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72 Cards in this Set
- Front
- Back
The endocrine system is composed of various tissues that produce and secrete chemicals called _______. The endocrine system and the ______ nervous system function together to regulate what 3 things?
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hormones
autonomic growth, reproduction, and metabolism |
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The endocrine system is less developed at birth than any other body system. Hormonal control of many body functions is lacking until what age? As a result, infants may manifest imbalances in concentration of fluids, electrolytes, glucose, and trace substances.
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12-18 months
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Phenylketonuria(PKU) is a genetic metabolic disorder resulting from ____ damage from toxic levels of amino acid? Is this disorder autosomal dominant, recessive, or x-linked?
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CNS
phenylalanine autosomal recessive |
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Infants should be tested for PKU as part of the newborn screening. Signs of PKU may not be present until the infant is about 3 months old. What is usually the first sign? What are some other signs.
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1st sign- digestive problems with vomiting
musty/mousy odor to urine eczema hypertonia hyperactive behavior Older children may have hypopigmentation of hair, skin, eyes- usually blonde with blue eyes. |
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How is PKU diagnosed?
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serum phenalanine greater than 20mg/dl
(need follow up testing to confirm) normal is about 2mg/dl |
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What is the therapeutic management of PKU?
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lifelong dietary modifications
Avoid high protein foods such as meats, fish, eggs, cheese, milk, legumes. Encourage low-protein breads, cereals, and pastas. Dietary staples are vegetables, fruits, and starches. |
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What is a long term consequence of untreated PKU?
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mental retardation
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What are glucocorticoids?
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steroid hormones-
cortisol and aldosterone |
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The group of inherited disorders of the adrenal glands is known as what?
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Congenital Adrenal Hyperplasia
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In Congenital Adrenal Hyperplasia, the adrenal glands produce too much/not enough glucocorticoids.
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not enough
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In Congenital Adrenal Hyperplasia, the adrenal glands don't produce adequate glucocorticoids (coritsol and aldosterone) which prompts increased production of what? This leads to the production of excess what? This overproduction causes the child to have too much ____ characteristics.
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ACTH
androgens male |
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Congenital Adrenal Hyperplasia effects boys, girls, or both?
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both
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What are some clinical manifestations of Congenital Adrenal Hyperplasia?
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newborn girl- ambiguous genitalia
newborn boy- enlarged genitalia boy may also me muscular, excess pubic hair, deep voice etc. low serum sodium high serum potassium hypovolemia |
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What are the 2 crises that a patient with Congenital Adrenal Hyperplasia may go through?
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salt wasting crisis
hypotensive crisis |
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True or False: Congenital Adrenal Hyperplasia can be mild to severe and these people may or may not be able to reproduce.
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true
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The goal in treating Congenital Adrenal Hyperplasia is to return hormone levels to normal (especially cortsol). What is the therapeutic management?
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Lifelong glucocorticoid therapy
-hydrocortisone acetate -cortisone acetate If salt wasting type--> -fludrocortisone (mineralocorticoid) |
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If a chld with Congenital Adrenal Hyperplasia is ill, has a broken bone, or is undergoing surgery, may need a ____ dose of additional gluococorticoids.
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stress
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____ surgery is often considered for treating Congenital Adrenal Hyperplasia,
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plastic
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True or False: Congenital Hypothyroidism is developed after birth.
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false. It is present at birth.
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Congenital Hypothyroidism is when the thyroid gland does not produce sufficient ____ ______. It can cause ___ ____ if not treated.
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thyroid hormone
mental retardation |
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Thyroid gland controls e____.
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energy
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In Congenital Hypothyroidism, either there is an absent or underdeveloped thyroid gland or there is a hypothalmic or hypopituitary disorder. This causes insufficient or an absence of ____
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thyroxine or T4
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thyroxine or T4 is essential for growth, development, and especially _____ development.
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brain
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Children with Congenital Hypothyroidism may be asymptomatic . What are some clinical manifestations of Congenital Hypothyroidism?
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lethargy
large fontanel large tongue skin mottling slow reflexes, hypotonia prolonged jaundice umbilical hernia distended abdomen cool skin feeding problems, constipation hoarse cry |
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The therapeutic management of Congenital Hypothyroidism includes lifelong thyroid hormone replacement, such as ______. Assessments of growth and development are important as well as teaching the family and patient about s/s of hypothyroid and hyperthyroid (from too much medication.
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levothyroxine
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Acquired hypothyroidism can be caused by or include Hashimoto's _______, surgical ______, radioactive _____ therapy for hyperthyroid, _____ therapy for malignancy, and excessive ____ ingestion.
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Acquired hypothyroidism includes Hashimoto's thyroiditis, surgical thyroidectomy, radioactive iodine therapy for hyperthyroid, radiation therapy for malignancy, and excessive iodine ingestion.
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Hashimoto's Thyroiditis is also known as what?
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chronic lymphocytic thyroiditis
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True or False: Hashimoto's Thyroiditis is the most common cause of acquired hypothyroidism, especially in children and adolescents.
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true
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Hashimoto's Thyroiditis is a ______ response and is usually associated with ______. It involves the destruction of the thyroid gland.
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autoimmune
goiter |
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Maternal intake of propylthiouracil (PTU) during pregnancy to control maternal ______ can cause transient ______ to the infant
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hyperthyroidism
hypothyroidism |
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What organ regulates the metabolic rate of the body?
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thyroid gland
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The therapeutic management for hypothyroidism involves _____ replacement therapy. ______ is the most common, and least expensive. When is it best taken? Patients and families need to be taught the s/s of both hyperthyroidism an hypothyroidism. Are the adverse affects from hypothyroidism acquired after 2 years of age permanent or reversible?
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thyroid
levothyroxine best in morning on an empty stomach reversible |
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Grave's disease is the most common cause of hyperthyroidism in children, which is an ______ condition in which excessive thyroid hormones are produced by an enlarged thyroid gland.
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autoimmune
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Neonatal Graves is associated with maternal HYPERthyroidism commonly or uncommonly?
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uncommonly
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The therapeutic management for hyperthyroidism involves antithyroid therapy and radioactive ____ for children of what age? What are some antithyroid medications
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radioactive iodine in an oral solution for children > 10 y
Antithyroid therapy: Propylthiouracil Methimazole |
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Sometimes a partial thyroidectomy is indicated for children with hyperthyroidism. What needs to be monitored in these children?
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calcium levels
(surgery presents a risk of injury to parathyroid glands resulting in hypocalcemia) |
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Tiredness/Fatigue is symptom of hyperthyroidism or hypothyroidism?
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hypo
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Nervousness and anxiety is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Prominent eyes (exophthalmos) is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Constipation is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Cold intolerance is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Heat intolerance is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Diarrhea is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Emotional liability is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Muscle hypertrophy is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Dry, thick skin is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Decreased growth is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Muscle weakness is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Accelerated linear growth is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Decreased activity & energy is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Smooth, velvety skin is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Edema of face, eyes, and hands is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Decreased heart rate is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Increased heart rate is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Weight gain is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Weight loss but increased appetite is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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Coarse, dull hair is a symptom of hyperthyroidism or hypothyroidism?
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hypo
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Fine hair is a symptom of hyperthyroidism or hypothyroidism?
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hyper
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True or False: Goiter is only present with hypothyroidism.
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False. Goiter is a symptom of both hyperthyroidism or hypothyroidism
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True or False: Autoimmune thyroiditis resulting in either hypothyroidism or hyperthyroidism is always permanent.
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False, it may be transient or permanent.
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Diabetes Insipidus is a _______ _____ dysfunction (hypofunction).
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posterior pituitary
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Diabetes Insipidus is the inability to _______ urine due to a _________ of what hormone? This causes increased ______.
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concentrate
deficiency ADH /vasopressin diuresis |
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What can Diabetes Insipidus result from? (5)
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ITCHI
Infection Tumors Cranial Surgery Head Trauma Idiopathic - no known cause |
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What are the clinical manifestations of Diabetes Insipidus?
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polyuria
polydipsia nocturia dehydratrion |
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Diabetes Insipidus presents with some similar symptoms to diabetes mellitus but there is no connection. How are the symptoms of Diabetes Insipidus different from diabetes mellitus?
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Diabetes Insipidus does not present with hypoglycemia, polyphagia, and urine is not sweet.
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How is diabetes insipidus diagnosed?
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symptom- polyuria
hypernatremia (>150 mEq/L) low urine specific gravity <1.005 water deprivation tests |
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What is involved in water deprivation tests?
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no water for 7-8 h
measure changes such as body wt., urine output, urine composition requires hospital setting, close monitoring |
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The key to diagnosing diabetes insipidus is frequent, _____ urine.
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dilute
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What is the therapeutic management of diabetes insipidus?
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maintain fluid balance
administer vasopressin Desmosspressin acetate (DDAVP) IV, SQ, intranasally Monitor sodium levels, watch for hyponatremic seizures. |
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Signs of need for the DDAVP
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increased thirst
polyuria dehydration |
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Signs of excessive DDAVP
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decreased urine output
headache water retention |
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Nursing considerations for the management of diabetes insipidus include educate the family about the disease process, teach about medication administration, teach about signs to watch for (i.e. dehydration) and one more thing....
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wear a medic alert bracelet.
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