Endocrine System Flashcards
(77 cards)
Leuprolide
nursing considerations & patient teaching
nursing:
- decreases effects of anti diabetic drugs
- give med until 11-12 years old
- IM or SQ injection
- rotate site
- effects will take 2-4 weeks
- usually given monthly
patient education:
- teach proper injection technique
- report irritation at injection site
- keep track of monthly dosing
- use nonhormonal birth control
Octreotide
- action
- use
- adverse effects
- contraindications
action: mimics somatostatin, inhibiting GH, insulin & some GI hormones
use: Acromegalia, GI bleeding, Diarrhea, some tumors
adverse effects: H/A, dizziness, bradycardia, hyperglycemia, diarrhea
contraindications: pancreatitis & diabetes
Octreotide nursing considerations & patient education
Nursing:
- many drug to drug interactions
- IV or IM route
- rotate injection site
- monitor height & weight
- monitor blood glucose
Patient education:
- teach proper injection technique
- monitor blood glucose if at risk
- monitor height & weight
- notify MD if severe GI upset
where are parathyroid glands located & what do they produce?
located ON back of thyroid gland; produce parathyroid hormone (PTH)
what two things does PTH regulate?
calcium (8.5 - 10.5) & phosphorus (indirectly)
which hormones are involved in calcium regulation? in which 3 ways do these hormones alter the absorption of calcium?
parathyroid hormone, calcitonin, & vitamin D
1. from GI tract
2. from bones
3. excreted by kidneys
when calcium levels are low:
- how does this affect PTH & amount of Ca in urine, GI, bone,
& blood?
increased PTH released & increased activation of Vitamin D
- decreased loss of Ca+ in urine
- increased GI absorption of Ca+
- Increased Ca+ release from bones
- raise calcium in blood
when calcium levels are high:
- how does this affect PTH & amount of Ca in GI tract, bones, & blood?
decreased secretion of PTH & increased secretion of calcitonin
- increased loss of Ca+ in GI tract
- decreased release of Ca+ from bones
- decrease calcium in blood
difference between hypo & hyperparathyroidism & causes
Hypoparathyroidism: not enough PTH, low calcium levels
causes: accidental removal of parathyroid glands
Hyperparathyroidism: too much PTH, high calcium levels
causes: tumor or enlargement of glands, genetic disease (Paget’s disease)
S/Sx of hypo & hypercalcemia
Hypocalcemia: Hyperactive reflexes, paresthesias, positive Chostek & Trousseau signs, hypotension, prolonged QT intervals, abdominal & muscular spasms & cramps
Hypercalcemia: lethargy, coma, hypertension, shortening of the QT interval, N/V, muscle atrophy, kidney stones, renal insufficiency
calcium supplements (calcium acetate, calcium carbonate (tums), calcium citrate, calcium gluconate)
- action
- use
- adverse effects
- contraindications
action: provides supplemental calcium
use: tx & prevent hypocalcemia, decrease bone loss & fractures, treat high phosphorus levels
adverse effects: GI upset (N/V, constipation), EKG changes, weakness
contraindications: kidney stones, cancer w bone involvement, hypercalcemia, hypophosphatemia
Calcium supplement nursing considerations & patient education
nursing:
- available PO & IV
- give PO after meals
- monitor IV closely, tissue toxic
- monitor lab values
- monitor EKG for changes
Patient education:
- calcium carbonate (tums) most calcium OTC
- high calcium diet (milk, yogurt, cheese)
- take after meals
without ___ calcium cannot be absorbed
Vitamin D
Vitamin D
- action
- use
- adverse effects
- contraindications
action: increases calcium & phosphorus, absorption in GI tract, pulls calcium & phosphorus from bones, decreases calcium & phosphorus in kidneys
use: vitamin D deficiency & treatment of hypoparathyroidism
adverse effects: high vitamin D (fat soluble) & high calcium
contraindications: high calcium & vitamin D toxicity
Vitamin D nursing considerations & patient education
nursing:
- monitor lab values
- many combination meds available
patient education:
- high vitamin D diet (fish, eggs, milk)
- sunlight good source of vitamin D
- may be taken w out regard to meals
normal range for calcium
8.5 - 10.5
Alendronate
- action
- use
- adverse effects
- contraindications
action: binds to bone & blocks calcium release, suppresses osteoclasts
use: treat & prevent osteoporosis
- post menopausal
- steroid induced
adverse effects: esophageal irritation / erosion**, bone pain
contraindications: **inability to sit upright for 30 minutes*, esophageal disorders
Alendronate nursing considerations & patient education
nursing:
- give first thing in the morning
- give w full glass of water
- nothing to eat or drink for 30 minutes before
- remain sitting upright for 30 minutes
patient education:
- proper administration
- report esophageal pain, heartburn, & difficulty swallowing to MD
which drug should be given instead of Alendronate if a patient is unable to sit upright for 30 minutes?
Calcitonin Salon (nasal spray)
adrenal glands
- where are they located?
- what are the two layers & their roles?
located on top of each kidney
layers:
1. adrenal cortex (makes 3 corticosteroids controlled by the hypothalamus)
2. adrenal medulla (part of SNS; fight or flight)
which 3 hormones does the adrenal cortex make & what responses do they regulate?
- Glucocorticoids (immune response)
- Mineral corticoids (water & electrolyte balance)
- Androgens (male / female reproductive)
what is addison’s disease? what do patients lack? what can it be caused by?
lack of adrenocortical hormones
can be caused by:
- lack of ACTH
- lack of response of adrenal glands
- damage to adrenal glands
- prolonged use of corticosteroids
what is an adrenal crisis? list some effects & how it can be treated
adrenal insufficiency + extreme stress = body unable to support SNS response
effects: hypotension, exhaustion, shock, death
treatment: massive steroid infusion
cushing’s disease
- what is it?
- what can it be caused by?
- what are some S/Sx?
excess adrenocortical hormones
can be caused by: excessive corticotropin & tumors
S/Sx: hyperglycemia, irritability, moon shaped face, fluid retention
