Endocrine Disorders

Question 1

Endocrine System

Answer 1

group of organs/glands that are involved in regulating moos, growth and development, tissue function, metabolism, and reproduction

Question 2

What is the major endocrine gland or “Master Gland”?

Answer 2

pituitary gland

Question 3

Pituitary Gland

Answer 3

• pea-sized body attached to the base of the brain

- important in controlling growth and development and the functioning of the other endocrine glands

Question 4

Over-secretion/Hypersecretion of Pituitary Gland Disorders

Answer 4

Cushing Syndrome

Acromegaly (gigantism)

Question 5

Cushing Syndromes results from what?

Answer 5

hypersecretion of ACTH/too much cortisol is produced and released into the body

Question 6

What is the stress hormone?

Answer 6

ACTH

Question 7

S/S of Cushing Syndrome

Answer 7

• weight gain
• thin purple striae
• moon face
• buffalo hump
• thinning/fragile skin that bruises easy
• slow healing
• fatigue
• muscle weakness
• irritability

Question 8

Cushing Syndrome is most likely the result of what kind of tumor?

Answer 8

pituitary tumor

Question 9

What are the complications of Cushing Syndrome?

Answer 9

• hypertension
• diabetes
• difficulty treating infections
• osteoporosis

Question 10

What is the treatment for Cushing Syndrome?

Answer 10

• medication to reduce cortisol production
• surgery to remove tumor
• radiation treatment

Question 11

Acromegaly (GIGANTISM) results from what?

Answer 11

excess growth hormones after the growth plates have closed/may be related to tumor on pituitary, lung, or pancreas

Question 12

S/S Acromegaly

Answer 12

bones increase in size especially in hands, feet, and face

Question 13

Complications of Acromegaly

Answer 13

• headaches
• vision loss
• cardiomyopathy
• diabetes
• osteoarthritis
• hypertension

Question 14

Treatment for Acromegaly

Answer 14

medications to suppress the production of growth hormone or surgery to remove tumor

Question 15

Under-secretion (hyposecretion) usually involves what part of the pituitary hormones?

Answer 15

Anterior pituitary hormones

Question 16

Hyposecretion of Pituitary can lead to what?

Answer 16

• absence of gonadal function
• loss of secondary sex characters
• insufficiency of thyroid and adrenal function

Question 17

Other general S/S of Hyposecretion of Pituitary

Answer 17

• weight gain
• small stature
• low BP
• excessive urination/thirst
• constipation
• fatigue
• dry skin

Question 18

Treatment for Hyposecretion of Pituitary

Answer 18

• hormone replacement (Synthroid, Cortef)
• sex hormones
• growth hormones
• fertility hormones

Question 19

Synthroid medication helps what?

Answer 19

thyroid

Question 20

Cortef medication helps what?

Answer 20

adrenal

Question 21

Pituitary Tumors

Answer 21

• usually benign

- location and effects on targeted organs may have life threatening effects

Question 22

S/S of Pituitary Tumors

Answer 22

• hyper/hyposecretion of pituitary hormones
• Prolactinoma leads to overproduction of prolactin
• loss of menstruation in females
• spontaneous production of milk in males and females
• infertility in females

Question 23

How is a pituitary tumor diagnosed?

Answer 23

Physical assessment
MRI
CT scan
Measure hormone levels

Question 24

Hypophysectomy

Answer 24

surgical removal of the pituitary gland using a transsphenoidal approach

Question 25

What happens during a hypophysectomy?

Answer 25

an incision is made beneath the upper lip; a speculum is inserted into nasal cavity; tumor is removed using forceps

Question 26

Complications from Hypophysectomy

Answer 26

- nose bleeds - intracranial hemorrhage - leaking of CSF - diabetes insipidus - hypopituitarism

Question 27

What to expect after Hypophysectomy?

Answer 27

- nasal packing - pain levels - deep breathing exercises

Question 28

Pre-Op Care for Hypophysectomy

Answer 28

- education on what to expect - ensure consent is signed - patent IV - avoid vigorous coughing, sneezing, sucking through straw, blowing nose, breathing through mouth

Question 29

Post-Op for Hypophysectomy

Answer 29

- monitor vitals - administer pain meds/prophylactic antibiotics - asses change in visual acuity - asses for leaking CSF - maintain HOB 15-30 - monitor electrolytes - strict I/O's - daily weights - soft sponge for tooth brush - frequently asses nasal packing

Question 30

Diabetes Insipidus

Answer 30

decrease in production of anti-diuretic hormone (ADH)-also called vasopressin leading to excess fluid loss

Question 31

What are some causes of Diabetes Insipidus?

Answer 31

- pituitary destruction from radiation or surgery - severe head injuries - tumors - infection

Question 32

How is Diabetes Insipidus diagnosed?

Answer 32

- 24 hr urine measure output ( > 2 L/24 hrs is positive) - monitor ADH levels - vasopressin test to monitor changes in serum cortisol

Question 33

S/S of Diabetes Insipidus

Answer 33

- increased daily urine output (polyuria) - urine is dilute - nocturia/frequency - specific gravity of urine is LOW - excessive thirst (polydipsia) - weight loss, decreased skin turgor, dry mucous membranes, tachycardia, hypotension - hypernatremia

Question 34

Treatment/Management for Diabetes Insipidus

Answer 34

- replacement of ADH - monitor daily weights/vitals - fluid replacement - sodium restriction - monitor neuro status - encourage medic alert bracelet - medication education-alternate nares w/ intranasal; alternate sites w/ injections

Question 35

ADH Replacement Meds

Answer 35

- Desmopressin intranasally | - Vasopressin IM

Question 36

What is Syndrome of Inappropriate Antidiuretic Hormone?

Answer 36

hypersecretion of ADH leading to excessive fluid retention

Question 37

What causes SIADH?

Answer 37

- brain tumors - malignancies - head injuries - infection

Question 38

How can SIADH be diagnosed?

Answer 38

- monitor serum ADH | - urine specific gravity and osmolarity