BC3 - Endocrine
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| Anterior Pituitary Secretes | growth hormone, thyroid stimulating hormone, adenocorticotropic hormone, Prolactin, Gonadotropic hormones
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| Counter regulatory Hormone | Growth Hormone
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| Too Much GH causes | giantism
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| Too little GH | they need some additional hormones
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| Posterior Pituitary secretes | Vasopressin or ADH
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| ADH is | a potent vasoconstrictor
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| When ADH is released | water is retained
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| ADH is inhibited by | increase in fluid volume, hypothermia, B-adrenergic agonists and alcohol
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| Thyroid gland produces | Calcitonin to inhibit high circulating calcium (increases Ca storage in the bones)
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| What is the main purpose of the thyroid gland | to produce, store & release Thyroxine T4 and T3
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| Calcitonin | takes calcium out of the blood and puts it back into bone (BUILDS BONES UP)
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| The parathyroid gland secretes | Parathormone (PTH)
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| PTH | pulls calcium out of bone and into the blood (BREAKS BONE DOWN)
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| PTH and Calcitonin | are opposites of each other
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| PTH | acts on bone, kidneys & indirectly the GI tract; inhibits bone formation
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| High levels of Vitamin D | inhibit PTH
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| Low levels of Magnesiuim | stimulate PTH
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| Decreased calcium causes | tetany
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| Hyperparathyroidism occurs as we age which means | osteoporosis occurs
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| Cortisol | most potent and abundant glucocorticoid
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| Cortisol facilitates the | breakdown of glycogen (inc. blood glucose levels)
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| Cortisol also has what type of action | anti-inflammatory
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| Aldosterone acts on the renal tubule to | keep sodium and excrete potassium and hydrogen ions
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| What happens to the endocrine system as we age | increase in PTH leads to hypothyroidism
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| Tx of Hypothyroidism | synthroid
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| Exophthalmos | protrusion of the eyeballs from the orbits
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| Myxedema | puffiness, periorbital edema, masklike affect
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| Goiter | enlargement of the thyroid gland
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| Acromegaly | occurs in adulthood - growth hormone excess
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| Tx of acromegaly | Hypophysectomy is tx of choice; radiation tx is secondary tx method; drugs to reduce growth hormone levels
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| Specific post-op care of hypophysectomy | Instruct to avoid coughing,sneezing, or straining with BM; elevate HOB 30 degrees; perform mouth care; discourage toothbrushing for 10 days
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| Hypofunction of the pituitary results from | tumors, autoimmune disorders, infections, vascular disease or destruction of the gland (trauma , radiation, surgical procedures)
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| Symptoms of hypofunction of pituitary | failure to grow, infertility, or amenorrhea
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| SIADH | occurs from overproduction of ADH; occurs more frequently in the elderly (retain fluid)
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| S/S SIADH | fluid retention, hypoosmolality, dilutional hyponatremia, hypochloremia, concentrated urine, normal or inc intravascular volume, normal renal function (BLOOD WOULD BE DILUTED)
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| SIADH patient has | low urinary output, inc body weight w/o edema, lethargy, anorexia, confusion, HA, seizures, coma
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| TX of SIADH | RESTRICT FLUIDS, suck on ice chips/candy; diet supplements of Na & K, diureetics
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| Diabetes Insipidus is the opposite of | SIADH
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| Diabetes insipidus is the caus of | reduced ADH (causing inc urinary output)
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| S/S of Diabetes Insipidus | Polydipsia & Polyuria, low specific gravity, fatigue from nocturia
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| Hyperthyroidism is caused by | increased synthesis and release of thyroid hormone
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| Thyrotoxicosis refers to | physical effects of hypemetabolism r/t over secretion of T3 & T4; usually occur together in Graves Disease
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| Graves Disease | Autoimmune disease (body attacks self); diffuse thyroid enlargement & excessive secretion; They are thin (hyperthyroidism)
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| Tx of Exophthalmos"Bug Eyes" | apply artificial tears, restrict salt intake, elevate HOB, wear dark glasses, eyes may be lightly taped for sleep, exercise intraocular muscles
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| Hyperthyroidism | Increased metabolism, Everything racing: ^ HR, ^ GI, ^ nervous - jittery. They are thin
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| Thyrotoxic Crisis is also called | Thyroid Storm
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| Thyrotoxic Crisis is a life threatening condition caused by | stressors: surgery, infection, trauma
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| Tx of Thyroid Storm | must reduce circulating thyroid hormone; reduce fever, fluid replacement, and eliminate stressors
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| Dx of thyroid issues | Radioactive iodine uptake tests and blood tests for TSH, T3 & T4
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| Tx of hyperthyroidism is based on | age, severity, complicating features, patient preference
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| Tx of hyperthyroidism | Antithyroid medications, B-adrenergic receptor blockers, thyroid ablation, subtotal thyroidectomy
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| What drugs inhibit synthesis of thyroid hormones | PTU, Tapazole
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| What drugs are B-adrenergic blockers | inderol & atenolol
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| What does iodine do | quiets the thyroid gland down and treats crisis by inhibiting T3 & T4
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| Radioactive Iodine Therapy is done when | patient is beyond childbearing years
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| Acute intervention for hyperthyroidism | calm, quiet room; adequate rest, cool room, light bed covers, exercise large muscle groups to decrease tremors, restrict visitors
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| After thyroid surgery | prepare room wit O2, suction, trach tray; teach how to support head; assess for hemorrhage; semi-fowlers; check for signs of tetany
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| After thyroid surgery, patient should avoid foods high in | iodine
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| What foods are high in iodine | red food dye, iodate in flour, public drinking sources, kelp tablets (seaweed), milk treated with iodine
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| When patient's return home | they should reduce stress; follow-up is important; avoid high temperature; normal use od iodized salt is ok
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| Thyroid nodules | a palpable deformity of the thyroid gland; can be benign or malignant
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| If the radiology evaluation of a thyroid nodule s hot it is | benign
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| If the radiology evaluation of the thyroid nodule is cold it is | higher risk of cancer
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| Tx of thyroid nodule | surgical removal
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| Thyroiditis | inflammation by bacteria, virus or fungus
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| Hashimoto's thyroiditis | autoimmune disorder; most common type in US
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| Hyperparathyroidism | "brittle bones & kidney stones"
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| Hypothyroidism in infancy | cretinism- they have a thick protruding tongue, short - limited all their lives
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| Hypothyroidism in adults | Insidious - middle to old age - comes on slowly - they are cold
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| S/S of hypothyroidism | fatigue, lethargy, personality changes, impaired memory, slowed speech, decreased initiative, somnolence, cold, hair loss, dry skin, brittle nails, wt gain
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| Tx of hypothyroidism | take thyroid replacement like synthroid; must be taken throughout the rest of ones life
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| Hypoparathyroidism | rare - can happen if thyroid gland is removed
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| Tx of hypoparathyroidism | Administer IV Calcium slowly to avoid hypotension; tetany can occur because of dec Ca levels; patient needs instruction on long term drug therapy and nutrition
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| Long-term Tx of hypoparathyroidism | Vitamin D, supplement calcium, oral phosphate binders
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| Cushing's Syndrome is caused by | excessive corticosteroids
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| Clinical Manifestations of Cushing's | Weight gain, glucose intolerance, protein wasting, mood disturbances, Acne, HBP, Hirsuitism, Truncal obesity, Moon face, unxplained hypokalemia, Purplish striae
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| Diagnostic Findings of Cushing's | Granulocytosis, Lymphocytopenis, Eosinopenia, Hyperglycemia, Glycosuria, Hypercalciuria, Osteoporosis
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| Tx of Cushing's | Hypophysectomy (pituitary); Adrenalectomy (adrenal tumors); Drygs to suppress Cortisol
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| Nursing Mgmt of Cushing's | Monitor f/e
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| Pre-operative care of Cushing's | Hypokalemia is corrected with diet & K supplements, Manage ^BP
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| Post-operative care of Cushing's | Constant assessment for glucocorticoid imbalance; Maintain bedrest until BP stabilizes; Constant vigilance to prevent infection; Risk for hemorrhage; f/e; keep IV line in place
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| Addison's Syndrome | Hypofunction of Adrenal Cortex - DECREASED secretion; most common cause is autoimmune
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| S/S of Addison's | Weakness/fatigue, Wt. loss/anorexia, loss of hair; "tan", low BP, Low Na but high K; N/V/D
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| Subjective Assessment of Addison's | cramping/abd pain; exhaustion; profound weakness; lack of interest; inablility to tolerate stress
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| Complications of Addison's | Low BP, Shock, Circulatory Collapse, Dehydration, Low Na, High K, Hypoglycemia, Fever, Weakness, Confusion
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| Care of Addison's | Replacement of Glucocorticoids; IV hydrocortisone; Administer Na, fluids, and dextrose; may need reverse isolation
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| Teaching Plan for Addison's | Take Glucocorticoids 2/3 in am - 1/3 in afternoon; Carry emergency kit at all times
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| Complications of Corticosteroids | Hypertension, Slow healing, Inhibits antibody response to healing
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