Alterations of Endocrine Function Flashcards
(104 cards)
1
Q
What hormones are produced from the hypothalamus?
A
TRH, CRH, GnRH, GHRH
2
Q
What hormones are produced from the Pituitary Gland?
A
Anterior: TSH, GH, PROLACTION
Posterior: ADH & OXYTOCIN
3
Q
What hormones are produced from the pineal gland?
A
Melatonin
4
Q
What hormones are produced from the Thyroid?
A
T3 and T4
5
Q
What hormones are produced from the Parathyroid?
A
PTH
6
Q
What does PTH regulate?
A
Calcium
7
Q
What hormones are produced from the Pancreas?
A
Insulin & Glucagon
8
Q
What hormones are produced from the Adrenal glands?
A
Aldosterone, Cortisol, Estrogen, Glucocorticoids, and Mineralcorticoids
9
Q
What causes Syndrome of Inappropriate Antidiuretic Hormone Secretion?
A
Increased ADH levels without physiologic stimuli
10
Q
What are some other common causes of SIADH?
A
Tumors, surgery, and medications
11
Q
What are 2 key characteristics of SIADH?
A
- Enhanced renal water retention
2. Dilutional Hyponatremia
12
Q
What are the Clinical Manifestations of SIADH?
A
Weight gain, confusion, lethargy, decrease LOC, seizures, cerebral edema
13
Q
What is the treatment for SIADH?
A
Correct underlying condition, electrolyte replacement, and diuretics
14
Q
What is the issue with Diabetes Insipidus (DI)?
A
Insufficiency of ADH activity
15
Q
What are the two forms of DI?
A
Neurogenic and Nephrogenic
16
Q
What is the cause of Neurogenic DI?
A
Insufficient secretion of ADH do to a lesion, infection, or ischemic injury
17
Q
What organ is being affected by Neurogenic DI?
A
The hypothalamus or posterior pituitary
18
Q
How soon are the symptoms prevalent in Neurogenic DI?
A
Brough on rapidly
19
Q
What is the cause of Nephrogenic DI?
A
Inadequate response of the renal tubules to ADH
20
Q
What organ is being affected by Nephrogenic DI?
A
Kidneys
21
Q
How soon are the symptoms prevalent in Nephrogenic DI?
A
Gradual onset
22
Q
What are the clinical manifestations of Nephrogenic DI?
A
Polyuria, polydipsia, and urine is normally clear
23
Q
What is a big complication of Diabetes Insipidus?
A
DEHYDRATION
24
Q
What is the treatment for DI?
A
Fluid replacement and monitor closely
25
What is the main cause of Hypopituitarism?
The absence or failure of one or more pituitary hormones
26
What are some other causes of hypopituitarism?
Tumor, brain injury, infection, ischemia
27
What is Dwarfism?
Insufficient GH in children
28
What are the risk factors for dwarfism?
Increased risk of mortality
29
What is treatment of hypopituitarism?
Give them more of that certain hormone
30
What typically causes hyperpituitarism?
Pituitary adenoma
31
What does a microadenoma do in hyperpituitarism?
It's so small, that it tends to not cause alot of problems
32
What does macroadenoma do in hyperpituitarism?
Cause the majority of problems
33
When population does Giantism effect?
Children
34
Which population does Acromegaly affect or when does it get diagnosed?
Adulthood
35
What are some clinical manifestations of Acromegaly?
Bony prominences, flatter forehead, more protrusion the jaw, enlargement of hands/feet, have an increased risk for heart disease, and can become insulin resistance
36
What is the main cause of hyperthyroidism?
Excessive amounts of TH secreted from the thyroid
37
What is Graves Disease?
It is an autoimmune disease and type II hypersensitivity, where the body is attacking the thyroid
38
What are the clinical manifestations of hyperthyroidism?
Weight loss, visual disturbances, heat intolerance, and an enlarged thyroid
39
What are the treatments for hyperthyroidism?
Medication to lower the thyroid hormone; also keep an eye on patients mental status/stress.
40
What is Thyroid Storm?
Increased action of thyroid hormones to exceed metabolic demands; metabolic activity is going to exceed what your body can handle
41
How severe is thyroid storm?
Dangerous crisis requiring immediate intervention
42
What are the clinical manifestations of Thyroid Storm?
Heart failure, Delirium, Hyperthermia, and Brain Damage
43
What is the treatment plane for Thyroid Storm?
Medication to lower thyroid hormone, and supportive care
44
How long will it take before death occurs with Thyroid Storm?
Within 48 hours
45
What is hypothyroidism?
A deficient production of the thyroid hormone
46
What is the most common cause of primary hypothyroidism?
Autoimmune thyroiditis and Hashimoto
47
What are the complications of primary hypothyroidism at birth?
Increased mortality rate, excessive sleepiness, decreased intake, trouble breast feeding, and constipation
48
What can happen if the clinical manifestations are not treated quickly enough for primary hypothyroidism?
Can be permanent stunted growth and mental deficits
49
What are they symptoms of hypothyroidism?
Cold intolerance, weight gain, lethargy, constipation, myxedema, and hoarse voice
50
What is the treatment of hypothyroidism?
Replace TH
51
What is Hyperparathyroidism?
Greater than normal secretion of parathyroid (PTH) and hypercalcemia
52
What is the cause of Primary hyperparathyroidism?
Adenoma or Hypercalcemia
53
What is the cause of Secondary hyperparathyroidism?
Some type of hypocalcemia- usually a vitamin D-deficiency
54
What is the cause of tertiary hyperparthyroidism?
Secondary that is unresolved for a period of time
55
What are the clinical manifestations of hyperparathyroidism?
Hypercalcemia, fatigue, N/V, headache, decrease neuromuscular excitability
56
What is the treatment for primary hyperparathyroidism?
Take out the tumor with surgical removal
57
What is the treatment for secondary/tertiary hyperparathyroidism?
Remove the calcium, give vitamin D, get the excess calcium out that signals to the parathyroid to stop secreting PTH
58
What is hypoparathyroidism?
Abnormally low PTH levels
59
What is the most common cause of hypoparathyroidism?
Damage to the parathyroid glands during thyroid surgery due to the anatomic proximity of the parathyroid to the thyroid
60
What are the clinical manifestations of hypoparathyroidism?
Low calcium levels, facial twitching (Chvestok sign), increased neuromuscular, tetany, hyperphophatemia
61
What is the treatment for hypoparathyroidism?
Calcium replacement
62
What is Diabetes Mellitus?
Chronic disease caused by the imbalance of insulin supply and demand, leading to hyperglycemia and abnormal carbohydrate, fat, and protein metabolism.
63
What is Type I Diabetes Mellitus?
Caused by an autoimmune destruction of beta cells in the pancreas, which leads to an absolute insulin deficiency.
64
What is the initial presentation of type I?
Characterized by sudden onset of hyperglycemia, with ketoacidosis, and cocurs most often in children and younger adults
65
What are the symptoms of type I?
Polyuria, polydipsia, polyphagia, weight loss, glycosuria, and not feeling well.
66
What is the treatment of Type I?
Insulin injections
67
What is Type II Diabetes Mellitus?
A gradual onset of hyperglycemia and is the result of the development of resistance to the action of insulin
68
What are the characteristics of type II?
Obesity, hypertension, hyperlipidemia, and hyperglycemia in older adults
69
How can type II be managed?
With diet and lifestyle changes
70
What is HbA1?
Blood test that measures the amount of red blood cells that are saturated with glucose; detects your average blood sugar for the long term.
71
What is FBG?
Fasting blood glucose; tested after 8 hours of fasting
72
What is OGTT?
Oral glucose tolerance test; Measures how an individuals body reacts immediately to sugar
73
What is "Pre-diabetes"?
Increased risk for developing diabetes; something in blood work is elevated
74
What are the 2 types of Type I Diabetes?
Autoimmune or idiopathic (beta cells are being destroyed)
75
What is Diabetic Ketoacidosis (DKA)?
Serious complication related to insulin deficiency
76
What is the Acid/Base Imbalance of DKA?
Metabolic Acidosis
77
What are the clinical manifestations of DKA?
Blood sugar over 300, Kussmaul respirations, Hyperventilation,Ketonuria,
Fruity acetone breath, CNS depression, Hyperkalemia, high blood sugar less responsive, decreased LOC/mental status, and cardiac dysrhythmias
78
What are the diagnostics for DKA?
Blood sugar readings, ABGs, and Urine test
79
What is the treatment of DKA?
Give them insulin, insulin drip, ICU bed through IV
80
What could happen if a nurse brings blood sugar levels for a patient with DKA down too fast?
Hypoglycemic state
81
What happens during type II diabetes?
There is a decreased insulin secretion so the pancreas isn't able to keep up with the carbohydrates and sugars, therefore destroying the pancreas slowly and eventually turning to Type I.
82
What are the clinical manifestations of Type II?
Polyuria, polydipsia, fatigue, headaches, nausea, and hyperinsulinemia
83
What is hyperinsulinemia?
The amount of insulin in the blood is higher than considered normal. They have a problem controlling blood sugar, meaning that the pancreas has to secrete larger amounts of insulin to keep blood sugar at a normal level. Excess levels of insulin circulating in the blood relative to the level of glucose.
84
What are some systemic complications of type II if left untreated?
Visual changes, Diabetic retinopathy, microvascular issues, poor wound healing, and impaired nerve sensation (diabetic neuropathy)
85
What nursing interventions are possible for Type II?
Promoting Skin inspection
86
What is a major complication of Type II?
Hyperglycemic hyperosmolar nonketotic syndrome (HHNS)
87
What is HHNS?
Higher serum glucose>solute diuresis> polyuria> dehydration> hyperosmolality
88
What is gestational diabetes?
Any degree of glucose intolerance with onset or first recognition during pregnancy
89
How is gestational diabetes diagnosed?
OGTT after 24 weeks gestation
90
What is hypoglycemia?
Complication of insulin therapy and oral medications
91
What are the symptoms of hyperglycemic shock?
Sweating, altered level of consciousness, fever, dizzy, lightheaded, nausea, visual disturbances
92
What is the Dawn Phenomenon?
An early morning rise in blood glucose related to release of GH, cortisol without preceding hypoglycemia
93
What is the treatment of Dawn Phenomenon?
Night-time insulin dose
94
What is Somogyi Effect?
Low blood glucose level during the night that leads to morning rise in blood glucose level, possible to go into hypoglycemic state during the night
95
What is the treatment of Somogyi Effect?
Bed-time snack
96
What is Cushing Syndrome?
Excessive cortisol secretion caused by adenomas
97
What are the clinical manifestations of Cushing syndrome?
Weight gain, personality changes, increased susceptibility to infection, gynecomastia, fat deposits on face and back of shoulders, hyperglycemia, CNS irritability, Gi distress, osteoporosis, thin extremities, amenorrhea & hirsutism, moon face, trunk edema, buffalo hump, vasoconstriction, thinning of the skin, purple striae bruises, and petechia
98
What is the treatment for Cushing syndrome?
Medications to reduce cortisol secretion, and if related to adenoma: surgery, radiation, and chemotherapy
99
What is hypocortical function?
Low levels of cortisol secretion from inadequate stimulation of the adrenal glands
100
What type of disease is Addison's Disease?
Autoimmune
101
What is Addison's Disease?
A primary adrenal insufficiency where the adrenal cortex is being destroyed.
102
What are the clinical manifestations of Addison's Disease?
Weakness, fatigue, hyperpigmentation of the skin, N/V/D, hypoglycemia, postural hypotension, weight loss, GI disturbances, changes in distribution of body hair
103
What are the clinical manifestations of adrenal crisis?
Profound fatigue, dehydration, vascular collapse, decreased blood pressure, renal shut down, decreased serum Na, and increased serum K
104
What is the treatment for Addison's Disease?
A life-time cortical replacement therapy
