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56 Cards in this Set
- Front
- Back
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The kidneys secrete what hormone?
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erythropoietin
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______ glands secrete their substances into ducts then into the body cavity
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exocrine
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_______ glands do not have ducts and they secrete directly into the blood stream
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endocrine
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What gland is referred to as the "master gland"?
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pituitary gland
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What do all hormones have in common?
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they influence cellular activity of specific target tissues
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If a patient has a high sodium the normal hormone response would be
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release of ADH
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All cells in the body are believed to have intracellular receptors for
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thyroid hormone
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What should you ask about when assessing the endocrine system?
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energy level
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How do you assess the thyroid?
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have the pt swallow water during inspection and palpatation of the gland
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Why do older adults with endocrine disorders go unrecognized?
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symptoms are often attributed to aging
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The endocrine system is responsible for?
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maintaining BP,responds to stress, for growth and developement,reproduction, energy metabolism, ionic metabolism
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What is the only glandyou can palpate?
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thyroid
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Throid storm can cause problems with the heart such as?
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murmurs
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What is a normal assessment of the thyroid?
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3-4cm, firm but pliable, non tender, moves when swallowing
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What hormones does the anterior pituitary gland secrete?
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TSH, ACTH, GH, FSH
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What stimulates the thyroid hormone and also known as thyrotropin?
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TSH(thyroid stimulating hormone)
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What stimulates the adrenal cortex to produce cortisone?
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ACTH(adrenal corticotropin hormone or adrenocorticotropic hormone)
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What hormone controls the bodys growth and metabolism?
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GH(growth hormone)
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Growth hormone(somatropin) actions include?
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stimulates metabolism, growth, bone and cartilage growth
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Gigantism is seen in _________ and effects ______
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children. heart, catliage and connective tissue
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hypersecretion of GH in adults is called
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acromegaly
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What is panhypopituitarism(Simmonds disease)?
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total absence of anterior pituitary secretions
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what is the name for hyposecretion of anterior pituitary in children?
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dwarfism
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what is Sheehan syndrome?
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postpartum pituitary necrosis-caused by hemorrhaging during delivery
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What are the first signs of hypopituitarism?
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very vague, weakness, HA, sex dysfunc, dry sallow skin, no tolerance of stress(ALL PRETTY VAGUE)
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What are the diagnostic studies for acromegaly and giantism?
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plasma GH, somatropin C(insulin like growth factor), IGF-1, IGF binding protein
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Cusing syndrome is a problem with what?
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ACTH
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hypophysectomy is the removal of what?
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tumor that causes excess growth hormone
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What are the problems when treating hyposecretions of growth hormone?
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expensive, fluid retention, replacement for rest of life
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what is the name for hypersecretion of ACTH?
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cushing disease
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what is hyposecretion of ACTH?
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Addisons
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what is the most common cause of cushing syndrome?
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excess corticotropin
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Complications of Cushings include?
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ostreoporosis and spontaneous fx(ca++), peptic ulcer, lipidosis, hyperglycemia, water and NA retention
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what is lipidosis?
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buffalo hump
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What are s/s of cushings?
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buffalo hump, thin extremities, muscle wasting, thin fagile skin, moon face, hirsutism, truncal obesity, purple striae, mood swings
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what is hirsutism?
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excessive hair growth in women
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what labs to do plan to see altered in cushings?
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high cortisol, NA, corticotropin, glucose and low potassium, **dexamethasone suppression test**
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What should you teach your patients when taking glucocorticoids?
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NEVER stop abruptly-can go into adrenal crisis
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If your pt is having surgery to treat cushing what should you try to control before surgery
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HTN and hyperglcemia
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What does the posterior pituitary secrete?
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oxytocin & ADH(vasopressin)
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what is the purpose of oxytocin?
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increases labor, stimulates breast milk
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What is the action of ADH(vasopressin)?
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increases water reabsorption(inhibits diuresis) by retention of water and sodium, causes vasoconstriction of arterioles
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when does ADH release increase?
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increase in osmo, high NA, hyovolemia, low BP, pain, trauma,stress, nausea
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ADH causes ______osmolarity and ______ urine ouput
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increased, decreased
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SIADH s/s include:
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thirst, DOE, fatigue, cramps, weaknesss, seizures, urine ouput low, increase in weight, edema, cerebral edema(LOC)
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diagnostic studies of SIADH show?
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sodium less than 135, urine specific gravity>1.025, BUN low, creat low, H&H low
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what is the treatment for SIADH?
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restrict fluids(800-100ml), hypertonic solution(3-5%), lasix, BUTORPHANOL(stadol),demeclocycline(declomycin)
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what diet should you instruct a patient with SIADH?
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supplement sodium and potassium
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This disorder is caused by deficiency of ADH/vasopresin and signs are excessive urination and thirst?
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Diabetes Insipidus(DI)
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S/S of diabetes insipidus?
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abrupt polyuria, 4-6L of diluted urine(30L), fatigue, weight loss, dizziness, weakness, constipation, increased Na &H2O
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Who is at risk for untreated DI?
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elderly,or ppl with impaired sense of thirst
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if DI is untreated it can lead to:
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hypovolemia, hyperosmolality, circulatory collapse, LOC,
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What are the test for DI?
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low urine omo(50-200), specific gravity<1.005, decreased NA, dehydration/water deprivation test, sodium>147, serum osmo>300
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What does the water deprivation test consist of?
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being NPO for 6 hours-hourls osmo and specific gravity and weigh. DC test if weight drops more than 2kg
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what is the treatment for DI?
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hydrate, saline and glucose(D5NS), electrolye replacement, ADH replacement
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In acute DI you should administer fluids slowly to decreased sodium ____
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1mEq/L every 2 hrs
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