exam 3: endocrine Flashcards
(29 cards)
In Addison’s Disease, these three classes are reduced
mineralocorticoids, androgens, glucocorticoids
the most common cause of addison’s disease in the U.S is ____
autoimmune response
addison’s disease, if caused by autosomal response, is most common in
white females
clinical manifestations of addison’s disease are not evident until
90% of adrenal cortex is destroyed
clin. manifestations of addison’s
progressive weakness, fatigue, weight loss, anorexia, bronze colored skin, ortho hypertension, diarrhea, depression, irritability
Addison’s-the changes in the skin are most likely due to
increased secretion of lipotropin
addisonian crisis is triggered by: 4 things
- stress (infection, surgery)
- sudden withdrawal of corticosteroid hormone
- adrenal surgery
- sudden pituitary gland destruction
S/S of Addisonian crisis:
postural hypotension, tachy, dehydration, hyponatremia, hyperkalemia, SHOCK!, N & V, lowered LOC
Collaborative care for addison’s disease
- hormone therapy (hydrocortisone, fludrocortisone)
- INCREASED salt intake
acute intervention for addison’s disease
Protect against infection
Protect from extremes
Light, noise, temperature
addisonian crisis management
Shock management
High-dose hydrocortisone replacement
0.9% saline solution and 5% dextrose
patient teaching for discharge and care of addison’s disease
Dosing
Glucocorticoids in divided doses
Mineralocorticoids once in the morning
Need to check BP
Increase salt intake
Need to increase corticosteroids during times of stress
Signs and symptoms of corticosteroid deficiency and excess
Wear medical ID bracelet
Emergency kit
Hydrocortisone 100mg IM
Syringes, alcohol, Band-Aids
Written instructions IM injection
Report significant changes to health care provider
what does hyperaldosteronism mean?
excessive aldosterone secretion
in hyperaldosteronism, what labs are affected
sodium retention, potassium and hydrogen ion excretion, hypertension with hypokalemic alkalosis
what is the hallmark lab signs of hyperaldosteronism?
hypertension with hypokalemic alkalosis
clinical manifestations of hyperaldosteronism?
Sodium retention
Hypernatremia, hypertension, headache
No edema
Hypokalemia
Muscle weakness
Fatigue
Cardiac dysrhythmias
Glucose intolerance
Metabolic alkalosis → tetanypre-op teaching for hyperaldosteronism: adrenalectomy to remove the adenoma
Preoperative
- Potassium-sparing diuretics (aldactone)
- Antihypertensives
- Oral potassium supplements
- Caution: not with K+ sparing diuretic (fear of hyperkalemia)
- Sodium restrictions
teach patient taking eplerenone to avoid ingesting
grapefruit juice
what give to someone with bilateral adrenal hyperplasia?
potassium-sparing diuretic, calcium channel blocker, dexamethasone to decrease hyperplasia
what is pheochromocytoma?
tumor in the adrenal medulla, which causes an excess production of catecholamines (epinephrine and norepeniphrine)
the most dangerous immediate effect of pheochromocytoma is …..
severe hypertension
the most striking clinical features of pheochromocytoma are
severe hypertension–> bad headache, teachycardia, profuse sweating, unexplained chest/abdominal pain
the best diagnostic tool for detecting phemochromocytoma
measurement of urinary fractionated metaniphrines
avoid _______ in pts who have pheochromo.
plapating the abdomen, because it releases cathecholamines, which can raise BP, and cause severe hypertension
