Nursing Concepts 5

Front 1

Pheochromocytoma

Back 1

genetic neuroendocrine disorder, caused by tumor in the adrenal medulla.

Front 2

What are the 2 catecholamine hormones that are secreted as the tumor grows?

Back 2

epinephrine and norepinephrine

Front 3

Hypersecretion of epinephrine and norepinephrine can be either ____ or _____.

Back 3

paroxysmal or persistent in nature.

Front 4

Pheochromocytoma has five primary symptoms all are related to overactivity of the sympathetic nervous system:

Back 4

*HTN, sometimes orthostatic in nature.
*HA, often pounding.
*Hyperhidrosis, excessive sweating.
*Hypermetabolism, or increased BMR with weight loss.
*Hyperglycemia

Front 5

Pheochromocytoma is diagnosed by way of symptoms and what else:

Back 5

Tests called serum catecholamine arrays, which detect high levels of epinephrine and norepinephrine.
24 hour urine, reveal increased urinary excretion of catecholamine metabolites such as vanillymandelic acid, or VMA
CAT scans, MRI, and angiograms: determine the presence of a tumor that may be responsible for adrenal hypersecretion

Front 6

What can increase catecholamine levels?

Back 6

Physical, mental or emotional stress of any kind.

Front 7

What can you do for a pt that is about to receive a test to check for Pheochromocytoma?

Back 7

Provide a quiet environment, place them on bedrest prior to blood and urine analysis, and encourage to deep breathe or do visualization exercises.

Front 8

If a patient has been taking any meds that can either increase or decrease catecholamine levels, what should they do?

Back 8

Stop them before testing.

Front 9

What meds interfere with testing catecholamine levels?

Back 9

ASA, or any OTC cough medication containing stimulants like ephedrine.

Front 10

What foods should be stopped prior to testing for catecholamine levels?

Back 10

bananas, caffeinated drinks, and chocolate, vanilla, alcohol and citrus fruit.

Front 11

What is the primary surgical treatment for pheochromocytoma?

Back 11

Adrenalectomy

Front 12

A condition caused by the presence of high levels of corticosteroids, especially glucocorticoids?

Back 12

Cushing's syndrome

Front 13

Symptoms of Cushing's?

Back 13

Weight gain, in face, back and trunk...truncal obesity.
Buffalo hump.
Thin arms and legs.
Moonlike rounding of facial features.
Pendulous abdomen.
Muscle Weakness.
Hypertension.
Thin skin that bruises easily and exhibits ecchymoses or areas of SQ hemorrhage.
Purple Striae, stretch marks on breast and/or abdomen.
Hirsutism, excessive facial hair in women.
Gynecomastia, breast enlargement in men.
sleep disturbances.
Menstrual disturbances.
Osteoporosis.
Frequent infections.
Polydipsia, polyuria and polyphagia.
Cataracts.
Acne.
Depressions and possible psychosis: related to changing body image.

Front 14

In Cushing's, what lab values are elevated?

Back 14

17-hydroxycorticosteroids, 17-ketosteroids in urine, blood glucose, plasma cortisol levels.

Front 15

In Cushing's what lab values will be decreased?

Back 15

potassium.

Front 16

Addison's Disease is caused by ____.

Back 16

insufficient production of corticosteroids by the adrenal cortex.

Front 17

Common causes of Addison's are _____.

Back 17

autoimmune destruction of the adrenal glands, and infectious processes such as TB, this disease can also be related to bilateral adrenalectomy.

Front 18

Symptoms of Addison's Disease:

Back 18

Fatigue, Weakness, Dizziness with postural hypotension, Weight loss secondary to anorexia, N/V, Abdomen pain, Skin pigmentation that becomes bronze or dark in color.

Front 19

Symptoms of acute Addisonian crisis are:

Back 19

Severe dehydration, severe hypotension, tachycardia with weak pulse,Rapid respirations, cardiac dysrhythmias, and circulatory collapse if the above syptoms are untreated.

Front 20

When the sodium and potassium levels, on a pt with Addison's, become imbalanced, often as a result of emotional or physiological stress, an event called ____ or _____ can occur.

Back 20

Adrenal or Addisonian crisis

Front 21

Labs of a patient with Addisons reveal:

Back 21

hyponatremia, hyperkalemia, hypoglycemia, WBC may be elevated in relations to an infection, 24 hour urine indicate increased plasma ACTH, decreased serum cortisol, and decreased levels of 17-ketosteroids and 17-hydroxycorticosteroids.

Front 22

Treatment and Nursing considerations for Addison's:

Back 22

high protein diet, high carb diet, increase sodium if sodium is low.

Front 23

DC planning for an Addison's patient includes:

Back 23

Information about stress management, increase fluids and sodium during times of GI upset accompanied by N/V, hot and humid weather and strenuous exercise.

Front 24

What are the 3 chronic conditions of hypersecreting pituitary?

Back 24

Acromegaly, Cushing's Syndrome, and Syndrome of inappropriate antidiuretic hormone secretion (SIAHD)

Front 25

Chronic endocrine disorder caused by overproduction of growth hormone, usually because of a benign adenoma or tumor in the anterior pituitary gland.

Back 25

Acromegaly

Front 26

Primary Characteristics of acromegaly are:

Back 26

Enlarged hands, feet and bones.
Deepening of the voice.
Separation of teeth.
Muscle pain and weakness.
Perspiration.
Hirsutism in women.
Decreased libido, impotence in men.
Somnolence: prolonged state of drowsiness.
HA and vision loss r/t the pressure of the tumor on the optic nerve.
Possible development of diabetes.
Enlarged and thickened facial features, especially the nose, jaw, lips, and tongue.

Front 27

Diagnosis of Acromegaly can be made by the physical symptoms and by:

Back 27

serum growth hormone is elevated, ACTH levels are elevated, Serum glucose and lipid levels may be elevated. Radiographic studies of people with acromegaly can reveal structural changes in the long bones as well as the location of the causative tumor.

Front 28

An evaluation of a patient's life stresses might include ___?

Back 28

Social Readjustment Rating Scale.

Front 29

Which of the following is considered an extrinsic health-infuencing factor?
Personality characteristics
Genetic predispostion
Gender
Culture

Back 29

Culture

Front 30

Which of the following is a true statement?
Antisocial behaviors are more common in women than in men.
Men are more prone to gallbladder disease than women.
Women are more prone to thyroid disease than are men.
Type I diabetes only occurs prior to age thirty.

Back 30

Women are more prone to thyroid disease than are men.

Front 31

The sequential acquisition of physical, mental, and social skills is called?

Back 31

the developmental process.

Front 32

Which of the following variables would be important to explore with a patient on MAOI's?
Exercise.
Diet.
Exposure to toxins in the environment.
Sleep patterns

Back 32

Diet

Front 33

Which of the following patients might benefit the most from a highly structured environment with familiar objects?

Back 33

A. a middle-aged adult with severe depression.
*B.an older adult with dementia of the Alzheimer's type.
C. A child with autism.
D. A teenager with anorexia and a history of abuse.

Front 34

What level of need would a highly structured environment best meet?

Back 34

Safety and security.

Front 35

Which of the following variables would be most likely to influence a patient's choice of medical treatments to prolong his life?

Back 35

A. dietary preferences and habits.
B. Genetic predispostion
*C. Culture and religion
D. environment

Front 36

An example of a situational variable that can influence a person's response to stress is

Back 36

occupation

Front 37

What organization publishes the DSM-IV?

Back 37

American Psychiatric Association (APA)