Endocrine System
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| The master gland of the endocrine system that controls the other glands in the body | Pituitary gland
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| What is another name for the anterior pituitary gland? | Adenohypophysis
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| What is another name for the posterior pituitary gland? | Neurohypophysis
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| What is responsible for growth, development, and metabolism - lies on either side of the trachea? | Thyroid gland
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| What is active in maintenance of calcium balance? | Parathyroid glands
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| What releases mineralocorticoids, glucocorticoids, and sex hormones? | Adrenal cortex
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| What is the most important glucocorticoid secreted which is responsible for glucose metabolism and providing extra energy during stress? | Cortisol
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| What does negative feedback mean? | An increase in the expected activity will lead to a decrease in the release of the hormone causing that effect
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| What plays an integral role in immune function and is located in the chest? | Thymus gland
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| What secretes melatonin and is located in the brain? | Pineal glands
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| What causes the kidneys to conserve water by decreasing the amount of urine produced? | Antidiuretic Hormone (ADH)
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| What does parathyroid hormone (PTH) serve as an antagonist to? | Calcitonin
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| What tends to increase calcium concentration in the blood and also regulates the amount of phosphorus in the blood? | PTH
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| What is the result of an overproduction of growth hormone after puberty that is a problem with the pituitary gland? | Acromegaly
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| What is the nursing care for acromegaly? | Keep patients safe, joints may become stiff and muscles become weak
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| What is an overproduction of growth hormone before the close of growth plates? | Gigantism
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| What is hypopituitary dwarfism caused by? | Growth hormone deficiency - can be genetic or related to pituitary
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| What is a disorder of the posterior pituitary in which ADH is deficient and results in electrolyte and fluid imbalances? | Diabetes Insipidus
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| What is diabetes insipidus characterized by? | Significant polyuria and intense polydipsia
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| What is the urinary output for a patient with diabetes insipidus? | Exceed 5-20 L per 24hrs
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| How does a patient with diabetes insipidus feel? | Weak, tired, and lethargic; specific gravity is altered and skin turgor is poor
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| What is patient care for a patient with diabetes insipidus? | Involves protecting the patient from injury
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| What is hyperthyroidism treated with? | Tapazole or propyithiouracil
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| What is the diet therapy for patient with hyperthyroidism? | Requires more calories due to increased metabolism, increased vitamin intake
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| What are the foods that aid in easing the burden of Graves' disease? | Lean meat, leafy greens, and supplemental vitamin D
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| What is the postoperative care for a patient with a thyroidectomy? | Maintain airway, monitor for Chvostek's sign and Trousseau's sign, and monitor for thyroid storm
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| What are possible complications of thyroidectomy? | Hemorrhage, tetany, and thyroid storm (crisis)
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| What can occur if the parathyroid is sometimes removed? | Hypocalcemia
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| What is the diet for hypocalcemia? | Canned fish with bones, tofu, cucumbers, and vitamin D
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| What are the NI for thyroidectomy? | Keep patient in semi-fowlers, have trach tray available, monitor for tetany (deficiency in calcium), maintain anatomic positioning of head, do voice check q 2 hours, hoarseness and a weak voice are normal, laryngeal stridor requires immediate attention
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| What is a rare but serious complication of a thyroidectomy due to manipulation of the thyroid? | Thyroid storm
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| What occurs during a thyroid storm? | Thyroid releases large amount of hormones & patient has all s/s of hyperthyroid such as N/V, tachycardia, increased BP, increased temp., restlessness, delirium, dysrhythmias (all v/s increase)
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| What can a thyroid storm lead to? | Congestive Heart failure
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| What is patients diet needs for simple goiter? | Adequate intake of iodine found in saltwater fish, milk, and eggs
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| What kind of therapy is used for thyroid cancer? | Radioactive iodine
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| What is important for a patient undergoing radioactive iodine therapy to remember? | Avoid pregnant people and sometimes children for several days after treatment
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| What is Chvostek's sign? | Abnormal reaction to the stimulation of the facial nerve (facial nerve is tapped at the angle of the jaw, facial muscles on the same side of face will contract; twitch of nose or lips)
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| What is Trousseau's sign? | Carpal spasms that occur when the upper arm is compressed, as by a tourniquet or a blood pressure cuff
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| What do the signs of hypocalcemia include? | Chvostek's & Trousseau's signs, carpopedal spasms
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| What is the treatment for hypocalcemia? | Calcium gluconate
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| What is a life threatening complication of hypothyroidism that involves multiple organ abnormalities? | Myexedema coma
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| What is the most important NI for Myexedema coma? | Maintain airway
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| What is dietary needs for patient with hypothyroidism? | High protein, low calorie meals
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| Why is it important for patient with hypothyroidism to follow up with physician? | Adjust medications as needed
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| What is the patient teaching for Cushing's Syndrome? | Eat foods high in potassium and low in sodium, gentle handling of skin and frequent observations for skin infection and breakdown
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| What are the three cardinal signs for DM? | Polydipsia, polyphagia, and polyuria
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| What are the NI and patient teaching aimed at for DM? | Diet & exercise education; medication dosage, type, & route; alternate injection sites to avoid lipodystrophy; notify HCP when glucose is over 250; glucose may be abnormal when ill; and certain meds (cortisone) may increase glucose levels
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| What does a glycosylated hemoglobin (HbA1c) do? | Gives an average glucose level over the last 120 days; is an indication if the patient is being compliant with glucose monitoring
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| What are the glucose levels for hyperglycemia? | Fasting blood glucose > 126
Random blood glucose > 200
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| What is treatment aimed at for hypoglycemia (aka insulin reaction)? | Replacing glucose in the body by oral intake (give 6 oz of orange juice), IV intake, and IM injection
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| What is it called when a patient blood glucose is > 400? | DKA - Diabetic Ketoacidosis
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| What is a diabetic diet? | Low concentrated sweets, moderate carbs, low fat, high protein, small meals with frequent snacks
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| When do you monitor glucose when starting a new exercise program? | Before, during, and after
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| What is the patient teaching for diabetic foot care? | Wear good shoes, don't go barefoot, don't soak feet for long periods, apply lotion but not between toes
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| What oral hypoglycemic agent cannot be given with insulin? | Byetta
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| What are the steps to preparing insulin? | Wash hands, assemble equipment, turn insulin vial in hands, clean rubber stopper w/alcohol, insert air into vial, withdrawal insulin, inspect for air bubbles, have another nurse verify amount
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| This insulin has a short onset and peak of action | Rapid- or short acting
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| What is a mixed insulin? | Combination of short-acting and long acting insulin
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| What insulin has an onset of about 30 minutes and 6-12 hour effect? | Intermediate insulin
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| What insulin has a long duration? | Long-acting
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| What are the steps to combining insulin's? | Withdrawal regular insulin first, then withdrawal longer-acting insulin
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| What are the steps to insulin injection? | Don gloves, clean injection site, quickly insert needle in subcutaneous tissue, inject insulin slowly, dispose of syringe appropriately
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| What are short term DM complications? | Hypoglycemia, HHNC, and DKA
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| What are long term DM complications? | Blindness, kidney disease and/or renal failure, heart disease, and poor circulation
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| What are the side effects of Tapazole? | Rash, pruritus, nausea, vomiting, loss of taste, paresthesia, and abdominal pain
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| What is Tapazole used to treat? | Hyperthyroidism
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| What is the actions of Byetta? | Insulin enhancing: gut hormone that promotes insulin secretions during meal, suppresses glucagon release, and delays gastric emptying which reduces blood sugar levels
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| What is the action of Sulfonylureas? | Stimulate beta cells of pancreas to release insulin
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| What are some examples of sulfonylureas? | Glyburide and Glimepiride
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| What is the action of Biguanides? | Reduces hepatic glucose production and lowers fasting blood glucose levels. Also, enhances tissue response to insulin and improves glucose transport into cells
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| What is an example of a biguanide? | Metformin
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| What type of insulin is Humulin NPH? | Intermediate
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| What are the onset, peak, and duration times for Humulin NPH? | O: 1.5-4 hours
P: 4-12 hours
D: 12-18 hours
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| What is the time frame that a patient would get hypoglycemic while taking Humulin NPH? | 4-12 hours
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| What type of insulin are Lantus and Levamir? | Long Acting
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| What are the onset, peak, and duration times for Lantus and Levamir? | O: 0.8-4 hours
P: no peak time
D: 24 + hours
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| What is the first step of negative feedback system for glucose control? | Low levels of blood glucose stimulate the secretion of glucagon
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| What is the second step of negative feedback system for glucose control? | Increased glucagon causes stored glycogen in liver to be converted into glucose for release into blood stream
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| What is the third step of negative feedback system for glucose control? | As blood sugar levels rise the glucagon stops; but the high blood glucose levels result in the release of insulin
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| What is the fourth step of negative feedback system for glucose control? | Increased insulin levels cause the intake of glucose into muscle cells and convert excess glucose into glycogen for storage in the liver
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| What is the fifth step of negative feedback system for glucose control? | When blood glucose levels drop, the cycle starts again
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