Assessment Of The Endocrine System

Front 1

Hormones

Back 1

Natural chemicals that exert their effects on specific tissues known as target tissues.

Front 2

Endocrine glands include:

Back 2

-Hypothalamus (a neuroendocrine gland).

-Pituitary gland.

-Adrenal galnd.

-Thyroid gland.

-Isleta cells of the pancreas.

-parathyroid glands.

-Gonads.

Front 3

Disorders of the endocrine system usually are related to:

Back 3

-An excess of a specific hormone.

-A deficiency of a specific hormone.

-A receptor defect.

Front 4

Negative feedback

Back 4

Control of hormone synthesis.

Response is stimulated until the need (demand) is met, and the body condition returns to the normal range. As the correction occurs, hormone secretion decreases (and may halt).

Front 5

Hypothalamic-hypophysial portal system

Back 5

A small, closed circulatory system the hypothalamus shares with the anterior pituitary gland.

Allows hormones produced in the hypothalamus to travel directly to the anterior pituitary gland so that only very little is wasted in the systemic circulation.

Front 6

Function of the hypothalamus

Back 6

To produce regulatory hormones.

-Corticotropin-releasing hormone (CRH)

-Thyrotropin-releasing hormone (TRH)

-Gonadotropin hormone -releasing hormone (GHRH)

-Growth hormone-inhibiting hormone (somatostatin GHIH)

-Prolactin-inhibiting hormone (PIH)

-Melanocyte-inhibiting hormone (MIH)

Front 7

Pituitary gland

Back 7

Located at the base of the brain in a protective pocket of the splendid bone.

Divided into the anterior lobe (adenohypophysis) and the posterior lobe (neurohypophysis).

Front 8

Anterior pituitary

Back 8

Secretes some tropic hormones that stimulate other endocrine glands. Other pituitary hormones, such as prolactin, produce their effect directly on final target tissues "lock and key"

Front 9

Anterior pituitary principal hormones

Back 9

-Thyroid-stimulating hormone (TSH), also known as thyrotropin.

-Adrenocorticotropic hormone (ACTH, corticotropin).

-Luteinizing hormone (LH), aka Leydig cell-stimulating hormone (LCSH).

-Follicle-stimulating hormone (FSH).

-Prolactin (PRL).

-Growth hormone (GH).

-Melanocyte-stimulating hormone (MSH).

Front 10

Posterior pituitary

Back 10

Hormones:

Vasopressin (antidiuretic hormone {ADH}) and Oxytocin- are produced in the hypothalamus and delivered to the posterior pituitary where they are stored. These hormones release into the blood when needed.

Front 11

Factors that can affect the release of hormones from the pituitary gland.

Back 11

Drugs, diet, lifestyle, and pathologic conditions can increase or decrease pituitary hormone secretion.

Front 12

Gonads

Back 12

Male, testies, and female,ovaries, reproductive endocrine glands.

Function begins at puberty when, under the influence of gonadotropic hormones secreted by the anterior pituitary, maturation of the glands and external genitalia occurs.

Front 13

Gonad hormones

Back 13

Testies: Testosterone.

Ovaries: Estrogen, Progesterone.

Front 14

Adrenal glands

Back 14

Vascular, tent-shaped organs on top of each kidney that have an outer cortex and an inner medulla. Have effects throughout the body.

Front 15

Adrenal Cortex

Back 15

Makes up about 90% of the adrenal gland. Has cells divided into three layers. The main hormone types secreted by the Cortex are the mineralcorticoids and the glucocorticoids. Also secretes small amounts of sex hormones.

Front 16

Adrenal Cortex: mineralcorticoids

Back 16

Mineralcorticoids are produced and secreted to help control body fluids and electrolytes.

Aldosterone: maintains extracellular fluid volume. Regulated by the renin-angiotensin system, serum K+ concentration, and adrenocorticotropic hormone (ACTH)

Front 17

Adrenal cortex: glucocorticoids

Back 17

Essential for life.

Cortisol is the main glucocorticoid, affects:

-Body's response to stress.

-Carbohydrate, protein, and fat metabolism.

-Emotional stability.

-Immune function.

-Sodium and water balance.

Front 18

Glucocorticoid

Back 18

Releases peaks in the morning and reaches its lowest levels 12 hours after each peak. Emotional, chemical, or physical stress increases the release.

Front 19

Functions of Glucocorticoid hormones.

Back 19

-Prevent hypoglycemia by increasing liver gluconeogenesis and inhibiting peripheral glucose use.

-Maintain excitability and responsiveness of cardiac muscles.

-Increase lipolysis, releasing glycerol and free fatty acids.

-Increase protein catabolism.

-Degrade collagen and connective tissue.

-Increase the number of mature neutrophils released from bone marrow.

-Exert anti-inflammatory effects that decrease the migration of inflammatory cells to sites of injury.

-Maintain behavior and cognitive function.

Front 20

Adrenal cortex: sex hormones

Back 20

Androgens and estrogens. Secreted in low levels in both genders, usually not significant because the gonads secrete much larger amounts of estrogens and androgens. In women, the adrenal gland is the major source of androgens.

Front 21

What is the name of the substance secreted by the endocrine glands?

Back 21

Hormones

Front 22

Which mechanism is used to transport the substance produced by the endocrine glands to their target tissue?

Back 22

Bloodstream.

Front 23

Which hormones are secreted by the posterior pituitary gland?

Back 23

Vasopressin (antidiuretic hormone {ADH}).

Oxytocin.

Front 24

Which hormones are secreted by the thyroid gland?

Back 24

Calcitonin.

Triiodothyronine (T3).

Thyroxine (T4).

Front 25

A patient has a low serum cortisol level. Which hormone would the nurse expect to be secreted to correct this?

Back 25

Adrenocorticotropic hormone (ACTH, corticotropin)

Front 26

The target tissue for ADH is which organ?

Back 26

Kidneys.

Front 27

The binding of a hormone to a specific receptor site is an example of which endocrine process?

Back 27

"Lock and key" manner.

Front 28

What are tropic hormones?

Back 28

Hormones produced by the anterior pituitary gland that stimulate other endocrine glands.

Front 29

Which hormone is directly suppressed when circulating levels of cortisol are above normal?

Back 29

Corticotropin-releasing hormone (CRH), in the hypothalamus.

Front 30

The maintenance of internal body temperature at approximately 98.6°F is an example of which endocrine process?

Back 30

Neuroendocrine regulation.

Front 31

What is the main role of the anterior pituitary?

Back 31

To secrete tropic hormones.

Front 32

The posterior pituitary gland stores hormones produced by what?

Back 32

The hypothalamus.

Front 33

The anterior pituitary gland secrets what hormones?

Back 33

Thyroid stimulating hormone (TSH), aka thyrotropin.

Adrenocorticotropic hormone (ACTH, corticotropin).

Luteinizing hormone (LH), aka Leydig cell-stimulating hormone (LCSH).

Follicle stimulating hormone (FSH).

Prolactin (PRL).

Growth hormone (GH).

Melanocyte-stimulating hormone (MSH).

Front 34

The anterior pituitary gland secretes tropic hormones in response to which hormones from the hypothalamus?

Back 34

Releasing hormones.

Front 35

T/F

Follicle-stimulating hormone (FSH) stimulates sperm production in men.

Back 35

True.

Front 36

Which is the major function of the hormones produced by the adrenal cortex?

Back 36

Control of potassium, sodium, and water.

Front 37

Which hormone responds to a low serum calcium blood levels by increasing bone resorption?

Back 37

Parathyroid hormone (PTH).

Front 38

Which hormone responds to elevated serum calcium blood levels by decreasing bone resorption?

Back 38

Calcitonin.

Front 39

In addition to the pancreas that secretes insulin, which glance secretes hormones that affect protein, carbohydrates, and fat metabolism?

Back 39

Thyroid.

Front 40

The bloodstream delivers glucose to the cells for energy production. Which hormone controls the cells' use of glucose?

Back 40

Insulin.

Front 41

Which disease involves the Islets of Langerhans?

Back 41

Diabetes mellitus.

Front 42

Which endocrine tissues are most commonly found to have reduced function as a result of aging?

Back 42

Ovaries, testes, pancreas, thyroid gland.

Front 43

In the older adult female, which physiologic changes occur as a result of decreased function of the ovaries?

Back 43

Decreased bone density, decreased production of estrogen.

Front 44

An older adult reports a lack of energy and not being able to do the usual daily activities without several naps during the day. Which problem may these symptoms indicate that is often seen in the older adult?

Back 44

Hypothyroidism.

Front 45

The nurse is performing a physical assessment of a patient's endocrine system. Which gland can be palpated?

Back 45

Thyroid.

Front 46

What are the diagnostic methods to measure patient hormone levels?

Back 46

Stimulation testing, suppression testing, 24-hour urine testing, chromatographic assay.

Front 47

What instructions are included when teaching a patient about urine collection for endocrine studies?

Back 47

Empty the bladder completely, and then start timing.

Time the test for exactly the instructed number of hours.

Avoid taking any unnecessary drugs during endocrine testing.

Empty the bladder at the end of the time period and keep that specimen.

Front 48

What are the types of radiography tests that may be used for an endocrine assessment?

Back 48

Ultrasound.

Skull x-ray.

Magnetic resonance imaging (MRI).

Compound tomography (CT).

Front 49

A patient is suspected of having a pituitary tumor. Which radiography test aids in determining this diagnosis?

Back 49

MRI/CT.

Front 50

After an ultrasound of the thyroid gland, which diagnosis test determines the need for surgical intervention for thyroid nodules?

Back 50

Needle biopsy.

Front 51

A patient is at risk for falling related to the effect of pathologic fractures as a result of bone demineralization. Which endocrine problem is pertinent to?

Back 51

Overproduction of PTH.

Front 52

Hormones exert their effects on...

Back 52

Specific target tissues.

Front 53

More than one hormone can be stimulated before....

Back 53

The target tissue is affected.

Front 54

There are.... of each hormone

Back 54

Specific normal blood levels

Front 55

The adrenal cortex secretes aldosterone that maintains...

Back 55

Extracellular fluid volume.

Front 56

External genitalia maturation is stimulated by what?

Back 56

Gonadotropins during puberty.

Front 57

Sperm production in men is stimulated by what hormone?

Back 57

Follicle stimulating hormone (FSH)

Front 58

Which assessment findings does the nurse monitor in response to catecholamines released by the adrenal medulla?

Back 58

Increased heart rate related to vasoconstriction.

Increased blood pressure related to vasoconstriction.

Increased perspiration.

Increased blood glucose in response to glycogenolysis.

Front 59

Diabetic ketoacidosis (DKA) treatment.

Back 59

K+

Insulin

NG tube: if comatose.

Glucose: once serum levels drop.

Urea monitoring.

Fluids: crystalloids.

Creatinine monitoring and catheterize.

Hint 59

"KING UFC"

Front 60

Hypoglycemia causes and characteristics

Back 60

REnal failure.

EXogenous.

Pituitary.

Liver failure.

Alcohol.

Infection.

Neoplasm.

Hint 60

"RE-EXPLAIN"

Front 61

Addisonian crisis

Back 61

A life-threatening disorder caused by adrenal hormone insufficiency. Crisis is precipitated by infection, trauma, stress, or surgery. Death can occur from shock, vascular collapse, or hyperkalemia.

Hint 61

Definition

Front 62

Addison's disease

Back 62

Hyposecretion of adrenal cortex hormones (glucocorticoids and mineralocoticoids) from the adrenal gland, resulting in deficiency of the corticosteroid hormones. The condition is fatal if left untreated.

Hint 62

Definition.

Front 63

Adrenalectomy

Back 63

The surgical removal of an adrenal gland. Lifelong replacement of glucocorticoids and mineralocorticoids is necessary with bilateral adrenalectomy. Temporary replacement may be necessary for up to 2 years for a unilateral adrenalectomy.

Hint 63

Definition.

Front 64

Chvostek's sign

Back 64

A sign of hypocalcemia. A spasm of the facial muscles elicited by tapping the facial nerve just anterior to the ear.

Hint 64

Definition

Front 65

Cushings disease.

Back 65

A metabolic d/o characterized by abnormally increased secretions (endogenous) of cortisol, caused by increased amounts of adrenocorticotropic hormone (ACTH) secreted by the pituitary gland.

Hint 65

Definition

Front 66

Cushing's syndrome

Back 66

A metabolic d/o resulting from the chronic and excessive production of cortisol by the adrenal cortex or by the administration of glucocorticoids in large doses for several weeks or longer (exogenous or iatrogenic).

Front 67

Dawn phenomenon

Back 67

A nocturnal release of growth hormone, which may cause blood glucose levels elevations before breakfast in the client with diabetes mellitus. Treatment includes administration of an evening dose of intermediate-acting insulin at 10pm.

Front 68

Diabetes insipidus

Back 68

The hyposecretion of antidiuretic hormone from the posterior pituitary gland, resulting in failure of tubular reabsorbtion of water in the kidneys and diuresis.

Front 69

Diabetes mellitus

Back 69

A chronic d/o of glucose intolerance and impaired carbohydrate, protein, and lipid metabolism caused by a deficiency of insulin or resistance to the action of insulin. A deficiency of effective insulin results in hyperglycemia.

Front 70

Diabetic ketoacidosis (DKA)

Back 70

A life-threatening complication of diabetes millions that develops when a severe insulin deficiency occurs. Hyperglycemia progresses to ketoacidosis over a period of several hours to several days. Acidosis occurs in clients with type 1 diabetes, persons with undiagnosed diabetes, and persons who stop prescribed treatment for diabetes.

Front 71

Hyperglycemia

Back 71

Elevated blood glucose as a result of too little insulin or the inability of the body to use insulin properly.

Front 72

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS)

Back 72

Extreme hyperglycemia without acidosis. A complication of type 2 diabetes, which may result in dehydration or vascular collapse but does not include the acidosis component of DKA. Onset is usually slow, taking from hours to days.

Front 73

Hyperthyroidism

Back 73

A condition that occurs as a result of excessive thyroid hormone secretion.

Front 74

Hypoglycemia

Back 74

Low blood glucose levels that results from too much insulin, not enough food, or excess activity.

Front 75

Hypothyroidism

Back 75

A hypothyroid state resulting from a hyposecretion of thyroid hormone.

Front 76

Myxedema coma

Back 76

A rare bur serious d/o that results from persistently low thyroid production. Coma can be precipitated by acute illness, rapid withdrawal of thyroid medication, anesthesia and surgery, hypothermia, and the use of sedatives and opioid analgesics.

Front 77

Somogyi phenomenon

Back 77

A rebound phenomenon that occurs in clients with type 1 DM. Normal or elevated blood glucose levels are present at bedtime; hypoglycemia occurs at about 2-3 am. Counterregulatory hormones, produced to prevent further hypoglycemia, result in hyperglycemia (evident in the prebreakfast blood glucose level). Treatment to includes decreasing the evening dose of intermediate acting insulin or increasing the bedtime snack.

Front 78

Thyroidectomy

Back 78

Surgical removal of the thyroid gland to treat persistent hyperthyroidism or thyroid tumors.

Front 79

Thyroid storm

Back 79

An acute, potentially fatal exacerbation of hyperthyroidism that may result from manipulation of the thyroid gland during surgery, severe infection, or stress.

Front 80

Trousseau's sign

Back 80

A sign of hypocalcemia. Carpal spasm can be elicited by compressing the brachial artery with a BP cuff for 3 minutes.

Front 81

Adrenal cortex

Back 81

Outer shell of the adrenal gland.

Front 82

Adrenal medulla

Back 82

Inner core of the adrenal gland.

Works as part of of the SNS and produces epinephrine and norepinephrine.

Front 83

Thyroid gland

Back 83

Located in the anterior part of the neck.

Controls the rate of body metabolism and growth and produces thyroxine (T4), triipdothyronine (T3), and thyrocalcitonin.

Front 84

Stimulation testing.

Back 84

In the client with suspected underactivity of an endocrine gland, a stimulus may be provided to determine whether the gland is capable of normal hormone production. Measured amounts of selected hormones or substances are administered to stimulate the target gland to produce its hormone. Hormone levels produced by the target gland are measured. Failure of the hormone levels to increase with stimulation indicates hypofunction.

Front 85

Suppression testing

Back 85

Used when hormone levels are high or in the upper range of normal. Agents that normally induce a suppressed response are administered to determine whether normal negative feedback is intact. Failure of the hormone production to be suppressed indicates hyperfunction.

Front 86

Negative-feedback loop

Back 86

Regulates hormone secretion by the hypothalamus and pituitary gland. Increased amounts of target gland hormones in the bloodstream decrease secretion of the same hormone and other hormones that stimulate its release.