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adrenal glands Flashcards

1
Q

what NS is the adrenal medulla a part of

A

autonomic NS

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2
Q

what…
-secretes catecholamines
-regulates metabolic pathways
-fight/flight

A

adrenal medulla

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3
Q

what is a tumor of the adrenal medulla called (usually benign)

A

pheochromocytoma

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4
Q

what are risk factors that can cause pheochromocytoma

A

anything that stimulates a paroxysm of catecholamine release

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5
Q

pheochromocytomas without early intervention can lead to….

A

cerebral hemorrhage and cardiac failure

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6
Q

s/sx of pheochromocytoma

A

*** HTN with pounding headaches
-hyperthyroidism
n/v from inc. pressure

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7
Q

5 H signs of pheochromocytoma

A

-HTN
-headache
-hyperhidrosis
-hypermetabolism
-hyperglycemia

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8
Q

what tests are done for pheochromocytoma

A

-urine and plasma levels of catecholamines
-vanillymandelic acid (VMA) urine test
-clonidine suppression test
-imaging studies (CT, MRI, US)

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9
Q

medical management of pheochromocytoma

A

pharmacologic therapy
pre-op meds
-surgical management (adrenalectomy, corticosteroid replacement)

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10
Q

what are the pre-op meds for pheochromocytoma

A

-low dose alpha adrenergic blockers
-doxazosin
-may try calcium channel blockers
-nifedipine
-beta blockers
-metyrosine

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11
Q

nursing management of pheochromocytoma

A

pre-op assessment (neuro/ control HTN)
post-op care (adequate perfusion, nutritional needs, comfort measures, prevent shock)

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12
Q

what’s secretions help the body adapt to stress?

A

adrenal cortex

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13
Q

what hormones are secreted by the adrenal cortex?

A

-glucocorticoids
-mineralocorticoids
-adrenal sex hormones
(sugar salt and sex)

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14
Q

what are the 2 disorders of the adrenal cortex?

A

addisons and cushings

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15
Q

what disorder is hypofunction of the adrenal cortex and deficiency of the hormones inside?

A

addison’s

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16
Q

what disorder is hyperfunction of the adrenal cortex and excess hormones inside?

A

cushing’s

17
Q

is addison’s autoimmune?

A

yes

18
Q

how to help addison’s

A

adrenalectomy

19
Q

what are risk factors of addison’s

A

-history of endocrine probs
-sudden stopping of glucocorticoids
-taking glucocorticoids
-adrenalectomy
-tuberculosis

20
Q

what are s/sx of addison’s

A

-slow insidious onset
-fatigue
-irritability
-weight loss
-bronze skin
-n/v
-hypotension (postural)
-changes in distribution of body hair

21
Q

what are symptoms of adrenal crisis

A

-profound fatigue
-dehydration
-vascular collapse
-renal shutdown
-low sodium high potassium

22
Q

how to diagnose addison’s

A

-blood/urine hormonal assay (cortisol/ACTH)
-serum electrolytes
-blood sugar
-CBC
-CT/MRI

23
Q

medical management of addison’s

A

-combat shock
-restore circulation
-administer fluids and corticosteroids
-monitor VS
-trendelenburg (lower BP, blood to heart)

24
Q

nursing management of addison’s

A

-assess patient
-monitor for addisonian crisis
-restore fluid balance
-improve activity

25
Q

characteristics of addisonian crisis

A

back, abd, leg pain
depressed/status change
hypotension/low volume
loss of consciousness
shock
hypoglycemia

26
Q

treatment of addisonian crisis

A

correct fluid/electrolytes
correct hypoglycemia
replace steroids

27
Q

what is the most common cause of cushing syndrome

A

long term use of corticosteroids

28
Q

what does the overactivity of the adrenal cortex cause

A

cushing’s

29
Q

what is a tumor of the pituitary that produces too much ACTH cause?

A

cushing’s

30
Q

s/sx of cushing’s

A

-personality change
-moon face
-male: gynecomastia
-fat deposits
-thin/purple/bruised skin
-thin extremities
-GI distress -> inc. acid
-Na and fluid retention (edema)
-hyperglycemia

31
Q

what is the diagnosis of cushing’s

A

-labs
-xray, CT, MRI
-arteriography
-overnight dexamethasone suppression test!

32
Q

what labs help find cushing’s

A

-palsma cortisol
-glucose and serum sodium
-inc. WBC, but dec. eosinophil and lymphocyte
-urinary free cortisol
-low dose dexamethasone suppression test

33
Q

what is the surgical managemnt of cushing’s if its caused by a benign tumor / adrenal carcinoma

A

adrenalectomy

34
Q

what is the surgical management of cushing’s if its caused by pituitary tumor or unidentified lesion

A

transphenoidal hypophysectomy (replace cortisol and TH)

35
Q

drug therapy for cushing’s

A

adrenal enzyme inhibitor (ketoconazole)
ACTH-reproducing agents (cyproheptadine or somatostatin)

36
Q

nursing management for cushing’s

A

-VS
-DW
-I&O
-glucose
-physical apprearance
-electrolytes
-protect from infection
-minimize stress
-diet education

Adults (35 decks)

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