Week 12 Flashcards
(97 cards)
1
Q
What are the major endocrine glands?
A
Hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas
These glands are responsible for hormone secretion and regulation.
2
Q
What are some hormones secreted by the endocrine system?
A
Insulin, cortisol, thyroid hormones (T3, T4), aldosterone, growth hormone, oxytocin
Hormones are chemicals that act on specific tissues.
3
Q
What are the two types of feedback mechanisms in the endocrine system?
A
Negative feedback loop, positive feedback loop
These mechanisms regulate hormone secretion.
4
Q
What is a positive feedback loop?
A
Increases target organ action causing another gland to release a hormone that stimulates further release
Example: Oxytocin during childbirth.
5
Q
What is a negative feedback loop?
A
The gland responds to an increase or decrease in the secretion of that hormone
Example: PTH/calcium regulation.
6
Q
What are some clinical manifestations of hypothyroidism?
A
Myxedema, weight gain, fatigue, cold intolerance
Hypothyroidism is characterized by low thyroid hormone levels.
7
Q
What are some clinical manifestations of hyperthyroidism?
A
Weight loss, heat intolerance, exophthalmos, goiter
Grave’s disease is a common cause of hyperthyroidism.
8
Q
What is the purpose of the hypothalamus in the endocrine system?
A
Regulates hormone secretion from the pituitary gland
It acts as the master regulator of the endocrine system.
9
Q
What are the two parts of the pituitary gland?
A
Anterior pituitary, posterior pituitary
The anterior pituitary produces tropic hormones while the posterior stores and releases ADH and oxytocin.
10
Q
What is SIADH?
A
Syndrome of Inappropriate Antidiuretic Hormone secretion
Characterized by excessive water retention and low sodium levels.
11
Q
What is diabetes insipidus?
A
Condition resulting from too little ADH, leading to increased urine production
Can result in hypernatremia due to excessive water loss.
12
Q
What is Cushing Syndrome?
A
Condition caused by excessive corticosteroid levels
Often results from a tumor or prolonged steroid use.
13
Q
What is Addison’s Disease?
A
Condition caused by insufficient corticosteroid production
Results in symptoms like fatigue, weight loss, and low blood pressure.
14
Q
What does TSH stand for?
A
Thyroid-stimulating hormone
It regulates the production of thyroid hormones.
15
Q
What is the significance of T3 and T4 levels?
A
They indicate thyroid function; high levels indicate hyperthyroidism and low levels indicate hypothyroidism
More specialized measurements than TSH.
16
Q
What can cause a goiter?
A
Iodine deficiency, changes in thyroid hormone production, medications
Can occur in both hypothyroidism and hyperthyroidism.
17
Q
What is the role of the pancreas in the endocrine system?
A
Secretes insulin and glucagon to regulate blood glucose levels
Dysfunction can lead to diabetes mellitus.
18
Q
What are the assessment components for the endocrine system?
A
Past medical history, vital signs, weight changes, subjective and objective assessments
Includes head-to-toe assessments for signs of endocrine disorders.
19
Q
What is the function of the adrenal cortex?
A
Produces cortisol, aldosterone, and adrenal androgens
Cortisol is involved in stress response and metabolism.
20
Q
What are the common diagnostics used in assessing the endocrine system?
A
Blood tests, urinalysis, radiographic studies (CT, ultrasound)
These tests help evaluate hormone levels and gland function.
21
Q
What is the most common cause of issues with the pituitary gland?
A
Tumor growth
Tumors can affect hormone production from both anterior and posterior glands.
22
Q
True or False: The endocrine system is ductless.
A
True
Endocrine glands release hormones directly into the bloodstream.
23
Q
Fill in the blank: The _______ is known as the master regulator of the endocrine system.
A
hypothalamus
It influences the pituitary gland’s hormone secretion.
24
Q
The endocrine system plays a role in:
A
- reproduction
- growth and development
- sexual reproduction
- maintaining homeostasis
- responding to emergency demands
25
Glands:
Endocrine
- secrete into blood
Exocrine
- excreting it into a duct
target tissue
26
Hormones
Chemical substances synthesized and secreted by a specific organ or tissue
- secretion in small amounts at variable but predictable rates
- circulation through the blood
- binding to specific receptors
27
Diagnostics blood tests for endocrine
- TSH
- T3, T4
- Calcium
- PTH
- phosphate
- aldosterone
- blood glucose
- HbA1C
- amylase
- cortisol
- lipase
28
Pituitary Gland
located under the hypothalamus
anterior pituitary (2/3 of the gland, 80% by weight)
- tropic hormones (ATCH, gonadotroic hormones)
- prolactin, TSH, GH
Posterior pituitary
- ADH
- oxytocin
29
Hypopituitarism
- tumour is a common cause
- trauma, surgery can also damage gland
- can influence all hormones secreted (anterior and posterior)
30
ADH imbalances
Too much ADH
- syndrome of inappropriate anti diuretic hormone (SIADH)
- too much water is retained = hyperbole is and hyponatremia
Too little ADH
- diabetes insipidus
- increased urine production = hypernatrimua
31
Acromegaly
- excessive secretion of GH
- generally caused by a tumour of the anterior pituitary gland
- overgrowth of bones
- enlargement of tissues in hands, feet and face
- treated with surgery and/or radiation therapy
- diagnostics: CT/MRI for tumour presence
32
The hypothalamus is..
The master regulator
- the control of the whole system
33
What physical assessments might a nurse expect to find in a patient with increased T3 and T4 levels?
* Bulging eyeballs
* Sweating
* Tachycardia
## Footnote
These findings are indicative of hyperthyroidism.
34
Which nursing diagnosis may be appropriate for a patient with hypothyroidism?
* Risk for altered nutritional status r/t anorexia
* Risk for body image changes r/t weight loss
* Risk for emotional changes r/t nervousness
* Risk for hyperthermia r/t impaired temperature regulation
* Risk for fluid imbalance r/t diarrhea
## Footnote
These diagnoses reflect potential complications associated with hypothyroidism.
35
What is an adverse effect of Synthroid in a patient with hypothyroidism?
* Tachycardia
## Footnote
Tachycardia can occur due to excessive thyroid hormone replacement.
36
When should levothyroxine sodium (Synthroid) be administered for hypothyroidism?
In the morning on an empty stomach
## Footnote
This enhances absorption and efficacy of the medication.
37
What is the primary purpose of the endocrine system?
Regulation of bodily functions through hormones
## Footnote
The endocrine system maintains homeostasis and coordinates complex processes.
38
List the major glands of the endocrine system.
* Hypothalamus
* Pituitary gland
* Thyroid gland
* Parathyroid glands
* Pancreas
## Footnote
Each gland has specific functions and hormone production.
39
What hormones are produced by the thyroid gland?
* Thyroxine (T4)
* Triiodothyronine (T3)
## Footnote
These hormones are crucial for regulating metabolism.
40
What role does iodine play in the endocrine system?
Necessary for the synthesis of thyroid hormones
## Footnote
Iodine deficiency can lead to thyroid dysfunction.
41
What is the function of parathyroid hormone (PTH)?
Regulates blood calcium levels
## Footnote
PTH increases serum calcium through bone resorption and renal reabsorption.
42
What are the common causes of acute pancreatitis?
* Gallbladder disease
* Alcohol (ETOH)
## Footnote
These are the most prevalent factors leading to acute inflammation of the pancreas.
43
What are some clinical manifestations of acute pancreatitis?
* LUQ or epigastric pain
* Nausea/vomiting
* Hypotension
* Tachycardia
* Jaundice
## Footnote
Symptoms may vary in severity and presentation.
44
What lab findings are indicative of acute pancreatitis?
* Dramatic increase in amylase/lipase
## Footnote
These enzymes are elevated significantly during acute episodes.
45
What is the mechanism of action of metformin?
Increases insulin sensitivity and decreases hepatic gluconeogenesis
## Footnote
Metformin is commonly used in managing Type 2 diabetes.
46
What symptoms are associated with hypoglycemia?
* Shaky
* Sweaty
* Dizzy
* Hunger
* Headache
* Pallor
## Footnote
These symptoms arise due to low blood sugar levels.
47
What treatment is recommended for hypoglycemia?
Consume 15-20 grams of glucose or simple carbohydrates
## Footnote
Followed by rechecking blood glucose after 15 minutes.
48
What is the primary function of the pancreas?
* Produces digestive enzymes (exocrine)
* Regulates blood glucose levels (endocrine)
## Footnote
The pancreas plays a dual role in digestion and metabolism.
49
What could cause hyperparathyroidism?
* Parathyroid tumor
## Footnote
This condition results in excessive secretion of parathyroid hormone.
50
What are the primary functions of T4 and T3?
* Affect metabolic rate
* Influence caloric requirements
* Regulate oxygen consumption
* Impact carbohydrate and lipid metabolism
* Support growth and development
* Affect brain function and nervous system activity
## Footnote
These hormones have widespread effects on bodily functions.
51
What is the difference between acute and chronic pancreatitis?
* Acute: sudden inflammation, often related to gallbladder disease or alcohol
* Chronic: prolonged inflammation leading to scar tissue development
## Footnote
The duration and underlying causes differentiate the two forms of pancreatitis.
52
Fill in the blank: The major function of the thyroid gland is the production, storage, and release of thyroid hormones: _______ and _______.
thyroxine (T4), triiodothyronine (T3)
## Footnote
These hormones play critical roles in metabolism.
53
Parathyroid glands regulate..
Serum calcium
Which is influenced by
- bone (primary reservoir for calcium (99%)
- kidneys (regulating ca+ excretion)
- GI tract (absorbs dietary calcium)
54
PTH function
Increases serum calcium via
- resorption of bone
- reabsorption of Ca+ in the kidney
55
Thyroid gland
- major function is the production, storage and release of thyroid hormones (thyroxine (T4) and tridothyronine (T3))
- iodine is necessary for the synthesis of thyroid hormones
- calcitonin is a hormone productive by the thyroid gland in response to high circulating calcium levels to help tone down serum calcium
56
Parathyroid glands
Four small oval structures usually arranged in pairs behind each thyroid lobe.
- excrete PTH (parathyroid hormone) which regulates the blood level of calcium
- helps to increase serum calcium
57
Too much PTH secretion =
Hyperparathyroidism
- r/t elevated resorption of calcium by the bone
- can be caused by parathyroid tumour
- results in serum hypercalcemia/hypercalcuria
58
Too little PTH secretion =
Hypoparathyroidimsm
- results from parathyroid gland destruction
- natural atrophy of the gland is rare
- results in serum hypocalcemia
59
Pancreas
- has both endocrine and exocrine function
Exocrine
- digestive enzymes (protein, lipase, amylase)
-secrete substances into ducts
Endocrine
-glucagon, insulin
- are ductless and secrete substances directly into bloodd
60
Pathophysiology of pancreatitis
- acute vs chronic inflammation
- acute: gallbaladder disease and ETOH
- chronic: prolonged inflammation with scar tissue development (ETOH is common but there are other functions)
61
Clinical manifestations of pancreatitis
- LUQ or epigastric pain with retroperitoneal radiation
- pain aggravated by eating
- nausea/vomiting/hypotension (in acute)
- jaundice
62
Diagnostics for pancreatitis
- amylase/lipase (dramatic increase in acute pancreatitis, no elevation or mild elevation in chronic pancreatitis)
- abdominal U/S or CT primarily used
63
Collaborative care/ nursing management for pancreatitis
- pain and symptom relief (N/V reduction)
- vital sign normalization (if shock present), hydration
- reduce pancreatic secretions (acute cases may require NPO)
- BGM monitoring
- treat or prevent infection
64
Chronic pancreatitis
- persistent, chronic inflammation of pancreas
decreased function of exocrine pancreas
- difficulties with digestion and absorption of nutrients
- abdominal pain (worse with eating)
- steatorrhea
- unintentional weight loss
65
Obstructive pancreatitis
R/t biliary disease and cholelithiasis
66
Non-obstructive pancreatissis
Inflammation/sclerosis of the head of pancreas and pancreatic duct
67
Diagnostics for chronic pancreatitis
- none to mild elevation in lipase/amylase
- bilirubin elevated (if common bile duct obstructed)
- ALP elevated
- Mild increased WBC
- Stool (check for high fat content)
- MRI, CT, US, MRCP
68
Management of pancreatitis
- bland diet, low fat, no alcohol use
- pancreatic enzyme replacement
- diabetes management
- manage bile duct obstructions
69
Insulin
- stimulates liver and muscle cells to store glucose in the form of glycogen (when the body does not need the glucose)
- stimulates fat cells to form fats from fatty acids and glycerol
- stimulates liver and muscle cells to make protein from amino acids
- inhibits the liver and kidney cells form making glucose intermidate compounds of metabolic pathways
70
Glucagon
- stimulates the liver and muscles to break down stored glycogen (glycogenolysis) and release the glucose
- stimulates breakdown of fat and protein into glucose
71
What is pre-diabetes
- also called impaired glucose tolerance (IGT)
- blood glucose levels that are higher than normal but not yet high enough to be diagnosed with diabetes
- no clear symptoms of prediabetes
- some people may have some of the symptoms or even problems of diabetes already
- 6 million Canadians have iGT
72
Risk factors for T2DM
- overweight or obese
- gestational diabetes
- family hx
- metabolic syndrome (high cholesterol, triglycerides, low HDL, high LDL, high blood pressure)
- older people
73
HbA1C
Glycated hemoglobin
74
Exocrine secrete into
Ducts
75
Endocrine secrete into
Blood
76
Clinical manifestations of cushings syndrome
- personality changes
- moon face
- hyperglycaemia
- CNS irritability
- increase susceptibility to infection
- Na+ and fluid retention
- fat deposits on back
- GI distress - increase acid
- thin skin
- purple striae
- bruises and petechiae
Males: gynecomastia
- females: amenorrhea hirsutismle
77
Clinical manifestations: addisons disease
- bronze pigmentation of skin
- changes in distribution of body hair
- GI disturbances
- weakness
- weight loss
- postural hypotension
- hypoglycaemia
78
S&S of adrenal crisis
- profound fatigue
- dehydration
- vascular collapse (decrease blood pressure)
- renal shut down
—> decrease serum Na+
—> increase serum K+
79
What are the three hormones the thyroid gland produces
Thyroxine (T4)
Triiodothyronine (T3)
Calcitonin
80
Is T3 & T4 decrease in the blood…
The release of TSH will increase which causes an increased output of T3 and T4
81
The thyroid gland is a…
Negative feedback mechanism
82
Serum TSH
- best screening test of thyroid function
- also used to monitor therapy affect
83
Serum T3 & T4
Includes protein bound and free hormone levels that occur in response to TSH secretion
- levels generally increase or decrease together
84
Thyroid hormones…
- accelerate metabolic processes
- influence cell replication
- important with brain development
- normal growth
- influence every major organ system
85
Hyperthyroidism
- a sustained increase in synthesis and release of hormone by thyroid gland
86
Presentation and eitology of hyperthyroidism
Presentation
- 2nd most prevelant endocrine disorder
- most common type: Graves’ disease
- affects more women than men
Etiology
- Graves’ disease
- oral thyroid hormone, excessive iodine
- thyroiditis
- tumors
- radiation, cancer
-
87
Key S&S of hyperthyroidism
-nervousness, emotional hyper excitable
- heat intolerance, excessive sweating
- weight loss despite increased appetite
- changes in bowel function, diarrhea
- tremors
- Palpitations, tachycardia
- warm, soft, moist, flushed skin
- infertility, menstrual irregularities
- ophthalmology, goitre, thyroid bruit
88
Complications and diagnostics of Hyperthyroidism
Complications
- thyroid storm: acute intervention
Diagnostics
- Hx
- physical examination
- TSH (what to expect)
- free T4
- thyroid CT/MRI
- radioactive iodine intake
89
Treatment for hyperthyroidism
anti thyroid drug
- propylthiouracil
- methimazole
Beta blocker therapy
Radioactive iodine therapy
Surgery
- partial
- subtotal
90
Hypothyroidism causes
- decreases T3/T4 causes hypo metabolism
Causes
- primary hypothyroidism
- thyroidectomy
- iodine deficiency
- drugs
- radioactive/antithyroid medication therapy
- hashimoto disease
91
S&S for hypothyroidism
- fatigue
- hair loss, brittle nails, dry skin
- sensitivity to cold
- unexplained weight gain
- constipation
As the disease progresses
- anorexia
- puffy face
- decreased libido
- menorrhagia
- paresthesia (numbness, prickling, tingling)
- jpiot strifffness
Muscle cramping
- mental changes
92
Diagnostics for hypothyroidism
- TSH, free T4, TRH
- thyroid antibodies
- hemoglobin
- triglycerides
93
Severe hypothyroidism
Associated with
- elevated serum cholesterol
- atherosclerosis
- CAD
- sensitivity to sedatives, opioids, anesthetic agents
94
Thyroid storm
AKA thyrotoxic crisis
- life threatening condition characterized by severe manifestations of thyrotoxicosis
- requires immediate medical attention and aggressive treatment
- treatment strategies generally include a combination of pharmacological interventions and supportive care
- generallyy admitted to ICU
95
Antithyroid medications: thyroid storm
Thionamides
- propylthiouracil (PTU) or methimazole (MMI) is typically administered to block the synthesis of thyroid hormones. PTU is often preferred in thyroid storm due to its additional inhibitory effect on peripheral conversion of T4 to T3
Iodine therapy
- potassium iodine or Lugol’s iodine solution can be given to inhibit thyroid hormones release
Beta-blockers
- beta-andrenergic blockers such as propranolol are used to control symptoms such as HTN, tremors, and tachycardia
Glucocorticoids
- IV glucocorticoids are administered to inhibit the peripheral conversion of T4 to T3 and to alleviate the systemic inflammatory response associated with thyroid storm
96
Levothyroxine synthroid [thyroid hormone (T4) replacement]
Brand names: synthroid, levoxyl, tyrosine
Medication class: thyroid hormone
Indications
- treatment of hypothyroidism
- thyroid hormone replacement therapy works in various conditions such as thyroid cancer, thyroid nodules and goitre
Dosage forms and strengths
- tablet: 25mcg, 50mcg, 75mcg, 88mcg. 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg, 300mcg
Oral: 5,mcg/ml
S/E
- palpitations
-tachycardia
-tremors
- headache
- Insomnia
- nervousness
Irritability
Sweating
-heath intolerance
- weight loss
- diarrhea
- menstrual irregularities
97
Serious S/E for levothyroxine synthroid
- chest pain
- rapid or irregular heartbeat
- shortness of breath
- excessive sweating
- fever
- confusion
- weakness
- leg cramps
- severe headache
