Term
|
Definition
can't pass through (cells' lipid bilayer)
messengers = cause a rxn in cell that starts protein synthesis and that protein creates a rxn in the cell |
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Term
|
Definition
| easily passes through cell membrane and attaches to nucleus |
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Term
Hormones
targets and receptors
STEROID HORMONE RECEPTORS |
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Definition
INTRACELLULAR
receptor on nucleus |
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Term
| Regulation of hormonal secretion |
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Definition
NEGATIVE FEEDBACK
SIMILAR TO THERMOSTAT
REVERSES THE CHANGE |
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Term
|
Definition
master regulator
part of brain
secretes releasing and inhibiting hormones |
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Term
ANTERIOR PITUITARY
Adenohypophysis |
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Definition
tropic hormones (controls secretions of other glands)
growth hormone
prolactin |
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Term
POSTERIOR PITUITARY
Neurohypophysis |
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Definition
antidiuretic hormone (vasopressin)
oxytocin (inhibited by alcohol) |
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Term
Hormones of hypothalamus
releasing |
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Definition
corticotropin-releasing hormone (CRH)
thyrotropin-releasing hormone (TRH)
growth hormone-releasing factor or somatotropin-releasing hormone
gonadotropin-releasing hormone (GnRH)
Prolactin-releasing hormone |
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Term
Hormones of hypothalamus
inhibiting |
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Definition
somatostatin (inhibits growth hormone release)
prolactin-inhibiting hormone |
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Term
|
Definition
| most abundant, necessary to sustain life, regulates blood glucose levels through gluconeogenesis & ketogenesis, antiinflammatory function-stabilizes cell membranes, supresses immune system-decreases Tcell production, stimulates calcium resorption-osteoporosis |
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Term
physical exam
NECK-THYROID |
|
Definition
DON'T PALPATE IF ENLARGED
bc it will release hormones (when there are already too many hormones) |
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Term
|
Definition
excess growth hormone (GH)
usual cause is Adenoma (benign glandular tumor) |
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Term
Acromegaly
clinical manifestations after epiphyseal closure (stoppage of bone growth) |
|
Definition
| ENLARGEMENT OF HANDS AND FEET, JOINT PAIN, AND SOFT TISSUE/BONE INVOLVEMENT OF FACE |
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Term
Acromegaly
collaborative care - surgery - transsphenoidal hypophysectomy
hormone replacement needed |
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Definition
| SOMATROPIN (GENOTROPIN) - GH REPLACEMENT GIVEN SQ DAILY |
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Term
Acromegaly
assessment
abnormal tissue growth |
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Definition
| INCREASED HAT/RING/GLOVE/SHOE SIZE |
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Term
|
Definition
ELEVATE HOB 30 DEGREES
CHECK CLEAR DRAINAGE FOR GLUCOSE
NO BRUSHING TEETH FOR 10 DAYS |
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Term
|
Definition
syndrome of inappropriate antidiuretic hormone
too much ADH |
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Term
SIADH
collaborative management |
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Definition
DEMECLOCYLINE (DECLOMYCIN)
BLOCKS EFFECTS OF ADH ON RENAL TUBULES |
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Term
Diabetes Insipidus
primary or psychogenic |
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Definition
THIRST CENTER INVOLVEMENT OR PSYCH ISSUE, CAN BE TRAUMA RELATED
increased fluid intake r/t dry mouth, often due to medications used for mental disorders rather than underlying condition |
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Term
diabetes insipidus
clinical manifestations |
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Definition
POLYURIA AND POLYDYPSIA
MAY EXPERIENCE SLEEP DISTURBANCE |
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Term
graves disease
clinical manifestations
exophtalmos |
|
Definition
impaired drainage from orbit
increased fat and edema in retroorbital tissues
ELEVATE HOB TO RELIEVE EDEMA |
|
|
Term
graves disease
clinical manifestations
cardiovascular system |
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Definition
SYSTOLIC HYPERTENSION
increased cardiac output
atrial fibrillation - ASSESS FOR CHEST PAIN |
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Term
graves disease
complications
thyrotoxic crisis - treatment |
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Definition
IN AN EMERGENCY, TX BP FIRST, OTHER DRUGS TAKE LONGER TO ACT
decrease thyroid hormone levels and clinical manifestations with drug therapy |
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Term
graves disease
collaborative care
antithyroid drugs |
|
Definition
inhibit synthesis of thyroid hormone
IMPROVEMENT IN 1-2 WEEKS
GOOD RESULTS IN 4-8 WEEKS |
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Term
antithyroid drugs
first-line examples |
|
Definition
PROPYLTHIOURACIL (PTU)
also blocks conversion of T4 to T3 |
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Term
graves disease
collaborative care
BETA-ADRENERGIC BLOCKERS |
|
Definition
GIVE FIRST IN AN EMERGENCY
symptomatic relief of tyrotoxicosis resulting from beta-adrenergic receptor stimulation
PROPRANOLOL (INDERAL) administered with other antithyroid agents |
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Term
graves disease
collaborative care
radioactive iodine-131 therapy (RAI) |
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Definition
HIGH INCIDENCE OF POSTTREATMENT HYPOTHYROIDISM
TEACH PT S/S OF HYPOTHYROIDISM |
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Term
graves disease
surgical therapy
thyroidectomy - before surgery |
|
Definition
ANTITHYROID DRUS, IODINE AND BETA-ADRENERGIC BLOCKERS MAY BE ADMINISTERED
-TO ACHIEVE EUTHYROID STATE
-TO CONTROL SYMPTOMS
-DECREASE VASCULARITY AND SIZE OF THYROID |
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|
Term
graves disease
nursing management
acute intervention |
|
Definition
| ELEVATE HOB TO REDUCE EXOPHTHALMOS |
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Term
graves disease
thyroid surgery
post-op care |
|
Definition
every 2 hours for 24 hours
-assess for signs of hemorrhage
-ASSESS FOR TRACHEAL COMPRESSION (IRREGULAR BREATHING, NECK SWELLING, FREQUENT SWALLOWING, CHOKING) |
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|
Term
graves disease
radioactive iodine therapy
TEACH |
|
Definition
SYMPTOMS OF HYPOTHYROIDISM
seek medical help if symptoms occur |
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Term
hypothyroidism
diagnostic studies |
|
Definition
lab test SERUM TSH - DETERMINES CAUSE OF HYPOTHYROIDISM
TRH STIMULATION TEST |
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Term
|
Definition
increase in TSH after TRH injection suggests hypothalamic dysfunction
no change after TRH injection suggests anterior pituitary dysfunction |
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|
Term
hypothyroidism
collaborative care
drug therapy |
|
Definition
MONITOR FOR ANGINA AND CARDIAC DYSRHYTHMIAS
ESPECIALLY IN ELDERLY: INCREASE MYOCARDIAL DEMAND |
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Term
hypothyroidism
ambulatory and home care |
|
Definition
| explain nature of thyroid hormone deficiency and self-care practices to prevent complications |
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Term
hypothyroidism
PATIENT AND FAMILY MUST UNDERSTAND REPLACEMENT THERAPY AND THAT IT IS |
|
Definition
|
|
Term
hypothyroidism
patient teaching |
|
Definition
| PROVIDE HANDOUTS FOR PATIENTS AND FAMILY MEMBERS WITH VERBAL INSTRUCTIONS |
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Term
hypoparathyroidism
nursing and collaborative management |
|
Definition
| INSTRUCT PT ON NEED FOR ORAL CALCIUM |
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Term
| why hypoparathyroidism and hypocalcemia? |
|
Definition
parathyroid secretes PTH in response to low blood calcium level and then PTH increases blood calcium
hypoparathyroidism leads to hypocalcemia bc can't regulate calcium |
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|
Term
hypoparathyroidism
clinical manifestations |
|
Definition
| manifestations of hypocalcemia: tetany, Chvostek's sign (tapping over facial nerve causes tick), Trousseau's sign (inflating a blood pressure cuff around the arm causes a tetanic spasm of the wrist), circumoral paresthesias, prolonged QT interval |
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|
Term
cushing syndrome
clinical manifestations |
|
Definition
| PURPLISH RED STRIAE ON ABDOMEN, BREAST OR BUTTOCKS |
|
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Term
|
Definition
excess corticosteroids, particularly glucocorticoids
MC cause: iatrogenic administration of exogenous corticosteroids |
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|
Term
cushing syndrome
nursing diagnoses |
|
Definition
| DISTURBED SELF-ESTEEM RELATED TO ALTERED BODY IMAGE |
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Term
cushing syndrome
nursing implementation
EMOTIONAL SUPPORT |
|
Definition
PATIENT MAY FEEL UNATTRACTIVE OR UNWANTED
NURSING STAFF SHOULD REMAIN SENSITIVE TO PATIENT'S FEELINGS AND BE RESPECTFUL
REASSURE PATIENT PHYSICAL SYMPTOMS WILL RESOLVE WHEN HORMONE LEVELS RETURN TO NORMAL |
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Term
cushing syndrome
nursing implementation
postoperative care |
|
Definition
| BP, FLUID BALANCE AND ELECTROLYTE LEVELS TEND TO BE UNSTABLE BC OF HORMONE FLUCTUATIONS |
|
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Term
addison's disease
etiology/ patho |
|
Definition
| adrenocortical insufficiency - all three classes are decreased - glucocorticoids, mineralcorticoids, androgens |
|
|
Term
addison's disease
clinical manifestations |
|
Definition
|
|
Term
addison's disease
complications: addisonian crisis
triggered by |
|
Definition
| SUDDEN WITHDRAWAL OF CORTICOSTEROID REPLACEMENT THERAPY |
|
|
Term
addison's disease
diagnostic studies
abnormal lab findings |
|
Definition
HYPERKALEMIA
HYPOCHLOREMIA
HYPONATREMIA
HYPOGLYCEMIA |
|
|
Term
addison's disease
collaborative care
GLUCOCORTICOID DOSAGE |
|
Definition
| MUST BE INCREASED DURING TIMES OF STRESS TO PREVENT ADDISONIAN CRISIS |
|
|
Term
addison's disease
SITUATIONS REQUIRING CORTICOSTEROID DOSE ADJUSTMENT INCLUDE |
|
Definition
| FEVER, INFLUENZA, TOOTH EXTRACTION, PHYSICAL EXERTION |
|
|
Term
addison's disease
corticosteroid
DOSES |
|
Definition
| DOSES ARE DOUBLED FOR MINOR STRESSORS AND TRIPLED FOR MAJOR STRESSORS |
|
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Term
|
Definition
| MUST NOT BE STOPPED ABRUPTLY |
|
|
Term
hyperaldosteronism
etiology/patho |
|
Definition
excessive aldosterone secretion
SODIUM RETENTION
POTASSIUM
HYDROGEN ION EXCRETION |
|
|
Term
| hallmark of hyperaldosteronism |
|
Definition
| HYPERTENSION WITH HYPOKALEMIC ALKALOSIS |
|
|
Term
pheochromocytoma
clinical manifestations |
|
Definition
SEVERE, EPISODIC HYPERTENSION
SEVERE, POUNDING HEADACHE
TACHYCARDIA WITH PALPITATIONS
PROFUSE SWEATING
ABDOMINAL OR CHEST PAIN |
|
|
Term
pheochromocytoma
etiology/patho |
|
Definition
produces excessive catecholamines
results in severe hypertension |
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