• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/94

Click to flip

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;

94 Cards in this Set

  • Front
  • Back
All hormones of the Anterior Pituitary are stimulated by what area of the brain?
Stimulated by the hypothalamus


What are those hormones called?

GH- TSH- ACTH- Prolactin- FSH- LH

Define panhypopituitarianism:
Panhypopituitarism is a condition of inadequate or absent production of the anterior pituitary hormones. It is frequently the result of other problems that affect the pituitary gland and either reduce or destroy its function or interfere with hypothalamic secretion of the varying pituitary-releasing hormones.

In panhypopituitarianism what changes would you expect to see in hormones stimulated in the anterior pituitary?

All hormone levels are decreased

Which two hormones are secreted in the body by a simple feedback loop and are not affected by the anterior pituitary?

Parathyroid hormone & insulin

What are the effects of lack of estrogen on the female?

Osteoporosis* mood swings* hot flashes* vaginal dryness*bladder problems* loss of femininity
What is ADH?
Antidiuretic hormone

where is it made
Made in the hypothalamus

and where is it stored?
Stored in the posterior pituitary


When ADH increases you would expect the reabsorption of free water from the renal tubules to____?

Increase

What is another name for ADH?

Vasopressin
What is SIADH?

Syndrome of inappropriate ADH occurs when ADH is released in excess amounts

What are the signs & symptoms of Soggy Sid?

*Fluid retention (in vascular space 1 not tissues)
*Serum hypo-osmolality
*Dilutional Hyponatremia (decreased Na due to water intoxication)
*Hypochloremia
*Concentrated urine (decreased urinary output)

What are the labs that diagnose SIADH?
Decreased serum sodium *decreased serum osmolality* increased urine osmolality* *increased urine specific gravity


What information would tell you that the patient is improving?(SIADH)

Improvement – increased serum sodium* increased serum osmolality* decreased urine osmolality* decreased urine specific gravity*

What are the major nursing assessments?(SIADH)

Low urinary output
High specific gravity
Sudden weight gain
Serum sodium decline

What is the treatment ACUTE: SIADH?

For serum Na >125- restrict fluids to 800-1000 ml/day
For serum Na >120- give IV 3-5% saline & potassium supplements
When Na is at least 125- give diuretic

What is the treatment? CHRONIC SIADH?

Lithium
Declomycin
Lasix
Potassium supplement

What are the 2 causes of death?(SIADH)

Water intoxication
Hyponatremia

What are the 2 major nursing diagnoses?(SIADH)

*Altered urinary elimination *Fluid volume excess r/t excess ADH, AEB_________
What is DI? Diabetes Insipidus:



Occurs when ADH is deficient

What is the treatment?(DI)

Administer IV fluids/glucose
Replace vasopressin with DDAVP
What are the signs & symptoms? (DI)
Increased thirst* increased urination (5-20 L/day)* generalized weakness* poor sleeping
What are the labs? (DI)
Increased serum sodium* increased serum osmolality* decreased urine specific gravity* decreased urine osmolality*
What are T3 & T4 in the thyroid gland?

Thyroid hormones

What is the function of thyroid hormones?

Oxygen consumption
Metabolic rate
What is hyperthyroidism?

Condition marked by an excessive increase in thyroid hormones

What are the signs & symptoms the nurse should assess for?
It can affect many systems see individual systems below:

Cardiovascular S/Sx of hyperthyroidism:

*Tachycardia systolic hypertension *bounding/rapid pulse *murmurs/angina *arrhythmias/a fib *palpitations

Respiratory S/Sx of hyperthyroidism

*Increased respiratory rate *dyspnea on mild exertion

GI S/Sx of hyperthyroidism:

Increased appetite/thirst

*weight loss


Integumentary S/Sx of hyperthyroidism

*Warm/smooth/moist skin* thin/brittle nails*hair loss


Nervous S/Sx (hyperthyroidism):

Nervousness* tremor* lability of mood* exhaustion* depression* apathy* lack of concentration



Reproductive S/Sx of hyperthyroidism:



Menstrual irregularities *decreased libido *impotence & gynecomastia in males* decreased fertility
Other S/Sx hyperthyroidism:
Heat intolerance* lid lag *exopthalamus *goiter *rapid speech
Musculoskeletal S/Sx: of hyperthyroidism:
Fatigue* muscle weakness* osteoporosis*
What labs indicate a primary hyperthyroid problem?

*Increased T3 and T4 *free T4 and T3 uptake *decreased TSH

What labs indicate a secondary hyperthyroid problem?

Increased TSH

What are the 3 treatments for hyperthyroidism?

*Antithyroid drugs
PTU* Tapazole* Inderal* Tenormin* Iodine
*Ablation therapy
*Subtotal Thyroidectomy

What is a thyroid storm?

Condition in which all hyperthyroid manifestations are heightened

What are the signs & symptoms of a thyroid storm?

*Same as hyperthyroidism but much worse
*Fever (up to 105) *tachycardia/CHF *systolic hypertension *abdominal pain* N&V* tremors*seizures *coma

What is the treatment of a thyroid storm?

Radioactive iodine therapy using 131I
Subtotal Thyroidectomy

What 3 items should be available in an emergency for thyroid storm?

Trach kit* suction* IV calcium gluconate

Why should a patient never stop thyroid medications as ordered?

May lead to thyroid storm

What are nursing interventions for hyperthyroidism?

Elevate HOB- tape eyes shut at night- use eye drops- avoid caffeine- provide high calorie diet
What is hypothyroidism?

Condition in which there is insufficient thyroid hormone

What are the signs & symptoms of hypothyroidism?

*Lethargy *personality changes *impaired memory *cold intolerance *hair loss *dry/coarse skin *brittle nails *hoarseness *muscle weakness *constipation *weight gain *menorrhagia


What is the major problem seen in the elderly in treatment for hypothyroidism?

Cardiac dysfunctions

What is myxedema crisis and what are the signs & symptoms?

Severe long-standing hypothyroidism

Myxedema s/sx
– coma *respiratory failure *hypotension *Hyponatremia *hypothermia *hypoglycemia

Why should patients never stop medications for hypothyroidism when ordered?

May cause myxedema coma

What are nursing interventions for hypothyroidism?

Provide blankets *increase fluids *provide written handouts with instructions
What labs would you expect to see if primary hypothyroidism?
*Decreased T3 and T4 *T3 uptake *increased TSH *cholesterol *TRH
What is the treatment for hypothyroidism?
Synthetic oral thyroxineSynthroid/Levothyroid
What is PTH Parathyroid Hormone:
Parathyroid Hormone:


and what does it do in the body?

Hormone released from the parathyroid glands which regulates blood calcium levels

Where is PTH located? and how is it secreted?

Located in the parathyroid gland (behind thyroid)
Secreted in response to low calcium levels

What is a normal calcium level in the blood?

8.8-10 mg/dl
What are the causes of Primary
hyperparathyroidism?

Benign neoplasms (single adenoma)

What are the causes of Secondary
hyperparathyroidism?

Compensatory states due to hypocalcemia

What is the treatment?

*Relieve symptoms
*Treat complications
*Remove tumors surgically
*Increase fluids to 3000-4000 ml/day
*Hyperparathyroidism Drug Therapy *Mithracin (antihypercalcemic agent)
*Estrogen
*IV saline (severe cases – correct fluid volume deficit and promote calcium excretion)
What is the greatest complication when the parathyroids are removed in surgery?

Tetany

What are the signs & symptoms of tetany?

Tingling lips *fingertips *feet
Painful spasms of smooth and skeletal muscles
Laryngeal stridor
Dysphagia
Chvostek’s Sign
Trousseau’s Sign
Compromised respiratory function

What is the lifelong treatment for hypoparathyroidism when the parathyroids have been removed?

Hormone replacement
Vitamin D*calcium & phosphate supplements
What are the hormones of the adrenal cortex?

Glucocorticoids (cortisol)
Mineral corticoids (aldosterone)
Androgens (sex hormones)

What are their functions?

*Glucocorticoids – regulate metabolism *increase blood glucose levels & *physiological stress response
*Mineral corticoids – regulate Na & K+ & water balance
*Androgens – sexual activity in women contribute to growth & development

What are the hormones of the adrenal medulla?

Norepinephrine
Epinephrine

Another name for these adrenal hormones is …?

Catecholamines

What is the function of Catecholamines?

Aid the body in response to stress
What are the signs & symptoms of Cushing’s Syndrome?

Acne *moon face *plethora (red cheeks) *buffalo hump *body & facial hair *pendulous abdomen (centripetal obesity)*ecchymosis *thin extremities *slow wound healing *edema in extremities* HTN

What are the labs that indicate this disorder?

Plasma cortisol levels-increased
Plasma ACTH level-decreased
Sodium-increased
Potassium-decreased
Glucose-increased

What are the nursing diagnoses in this disorder?

*Altered body image
*Risk for injury r/t hyperglycemia and hypokalemia
*Risk for Infection

What are the treatments?

Surgical adrenalectomy (laparotomy – benign or open – malignant)
Drug Therapy:
Lysodren
Nizaral
Cytadren
What are the signs & symptoms of Addison’s Disease?

*Hypotension *hyponatremia *hyperkalemia *nausea/vomiting *diarrhea *dehydration

The lack of what major hormone is the leading cause of death?

Cortisol

What is the crisis associated with this disorder’s name?

Addison’s Crisis *Acute Adrenal Insufficiency *Adrenal Crisis

What are the symptoms of acute adrenal insufficiency?

Hypotension *tachycardia *dehydration *abdominal pain *hyponatremia *hyperkalemia *hypoglycemia *nausea/vomiting/diarrhea *weakness *confusion

What are the major nursing diagnoses for acute adrenal insufficiency?

*Activity intolerance *altered nutrition: less than body requirements *decreased cardiac output

What are the major treatments for acute adrenal insufficiency?

IV hydrocortisone
Fluid & electrolyte replacement

What are some patient teaching points for Addison’s Disease?

Avoid stress *be timely with doses *don’t abruptly stop medication *take medication with meals *know the signs & symptoms of adrenal crisis

Why are patients given IV hydrocortisone after bilateral adrenalectomy?

To prevent the cortisol levels from bottoming out and causing adrenal insufficiency
Why is it not advised to stop steroids abruptly?

Can lead to adrenal insufficiency and death

What are the nursing considerations for giving steroids? (time of day)

Glucocorticoids – 2/3 given in morning and 1/3 given in afternoon
Mineral corticoids – given once a day in the evening
What is pheochromocytoma?

Neoplasms that produce excessive urinary catecholamines

What are the signs & symptoms?

Severe episodic hypertension accompanied by severe pounding headache tachycardia & perfuse sweating

Why can it be so deadly if untreated?

Cardiac complications & stress (r/t epi & norepi production)
What is acromegaly?

Condition in adults caused by excesses of growth hormone

What are the signs & symptoms of excess growth hormone?

Feet & hand enlargement *deformities in spine & mandible *speech difficulty *hoarseness *abdominal distention *hypertension *cardiomegaly *diaphoresis *chest/joint pain *peripheral neuropathy *menstrual disturbances
Transsphenoidal hypophysectomy?:
is a commonly used surgical approach for pituitary region masses


What complications can occur after Transphenoidal Hypophysectomy:
surgery?

CSF leak *increased ICP *meningitis *diabetes insipidus

What are areas for patient teaching post-op?

*Avoid coughing *blowing nose *sneezing *or straining
*Instruct to use dental floss & rinses (no brushing for 10 days post-op)
*Avoid bending at waist

What are nursing interventions post-op?

*Monitor nasal drip pad for type & amount of drainage
*Monitor neurological status & fluid/electrolyte balance
*HOB elevated 30 degrees at all times
*Mild analgesia for headaches
What is Sheehan’s?

Condition following postpartum hemorrhage that causes failure to lactate & amenorrhea

Why is it a dangerous disorder?

May lead to panhypopituitarianism acute adrenal insufficiency & shock