Endocrine Ch 42 #2

Front 1

Adrenocortical Insufficiency (Addison’s Disease)
def

Back 1

Addison's disease, or adrenocortical insufficiency, occurs when adrenal cortex function is inadequate to meet the patient's need for cortical hormones. May be auto imminue or idiopathic. Therapeutic use of corticosteroids is the most common cause of adrenocortical insufficiency

Front 2

Addison’s Disease
assessment and diagnostic findings

Back 2

early-morning serum cortisol(less than 165 nmol/L)
plasma ACTH(more than 22.0 pmol/L)

Front 3

Addison’s Disease
medical managent

Back 3

1. Immediate treatment is directed toward combating circulatory shock:
a.restoring blood circulation
b. administering fluids and corticosteroids
c. monitoring vital signs
d.placing the patient in a recumbent position with the legs elevated.

Front 4

Cushing’s Syndrome-
def

Back 4

Cushing's syndrome results from excessive, rather than deficient, adrenocortical activity. Cushing's syndrome is commonly caused by use of corticosteroid medications and is infrequently due to excessive corticosteroid production secondary to hyperplasia of the adrenal cortex.

Front 5

Cushing’s Syndrome-
clinical manifesations

Back 5

1. Arrest of growth
2. Obesity
3. musculoskeletal changes
4. Glucose intolerance
5. Fatty “buffalo hump.”
6. This extremities
7. Fragile skin
8. “moon faced”
9. Sexual side effects
10. Mental status changes
11. Cataracts/Glaucoma
12. Hypertension/Heart failure

Front 6

Cushing’s Syndrome-
diagnostic findings

Back 6

increase in serum sodium and blood glucose levels
decrease in serum potassium
a reduction in the number of blood eosinophils
disappearance of lymphoid tissue

Front 7

Cushing’s Syndrome-
diagnostic findings

Back 7

increase in serum sodium and blood glucose levels
decrease in serum potassium
a reduction in the number of blood eosinophils
disappearance of lymphoid tissue

Front 8

Primary Aldosteronism-
def

Back 8

Excessive production of aldosterone, which occurs in some patients with functioning tumors of the adrenal gland, causes a distinctive pattern of biochemical changes and a corresponding set of clinical manifestations that are diagnostic of this condition.

Front 9

Primary Aldosteronism
clinical manifestations

Back 9

clinical manifestations
1. profound decline in the serum levels of potassium
2. increase in pH and serum bicarbonate concentration
3. Hypertension

Front 10

Primary Aldosteronism
Nursing Management-

Back 10

Nursing management in the postoperative period includes frequent assessment of vital signs to detect early signs and symptoms of adrenal insufficiency and crisis or hemorrhage. Explaining all treatments and procedures, providing comfort measures, and providing rest periods can reduce the patient's stress and anxiety level.

Front 11

Therapeutic Uses of Corticosteroids-

Back 11

Corticosteroids are used extensively for adrenal insufficiency and are also widely used in suppressing inflammation and autoimmune reactions, controlling allergic reactions, and reducing the rejection process in transplantation

Front 12

Hypothalamus
Major Action

Back 12

Controls the release of pituitary hormones

Front 13

Adrenal medulla
major action

Back 13

Serve as neurotransmitters for the sympathetic nervous system

Front 14

Thyroid
major action

Back 14

Increase the metabolic rate; increase protein and bone turnover; increase responsiveness to catecholamines; necessary for fetal and infant growth and development

Front 15

Thyroid C cells
major action

Back 15

Lowers blood calcium and phosphate levels

Front 16

Parathyroid glands
major action

Back 16

Regulates serum calcium

Front 17

hormones of the anterior pituitary

Back 17

FSH
LH
prolactin
ACTH
TSH
growth hormone

Front 18

Diabetes Insipidus:
def

Back 18

Diabetes insipidus is a disorder of the posterior lobe of the pituitary gland that is characterized by a deficiency of ADH (vasopressin).

Front 19

Diabetes Insipidus:
clinical manifestations

Back 19

Clinical Manifestations
daily output of very dilute, waterlike urine with a specific gravity of 1.001 to 1.005 occurs.
Intense Thirst. Craves cold water.

Front 20

Diabetes Insipidus:
Medical Management:

Back 20

The objectives of therapy are (1) to replace ADH (which is usually a long-term therapeutic program)
(2) to ensure adequate fluid replacement
(3) to identify and correct the underlying intracranial pathology. Nephrogenic causes require different management approaches.

Front 21

Diabetes Insipidus:
Nursing Management

Back 21

1. Support pt and family and provide fu instructions
2. Medical ID bracelet.
3. Vasopressin must be administered with caution if the patient has coronary artery disease, because the medication causes vasoconstriction

Front 22

The syndrome of inappropriate antidiuretic hormone (SIADH)
def

Back 22

secretion includes excessive ADH secretion from the pituitary gland even in the face of subnormal serum osmolality.

Front 23

(SIADH)
clinical manifestations

Back 23

Patients with this disorder cannot excrete dilute urine. They retain fluids and develop a sodium deficiency known as dilutional hyponatremia.

Front 24

Calcitonin-
def

Back 24

It is secreted in response to high plasma levels of calcium, and it reduces the plasma level of calcium by increasing its deposition in bone.

Front 25

Serum Free T4-

Back 25

The test most commonly used to confirm an abnormal TSH result is free T4

Front 26

Serum T3 and T4-

Back 26

Measurement of total T3 or T4 includes protein-bound and free hormone levels that occur in response to TSH secretion.