Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
What are the disorders of the pituitary gland
|
pituitary tumors, posterior pituitary disorder, Anterior pituitary disorders
|
|
|
pituitary tumors are
|
usually benign-primary or secondary
may secrete hormones, may be life threatening, diagnosed with CT or MRI and serum levels Hypophysectormy is the usual treatment. Necessary hormone replacemnt therapy. |
|
|
health problems from the posterior pituitary
|
Hypersecretion of ADH: Syndrome of inappropriate Antidiuretic Hormone (SIADH)
Hyposecretion of ADH: Diabetes insipidus (DI) |
|
|
SIADH is characterized by
|
excessive releae of ADH from the posterior pituitary gland.
Results in dilutional hyponatremia and rentention of water within the body |
|
|
Medical causes of SIADH-1
|
lung cancer, pancreatic cancer, prostate cancer, hodgkin's disese, brain tumors, brain infections, pulmonary disorders, viral pneumonia, thymomas, myxedema, psychosis-from meds, damage to hypothalamus
|
|
|
medical causes of SIADH 2
|
Anti-depressants, antidiabetic drugs, antineoplastic agents, analgesics, anti-epilectic drugs, diuretics, other-alpha interferon, ecstacy, lithium
|
|
|
other causes-siadh
|
gestational-caused by enzyme secreted from placenta that interferes with mother's ADH.
Idiopathic-unknow psychogenic-medication induced-schizophrenia, mania, neurosis |
|
|
criteria for SIADH
|
Low urine output in the absence of hypovolumia,
hyponatremia (serum sodium <135 mEq/L) Plasma osmoality <280 Urine osmolatity > 100 mOsmo high urine specific gravity .1.020 Nausea and vomiting Mental status changes |
|
|
Signs and symptoms -SIADH
|
weight gain, loss of appetite, nausea, vomiting headache, muscle weakness, muscle spasms or cramps, restlessness, fatigue, irrability, abnomrmal mental status-possible coma, hallucinations, decreased consciousness, confusion
|
|
|
treatment of siadh
|
increase urine output and decrease urine specific gravity; return sodium to normal levels
Restrict fluid intak usually 1/2 or 1 liter per day chemotherapy radiation or sugical removal of tumor, demeclocyclin, hypertonic saline furosemide, lasix |
|
|
nursing care-siadh
|
fluid restriction, intake and output, daily weight, call dr. if pt. gains 2 or more lbs. seizure precautions, admin meds
Neurological status-monitor for improvement or deterioration, pt. teaching-educate about fluid rest, can last from 3-10 days, teach family how to respond to seizures |
|
|
Diabetes insipidus-definition
|
a condition in which abnormally large amounts of dilute urine are excreted as a result of deficient production of vasopress (ADH)
|
|
|
Signs of DI
|
Excessive thirst, dilute urine
|
|
|
di causes
|
kidney unable to conserve water because of:
kidney/head trauma tumor aneurysm/stroke radiation/ablation to pt. tumor infections to CNS Meds. any that decrease ADH: dilantin, excessive alcohol, lithium |
|
|
Nephorgenic case
|
kidneys unable to respond to ADH
|
|
|
dipsogenic cause
|
defect in thirst mechanism
|
|
|
s/s of di
|
enormous urine output-very dilute, water like urine
Increased thisrt-craves cold water Dehydration fatigue, headach, muscle weakness, tachycardia, weight loss |
|
|
medical mngt of DI-most important
|
ensure adequate fluid replacement
|
|
|
di fluid dep test
|
withhold fluids for 8-12 hours
or until 3-5% of body weight is lost monitor for tachy, hypovolemia, weightloss |
|
|
di mm
|
weight frequently, measure plasma and urine osmolarlity and spec gravity
|
|
|
di-ddavp
|
demopression-synthetic vasopressin without the effect of natural adh,
admin nassaly causes vasoconstriciton therfor must be used cautionsly in pts. with CAD |
|
|
NURSING MNGTof DI
|
assess fluid balance, monitor 1's/0's, weight,
force fluids to equal output to prevent dehydration |
|
|
siadh-fact
|
sodium down, urine output down, weight up, urine appearance-concentrate
urine specific gravity up |
|
|
di-fact
|
sodium up, urine output up, weight down, urine appearance-dilute, urine spec. gravity down
|
