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57 Cards in this Set

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What is the primary role of the endocrine system?
To maintain homeostasis
What kinds of roles does the endocrine system play when adapting to our external environment?
It helps us to adapt to stress, trauma, and temperature changes.
What kinds of roles does the endocrine system play when adapting to our internal environment?
It helps us to adapt to shock, F&E imbalances, and osmolarity changes.
What is the Endocrine system composed of?
Glands: thyroid, pituitary, adrenal, and gonads.
_________ produced by the glands, are a primary source of communication.
Hormones
What are the four actions of Hormones?
1. Maintain internal environment homeostasis
2. Help regulate energy production and usage
3. Exert and effect on reproduction
4. Impact growth and development
Glands are ________ and therefore secrete hormones directly into the _____________ system.
ductless, circulatory
The Endocrine system works in conjunction with the _________ and _________ systems to maintain homeostasis.
Immune, neuro
What is the "core" of or the connection between the neuro and endocrine systems?
The Hypothalamic-pituitary complex
What is produced by both the neuro system and the endocrine system ?
Catecholamines: epinephrine and norepinephrine
What are modes of communication in the endocrine system?
Paracrine and Autocrine
Define paracrine and give an example of this type of communication.
Hormones have an effect on neighboring cells from where they were released (local effect). i.e. Beta cells in the pancreas release insulin which suppresses glucogon released from the neighboring alpha cells.
Define autocrine and give an example of this type of communication.
Hormones have an effect on the cell they are released from. i.e. growth hormone.
What are two types of hormonal regulation and give an example of each?
Negative feedback loop (RAAS system) and positive feedback loop (FSH & estrodiol)
After the hypothalamus gets information from the CNS it releases ___________ and ___________ factors which have an effect on the pituitary gland.
inhibiting, releasing
Hormones released by the hypothalamus which are released into the vascular system and travel to the _________ pituitary. A name for this is_________________.
anterior, adenohypophysis
Hormones released by the hypothalamus which travel via the neuro system travel to the __________ pituitary for storage. A name for this is ________________.
posterior, neurohypophysis
What three steroids are produced by the adrenal cortex?
Mineral corticoids, glucocorticoids, and sex hormones.
What do mineral corticoids do?
They have an effect on F & E balance, specifically aldosterone (controlled by the RAAS system and controls fluid volume)
What do glucocorticoids do?
Cortisol efects carb, protein & fat metabolism, stress reponse, anti-inflammatory effect, gastric acid secretion, growth hormone, etc.
What are two types sex hormones and what do they do?
Androgens & estrogen. They impact sexual maturation and secondary sex characteristics
What is the adrenal medulla primarily responsible for?
Secretion of catecholamines (epi & norepi) which play an important role in response to stress
What 3 hormones does the thyroid gland secrete?
T3, T4, and Calcitonin
The thyroid hormone (T3 & T4) have an effect on what tissues?
They effect all body tissues.
What is essential for thyroid hormone synthesis and where is it found?
Iodide which is found in salt and salty foods such as seafood.
What are the actions of the thyroid hormone?
Regulates O2 requirements and consumption, metabolism, protein synthesis, excess breakdown of protein, and temperature regulation.
What does calcitonin do?
It lowers serum Ca levels by inhibiting bone resorption(stimulus is hypercalcemia)
What does the parathyroid hormone (PTH) do?
regulates Ca and phosphate metabolism
PTH increases serum Ca levels by what 3 mechanisms?
1. Pulls Ca out of bone to increase serum level (resorption)
2. reabsorption in distal tubules (kidneys)
3. Activation of vit. D to increase Ca absorption from the GI tract.
What is the endocrine functions of the pancreas?
Alpha cells secrete glucagons, Beta cells secrete insulin, and the dela cells secrete somatastatin.
What is hypopituitarism?
A deficiency in one or more hormones from the anterior pituitary.
What is panhypopituitarism?
A deficiency in ALL hormones from the anterior pituitary.
What are the most critical hormones of the pituitary and why?
TSH, ACTH because they control growth and development and homeostasis
What can cause hypopituitarism?
Tumors compressing or destroying the gland, Malnutrition, Trauma (increases ICP), radiation therapy, pituitary infarction (as seen during post partum hemorrhage causing lack of perfusion to pituitary)
What are some of the initial symptoms of hypopituitarism?
visual problems (especially with tumors)& head aches. Will also depend on hormone involved, age and gender of pt.
What are some tests that should be done with hypopituitarism?
Test cranial nerves 3,4,6 (occulomotor, trochlear, abducens; eyes "range of motion"), serum hormone levels (changes in TSH or cortisol), stimulation tests to check pituitary reserve, CT, MRI, and skull series.
What are some s/sx of male gonadatropin deficiencies?
testicular failure, delayed onset of puberty, diminished or absence of speratogen, sterility, decreased libido, impotence, loss of body hair, etc.
What are some s/sx of female gonadatropin deficiencies?
Ovarian failure, loss of follicle stimulation, loss of ovulation, sterility, amenorrhea, breast atrophy, absence of axillary or pubic hair.
What are some interventions we can do for male gonadatropin deficiencies?
IM testosterone injections if epiphyses have closed. (titrate higher as needed)
What are some of the risks to testosterone injections?
Breast cancer (within first 3 months), premature closure of epiphyses, precocious sex development, wt. gain.
What are some interventions we can do for female gonadatropin deficiencies and what are the risks?
Estrogen & progesterone replacement. Risks: hypertention, DVT's, thrombophlebitis.
What are some s/sx of a deficiency of growth hormone?
In children: short stature, growth retardation, doesn't meet growth requirements and falls of growth chart.
In adults: none
What are some causes of growth hormone deficiency?
Problems with the synthesis or release of GH or if the body is unable to use GH can cause a deficiency.
What interventions are done for children with a GH deficiency?
Must be treated with exogenous growth hormones BEFORE epiphyses close. Meds given: Somatrim, Seatrain
What are some nursing considerations for GH deficiencies?
Monitor: bone growth (may grow up to 7" first yr.) , limping or bone pain, bone age, height.
What can cause hyperpituitarism?
A benign tumor, dysfunction of the hypothalamus or there may be a miscommunication.
An excess of Growth hormone (hyperpituitarism) can cause what type of s/sx?
gigantism-tall stature, proportional growth in long bones (before the epiphyses close), Acromegaly-thick skin, enlarged visceral organs, increase in nose & lip size, etc. (after epiphyses closes) Other s/sx: bone pain, lethargy, fatigue, arthalgias, back pain, joint pain, mal-fitting dentures, etc.
What are some interventions for hyperpituitarism?
Parlodel: reduces tumor size, but can cause hypotension
Hypophysectomy: removal of anterior pituitary to decrease hormone levels.
After a hypophysectomy, what would you tell your patient not to do?
Not to cough, sneeze, bare down post-op as to not risk leakage of CSF. Also no brushing teeth. Deep breathing ok.
What would you monitor after a hypophysectomy?
visual changes, altered LOC, strength of extremities, leakage of CSF, fluid balance, prevent constipation, bleeding
What can cause hyperpituitarism?
A benign tumor, dysfunction of the hypothalamus or there may be a miscommunication.
An excess of Growth hormone (hyperpituitarism) can cause what type of s/sx?
gigantism-tall stature, proportional growth in long bones (before the epiphyses close), Acromegaly-thick skin, enlarged visceral organs, increase in nose & lip size, etc. (after epiphyses closes) Other s/sx: bone pain, lethargy, fatigue, arthalgias, back pain, joint pain, mal-fitting dentures, etc.
What are some interventions for hyperpituitarism?
Parlodel: reduces tumor size, but can cause hypotension
Hypophysectomy: removal of anterior pituitary to decrease hormone levels.
After a hypophysectomy, what would you tell your patient not to do?
Not to cough, sneeze, bare down post-op as to not risk leakage of CSF. Also no brushing teeth. Deep breathing ok.
What would you monitor after a hypophysectomy?
visual changes, altered LOC, strength of extremities, leakage of CSF, fluid balance, prevent constipation, bleeding
What is diabetes insipidus?
A disorder of water metabolism in which there is excess water loss due to hypo secretion of ADH, damage to posterior pituitary or inability of kidney's to respond to ADH.
What are some s/sx of diabetes insipidus?
polyuria, polydypsia, dehydration, hyponaturemia, hypotention.