone production w/in normal limits | Euthyroid
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| Primary function r/t Thyroid hormones | Cellular metabolic activity
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| Calcitonin function | Reduce plasma level of Ca by increasing its deposition into bone
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| Pathology r/t Goiter | Iodine deficiency causes goiter, Goiter causes oversecretion of thyroid hormone
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| Abnormal finding r/t Enlarged thyroid gland | Bruit
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| Best screening test r/t Thyroid function | Serum TSH function
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| Hypothyroidism vs. Hyperthyoidism r/t Values | Hypo:value > 6.15, Hyper:value < 0.4
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| Current recommendations r/t TSH screening | All adults 35+ and every 5 years after
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| T3 vs. T4 r/t Normal ranges | T3:70 - 220, T4:4.5 - 11.5
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| Most common cause r/t Hypothyroidism | Hashimoto's disease (autoimmune thyroiditis)
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| Most severe stage r/t Hypothyroidism/Hashimoto's | Myxedema coma
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| S/Sx r/t Myxedema coma | Hypothermia, Unconscious, Depressed respiratory drive, Progressive CO2 retention
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| Analgesic, sedative, anesthetic effects r/t Hypothyroidism | Prolonged d/t altered metabolism and excretion
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| Heating pad & electric blanket usage r/t Myxedema coma | Do not use d/t risk for peripheral vasodilation
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| Most commmon type r/t Hyperthyroidism | Graves' disease
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| Most severe form of hyperthyroidism | Thyoid storm
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| S/Sx r/t Thyroid storm | High fever & Extreme tachycardia
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| Common precipating event r/t Thyroid storm | Stress such as injury, infection, DKA et cetera
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| Management r/t Thyroid storm | Hypothermia mattress, Humidified oxygen, IV fluids w/dextrose, Iodine administration
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| Cause r/t Acute thyroiditis | Infection of thyroid gland
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| Aspirin r/t Subacute thyroiditis | Avoided b/c it increases amount of circulating thyroid hormone
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| Synonym r/t Chronic thyroiditis | Hashimoto's disease
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| Chronic vs. Acute thyroiditis r/t Pain & thyroid activity | C:pain, pressure & fever are not normal, Thyroid activity is normal/low, A:pain, pressure & fever are normal, Thyroid activity is increased
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| Most common type of goiter | Simple/colloid d/t Iodine deficiency in diet
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| Parathormone (parathyroid hormone) regulates | Ca & phosphorus metabolism
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| Ca absorption r/t Increased parathormone | Increased parathormone = Increased Ca absorption = Increased serum calcium levels
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| Characteristics r/t hyperparathyroidism | Bone decalcification, Development of renal calculi
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| Secondary hyperparathyroidism occurs d/t | Chronic renal failure
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| Management r/t Hyperparathyroidism | Hydration, Mobility, Diet, Medication
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| Diet r/t Hyperparathyroidism management | Nutritional needs met but avoid diets that restrict/excess Ca
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| Treatment r/t Acute hypercalcemic crisis | Rehydration w/large volumes of IV fluid, Diuretics to excrete excess Ca, Phophate therapy to promote Ca deposition
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| Tetany | General muscle hypertonia
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| Assessment/diagnostic findings r/t Hypoparathyroidism | Positive Trousseau's & Chvostek's signs
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| Trousseau's sign vs. Chvostek's sign | T:carpopedal spasm caused by occluding blood flow to arm for 3 minutes, C:sharp tapping of facial nerve causes twitch of mouth, nose & eye
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| Restricted foods r/t Hypoparthyroidism diet | Milk products, egg yolk & spinach d/t high levels of phosphorus
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| Adrenal medulla vs. Adrenal cortex r/t Hormone secretion | M:middle of gland which secretes catecholamines(epinephrine/norepinephrine), C:outer portion which secretes steroid hormones
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| Effects r/t Catecholamines | Release free fatty acids, Increase basal metabolic rate, Elevate blood glucose levels
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| 3 types of hormones released by adrenal cortex | Glucocorticoids, Mineralocorticoids, Androgens
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| Increased glucocorticoids (hydrocortisone) r/t Blood glucose levels | Increased blood glucose levels
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| Mineralocorticoids mainly effect | Electrolyte metabolism
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| Mineralocorticoid pathology | Act on renal tubule & GI epithelium, Increase Na absorption, Excrete K
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| Mineralocorticoid excretion r/t Angiotensin II | Excreted as response to presence of Antiotensin II
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| Form of HTN cured by surgery | Pheochromocytoma
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| Pheochromocytoma r/t Adrenal medulla | Benign tumor found on medulla
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| Caused d/t inadequate adrenal cortex function | Addison's disease
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| Most common cause r/t Adrenocortical insufficiency | Corticosteroid therapy
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| S/Sx r/t Addison's disease | Cyanosis & Signs of circulatory shock
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| Provide information regarding fluid status | Orthostatic VS
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| Caused d/t excessive adrenocortical activity | Cushing's syndrome
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| S/Sx r/t Cushing's syndrome | Central obesity, Buffalo hump, Appearance of masculine traits
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| Serum Na vs. Serum K vs. Blood glucose r/t Cushing's vs. Addison's | C:increased Na and glucose w/decreased K, A:decreased Na and glucose w/increased K
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| Diet r/t Cushing's syndrome | Foods high in protein, Ca, Vitamin D
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| Manifestations r/t Aldosteronism | Hypokalemia, Alkalosis, Increased serum bicarbonate, Inability to concentrate urine, Blood serum abnormally concentrated
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| Most prominent sign r/t Aldosteronism | HTN
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