Endocrine Flashcards
(88 cards)
1
Q
The endocrine system consists of glands located throughout the body to carry out vital functions such as
A
regulating metabolism, nutrition, elimination, temperature, fluid and electrolyte balance, and growth and reproduction.
2
Q
The hypothalamus plays a major role in endocrine function because of its control of the
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anterior and pituitary glands
3
Q
Hormones from the endocrine glands are secreted directly into the _________ compared to exocrine glands that are released through _____
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blood stream
ducts
4
Q
Exocrine glands include ______ and ______ glands
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salivary and sweat glands
5
Q
negative feedback system that increases
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hormone secretion when circulating levels are decreased
6
Q
Hypothalamus (Control Center) target is…
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anterior pituitary
7
Q
Anterior pituitary (Distribution) targets…..
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adrenal, thyroid, reproductive, growth
8
Q
Posterior pituitary (storage and distriubtion) targets….
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ADH release (fluid balance) and oxytocin
9
Q
The adrenal gland consists of an
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adrenal cortex and medulla
10
Q
The cortex triggers release of ……
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glucocorticoids and mineralcorticoids
11
Q
Glucocorticoids help regulate……
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fluid balance, have anti-inflammatory properties, aid in growth and development, and play a role in regulating blood glucose levels
12
Q
what is the primary glucocorticoid
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cortisol
13
Q
what does cortisol do
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promotes glucogenesis and glycogenolysis that can increase glucose levels
14
Q
what does the medulla release
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catecholamines (epinephrine and norepinephrine).
15
Q
Thyroid gland affects
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affects metabolism, heart rate and contractility, red blood cell production, respiratory rate and drive
16
Q
what are the hormones in thyroid gland
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T3 and T4
17
Q
where is TSH and TRH secreted from
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hypothalamus
18
Q
TSH and TRH secreted from the hypothalamus trigger
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T3 and T4 release from thyroid
19
Q
Parathyroid gland secretes ______ to regulate_____
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calcitonin to regulate calcium levels
20
Q
calcium serum levels determine how much _______ is secreted
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calcitonin
21
Q
Calcitonin lowers calcium and phosphate levels by
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reducing bone release of these minerals.
22
Q
Gonads include the
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reproductive organs, ovaries and testes.
23
Q
what hormones are released from the gonads
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testosterone and progesterone, and estrogen.
24
Q
Pancreas secretes ____ and _____ to….
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glucagon and insulin to maintain appropriate blood glucose levels
25
In addition to levels of circulating hormones, release of hormones is influenced by
intrinsic factors
26
When patients are prescribed certain medications such as corticosteroids for inflammation, these exogenous agents impact the function of the ________ so they must be _______ to prevent _____
negative feedback system. Therefore, they must be tapered to prevent abrupt withdrawal of the exogenous drug which may lead to adrenal insufficiency
27
what is adrenal insufficiency
medical emergency characterized by decreased blood pressure and hypoglycemia.
28
what is included to look for in physical assessment
- Hair distribution, coarseness
- -Bulging eyes
- -Round or puffy face
- Thyroid nodule: easiest to assess during swallowing
- Jugular Vein Distention
- Skin: pigment, slow healing wounds, edema
- Fingernails
- Trunk: Breast for abnormalities
29
where is the buffalo hump and what does it indicate?
between shoulder blades may indicate adrenal cortical excess.
30
what is a striae and what may it indicate
reddish purple “stretch mark” on breasts or abdomen may indicate adrenal cortical excess.
31
what are you listening for during a physical assessment
Auscultate the chest and assess heart rate and rhythm. Endocrine problems can cause dehydration, volume depletion, or fluid excess. Document orthostatic blood pressures and monitor trends.
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what are you palpating during a physical assessment
The thyroid gland and testes should only be palpated by a healthcare professional-- never manipulate a gland
33
Applying pressure to the thyroid can stimulate .....
sudden release of thyroid hormones and cause a thyroid storm.
34
what endocrine issues are more common in older adults
such as diabetes, loss of ovarian function, and decreased thyroid function
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thyroid problems are more common in men or women.
women
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what questions should you ask during an endocrine assessment
Did symptoms occur gradually or start suddenly?
Ask about elimination patterns
Ask about changes in menstrual cycle
Has the client experience impotence, change in libido?
Has hair texture changed?
Has the client been experiencing fatigue?
Has the client been experiencing temperature changes?
37
The thyroid, parathyroid, ovaries, and testes should be evaluated using
ultrasound
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what imaging is used to look at to evaluate ovaries, pancreas, and adrenal glands
CT scan
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what is a Provocative Suppression Tests
are performed by “provoking” a hormone response
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what happens if the hormone doesnt respond during a provocative suppression test
client would be considered to have hypofunction
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what happens if the hormone over responds during a provocative suppression test
hyperfunction.
42
Hormones and metabolites can be accurately measured by collecting a _______ and why
24 hour urine
| Because many endocrine hormones are secreted in a pulsatile fashion, a one-time collection wouldn’t be accurate
43
what labs would you take to evaluate the posterior pituitary glands
Hematocrit, serum sodium, urine-specific gravity
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what labs would you take to evaluate the anterior pituitary gland
ALL THE LABS and growth hormone
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what labs would you take to evaluate the parathyroid
Calcium, ionized calcium, vitamin D, magnesium, and phosphorus
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what labs would you take to evaluate the thyroid
T3, T4, TSH
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what labs would you look at to evaluate the adrenal
Cortisol, potassium, and sodium
48
what does aldosterone do
a mineralocorticoid, promotes sodium and potassium excretion by the kidney
49
what labs would you take to evaluate the ovaries
FSH, Luteinizing hormone, estrogen levels
50
what labs would you take to evaluate the testes
testosterone
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what labs would you take to evaluate the pancreas
insulin, and glucose levels
52
The three endocrine tissues that usually have reduced function with aging are the
gonads, the thyroid gland, and the endocrine pancreas
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Decreased ADH production causes
more UOP and risk of dehydration
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Decreased glucose tolerance- causes what
elevated glucose levels, polydipsia, polyuria, slow wound healing, and frequent UTI or yeast infections.
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decreased metabolism causes what
colder, decreased appetite, BP and HR decreased.
56
The anterior pituitary regulates
growth, metabolism, pigmentation, and sexual development
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Hormones secreted from the anterior pituitary gland are regulated by the
hypothalamus
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The hormones released by the posterior pituitary are synthesized in the ________ but stored and released from the ______ ______when needed.
hypothalamus
| posterior pituitary
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what are the anterior pituitary gland hormones
```
Adrenocorticotropic hormone (ACTH)
growth hormone
follicle stimulating
Luteinizing
prolactin
thyroid stimulating
```
60
Adrenocorticotropic hormone (ACTH) is involved in synthesis of....
Corticosteroid’s
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Growth hormone stimulates
growth through metabolism
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Follicle stimulating hormone assists in the
maturation of the ovaries and spermatogenesis in males
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Luteinizing hormone is involved in
ovulation in females and production of testosterone in males
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Prolactin stimulates the
mammary glands for milk production.
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Thyroid stimulating hormone controls secretion
T3and T4
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Weakness and bone fractures are a s/s of
decreased levels of GH
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Ensure the client with hypopituitarism has adequate amounts of
vitamin D and calcium.
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Hyperpituitarism is usually related to a
hypersecreting tumor
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what are the Signs and symptoms of hyperpituitarism
hyperglycemia, hypernatremia, hypertension, increased bone density, menstrual irregularities, weight loss, exopthalamos, and exaggerated facial features. In children before the closure of epiphyses, gigantism develops. An excess of growth hormone in adults does not affect bone length because of the closure. Acromegaly can occur especially in hands, feet, and facial bones
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what labs would you assess for hyperpituitarism
TSH, FSH, LH, prolactin, GH, and ACTH stimulation test.
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what does the med Dopamine agonist (bromocriptine mesylate do
for hyperpituitarism
| inhibits release of anterior pituitary hormones
72
what is Stereotactic radiosurgery
a minimal invasive procedure. It delivers high dose radiation to a precisely targeted area of the brain. The goal is eradication of the tumor with minimal effects to adjacent normal brain tissues.
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what is Transsphenoidal Hypophysectomy
The sublabial transseptal approach to a pituitary tumor involves an incision made under the top lip, with entry to the nasal cavity through the floor of the nose. The septum is moved to the side and the sphenoid sinus is opened to access the pituitary gland. A muscle graft is placed after removal of the tumor, typically from the thigh muscle. The graft aids in healing and prevents cerebrospinal fluid leakage. Nasal packing is placed and a “moustache dressing”.
74
what vital signs would indicate DI after Transsphenoidal Hypophysectomy
decreased BP and tachycardia increased thirst or UOP
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what are the ss od meningitis
temperature, stiff neck, and photophobia
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what will you report after Transsphenoidal Hypophysectomy
clear drainage from nose
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what interventions are involved after Transsphenoidal Hypophysectomy
If needed, administer IVF to correct sodium levels. Administer vasopressin to cause water reabsorption in the kidneys and help decrease UOP. Maintain HOB greater than 45 degrees, provide adequate oral fluids, and provide frequent mouth care.
78
ADH helps maintain
fluid and electrolyte balance
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Oxytocin plays a major role in
circadian homeostasis, release of breast milk, and cervical and uterine changes during labor
80
Diabetes insipidus is classified as either
central or nephrogenic.
81
Central DI is caused by a
decreased secretion of ADH from the posterior pituitary gland.
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Nephrogenic DI occurs when
kidneys are resistant to ADH and unable to concentrate urine. This type of DI is observed in clients with chronic renal insufficiency, hypercalcemia, hypokalemia, and interstitial disease of the renal tubules.
83
what are the ss of diabetes insipidus
will depend on the amount of water loss. Lack of ADH causes an increase in water secretion. Excessive water loss leads to hemoconcentration observed with elevations in serum sodium and hematocrit. The patient may have hypotension and tachycardia secondary to hypovolemia. Polyuria, polydipsia, and nocturia are the primary clinical manifestations.
84
Urine specific gravity less than 1.005 and urine osmolality less than 200 are key indicators
of DI
85
what is the med Desmopressin used for and how does it work
a synthetic analog of ADH and is the drug of choice in clients with DI. It works by increasing the amount of fluid absorbed in the kidney. The fluid is returned to the blood stream.
86
what is Syndrome of Inappropriate Antidiuretic Hormone
a disorder related to an increase in ADH. Water overload and hemodilution are characteristics of SIADH.
cause by CNS disorders such as tumors, side effects of NSAIDs, psychotropic medications, and bronchogenic carcinoma.
87
what are the ss of Syndrome of Inappropriate Antidiuretic Hormone
Decreased UOP, increase in osmolality and specific gravity, are common. Hyponatremia is the cardinal symptom of SIADH. As sodium levels decrease the patient may have seizures or become comatose.
88
Demeclocycline is used to
increase water secretion from the kidneys.
