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Endocrine,Thyroid,Diabetes
Med Surg Nursing Review
132
Medical
Undergraduate 1
04/29/2009

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Term
Pancreas
Definition
secrets digestive enzymes and releases insulin and glucagon into the bloodstream
Term
Hypothalamus
Definition
regulates temp, fluid volume and growth
Term
Pituitary
Definition
Master Gland
Term
Adrenal cortex
Definition
produces corticosteroids
Term
Iodine
Definition
necessary for the proper functioning of the thyroid
Term
Islets of Langerhans
Definition
produces insulin
Term
Epinephrine
Definition
a counter regulatory hormone
Term
Parathyroid
Definition
increases calcium blood levels
Term
Thyroid
Definition
reduces excess calcium in the blood
Term
adrenal medulla
Definition
produces hormones known as catecholamine's
Term
Disorders of the anterior pituitary gland
Definition
1. Hyperpituitarism
2. prolactinemia
3. Giantism
4. Acromegaly
5. Hypopitutuitarism
6. Dwarfism
Term
Hyperpituitarism
Definition
hyperfunction of the pituitary gland
Term
prolactinemia
Definition
abnormal lactation
Term
giantism
Definition
excess secretion of GH before puberty and the closure of the epiphyseal plates
Term
acromegaly
Definition
enlargement of bones and connectiv tissues
Term
hypopitutuitarism
Definition
hypofunction of the anterior pituitary gland
Term
Dwarfism
Definition
inadequate production of GH during childhood
Term
disorders of the posterior pituitary
Definition
1. Diabetes insipidus
2. SIADH
Term
Diabetes insipidus
Definition
results from ADH (vasopressin) insufficiency.
Term
diabetes insipidus causes:
Definition
massive dieresis, dehydration and thirst
Term
s/s of diabetes insipidus
Definition
malaise, lethargy, irritibility
Term
SIADH
Definition
(syndrome of inappropriate antidiuretic hormone) Excess production of ADH
Term
s/s of SIADH
Definition
HTN, hyponatremia, water retention, weakness, muscle cramps, anorexia, nausea, diarrhea, weight gain and edema
Term
Disorders of the adrenal gland
Definition
1. Cushing's syndrome
2. addison's disease
Term
cushing's syndrome
Definition
adrenal hyperfunction/ adrenal cortex produces excessive amounts of the hormone cortisol
Term
s/s of cushing's disease
Definition
truncal obesity, protein wasting, facial fullness, purple striae on abd, osteoporosis, hypokalemia
Term
addison's disease
Definition
adrenal hypofunction; adrenal cortex insufficiency
Term
s/s of addison's disease
Definition
Term
diseases of the adrenal medulla
Definition
1. pheochromocytoma
Term
pheochromocytoma
Definition
a benign tumor which erratically produces excessive amounts of catecholamines which stimulates the sympathetic nervous system
Term
s/s of pheochromocytoma
Definition
classic HTN, severe pounding headache, diaphoresis
Term
Diseases of the thyroid gland
Definition
1. hyperthyroidism
2. graves disease
3. thyrotoxic crisis (thyroid storm)
4. hypothyroidism
5. myxedema
6. cretinism
7. goiter
8. thyroid cancer
Term
hyperthyroidism
Definition
excess production of the thyroid hormone
Term
s/s of hypertyroidism
Definition
early wt loss, nervousness, restlessness, irritable behavior, sleep disturbances, poor tolerance to heat and excessive perspiration
Term
grave's disease
Definition
autoimmune disorder, increased production of TH results in a characteristic enlargement of the thyroid gland
Term
thyrotoxic crisis
Definition
(thyroid storm); an estrem state of hyperthyroidism
Term
s/s of thyroid storm
Definition
dangerous tachycardia and hyperthermia
Term
hypothyroidism
Definition
thyroid gland produces an insufficient amount of TH
Term
s/s of hypothyroidism
Definition
swelling of lips, dry/thick skin, wt gain with decreased intake, lethargy, forgetfulness,intolerance to cold, slow pulse, irritable
Term
myxedema
Definition
facial edema that develops with severe, longterm hypothyroidism
Term
cretinism
Definition
hypothyroidism during infancy; if not treated, may lead to permanent retardation of physical and mental development
Term
goiter
Definition
when TH production decreases, the thyroid gland enlarges in an attempt to produce more hormone
Term
disorders of the parathyroid glands
Definition
1. hyperparathyroidism
2. hypoparathyroidism
Term
hyperparathyroidism
Definition
increased secretion of parathyroid hormone (PTH)= regulates normal serum levels of calcium
Term
s/s of hyperparathyroidism
Definition
weakness, lethargy, depression, anorexia, increased calcium, decreased phosporus
Term
hypoparathyroidism
Definition
inadequate secretion of PTH; causes hypocalcemia and an elevated blood phosphate level
Term
s/s of hypoparathyroidism
Definition
decreased calcium
Term
Diabetes mellitus
Definition
due to an insufficient supply of insulin, ineffective insulin action or both
Term
Types of diabetes
Definition
Type 1: results from an autoimmune response; destroys beta cells of the islets of Langerhans in the pancreas. End result is that insulin is no longer produced
Type 2: due to insufficient insulin production and insulin resistance
Term
Acute complications of DM
Definition
1. acute hypoglycemia
2. diabetic ketoacidosis
3. hyperglycemic hyperosmolar nonketotic syndrome (HHNKS)
Term
acute hypoglycemia
Definition
a dangerous drop in blood glucose secondary to taking too much insulin, not eating enough food or not eating at the right time, and an inconsistent pattern of exercise
Term
diabetic ketoacidosis (DKA)
Definition
1. occurs in type 1 diabetes
2. characterized by hyperglycemia, dehydration and coma
3. early s/s: anorexia, headache, and fatigue
4. As progresses, the classic symptoms of poldipsia, polyuria, and polyphagia develop
5. If goes untreated, pt becomes dehydrated, weak and lethargic with abd pain, n/v, fruity breah, increased respiration, tachycardia, blurred vision, and hypothermia
6. Late signs: kussmaul's respirations which are rapid and deep. Formation of ketones
Term
HHNKS
Definition
(hyperglycemic hyperosmoler Nonketotic syndrome); occurs in type 2 diabetes.
2. characterized by severely elevated blood glucose levels (>600), extreme dehydration and an altered LOC.
3. There is no evidence of elevated ketones
Term
chronic complications of DM
Definition
1. microvascular
2. macrovascular
3. neuropathic
4. hypoglycemic unawareness
5. foot complications of DM
Term
microvascular
Definition
retinopathy, nephropathy
Term
macrovascular
Definition
atherosclerotic plaque, atherosclerosis affecting the peripheral, carotid, cerebral and coronary blood supply. Other risk factors include central obesity, hyperlipidemia, HTN, genetics, sedentary lifestyle and smoking
Term
neuropathic
Definition
neuropathy
Term
hypoglycemic unawareness:
Definition
the usual symptoms of tachycardia, palpitations, tremor, sweating, and nervousness may be absent. Without this "early warning system" the pt may have changes in teh mental status as the first sign of hypoglycemia
Term
foot complications of DM
Definition
mechanical irritation, thermal injury, chemical irritation
Term
hypoglycemia
Definition
when the blood glucose falls to <45-50 mg/dl. May occur if there are abnormalities in these regulators: insulin levels, available glucagon, and the secretion of catecholamines, GH, and cortisol.
Term
exophthalmos:
Definition
protrusion of the eyeballs associated with hyperthyroidism
Term
chvostek's sign
Definition
spasm of the facial muscle when the facial nerve is tapped. Indicative of hypocalemia
Term
Laryngospasm
Definition
a closure of the larnyx that blocks the passage of air to the lungs
Term
Tetany
Definition
muscle twitching, cramps, seizures: associated with calcium defiency
Term
trousseau's sign
Definition
upper arm compression causes carpal spasm. Latent stage of tetany
Term
endogenous:
Definition
internally produced or caused by internal factors
Term
exogenous
Definition
developed outside the organism
Term
nephropathy
Definition
kidney disease
Term
neuropathy
Definition
pathologic changes in teh peripheral nervous system
Term
retinopathy
Definition
disease of the retina that can result in loss of vision
Term
polydipsia
Definition
excessive thirst
Term
polyphagia
Definition
excessive hunger
Term
polyuria
Definition
excessive urine output
Term
gynecomastia
Definition
excessive development of breasts in males
Term
hirsutism
Definition
excessive facial hair growth in woman
Term
somogyi phenomenon
Definition
nocturnal hypoglycemia rebound that causes high glucose in the morning
Term
dawn phenomenon
Definition
an increase in the blood sugar in the morning and is typically invoked in the context of diabetes. It is different from Chronic Somogyi rebound in that dawn effect is not associated with nocturnal hypoglycemia
Term
How to mix/adm insulin
Definition
Term
kinds of insulin
Definition
Term
types of oral hypoglycemia agents
Definition
Term
what is Hgb AIC?
Definition
Term
Target blood fat levels for people with diabetes
Definition
1. Total cholesterol: below 200
2. LDL cholesterol (lethal): below 100
3. HDL cholesterol (healthy): above 40 (men); above 50 (women)
4. triglycerides: below 150
Term
hyperpituitarism:Hormone Involved
Definition
GH
Term
hyperpituitarism (anterior pituitary): S/S
Definition
1. Gigantism
2. Acromegaly
Term
Gigantism:
Definition
1. before growth plates close
2. growth up to 8 ft, and wt of over 300 lbs
Term
Acromegaly:
Definition
1. after growth plates close
2. Appears in 40s or 50s
3. bones get thicker and wider, HA, visual problems, enlargement of hands and feet, enlarged tongue/liver/spleen;
Term
hyperpituitarism diagonsis:
Definition
1. GH and prolactn levels checked
2. Acromegaly: glucose tolerance tet. Glucose remains unchanged.
Term
sandostatin
Definition
1. treats hyperpituitarism
2. given 3x a wk SQ
3. suppresses insulin secretion
4. Accuchecks must be monitored
5. monitor BP and wt for fluid retention
Term
treatment for hyperpituitarism
Definition
1. sandostalin
2. somavert
Term
somavert
Definition
a GH receptor antagonist, used after radiotherapy
Term
hypopituitarism (anterior pituitary): Hormone involved
Definition
GH
Term
s/s of hypopituitarism
Definition
dwarfism: max ht that is 40% below normal
Term
diagnosis of hypopituitarism
Definition
1. CT scans
2. GH levels
3. Health History
4. assessment
5. cerebral angiography
Term
treatment for hypopituitarism
Definition
hormones are replaced
Term
Diabetes insipidus: Hormones involved
Definition
ADH--vasopressin
Term
diagnosing diabetes insipidus:
Definition
inital diagnosis is based on 24 hr urine output of greater than 4 liters, without food or fluid restrictions. Health hx, exam and lab findings, patient may have had recent surgery, infection, injury of med ingestion.
Term
treatment: Diabetes insipidus
Definition
control s/s of disease and reverse cause of the syndrome.
Vasopressors to maintain B/P
Hormone replacement therapy (DDAVP)
Iv fluids, soium restrictions and thiazide diuretic
Term
SIADH (syndrome of inappropriate antidiuretic hormone): Hormone involved
Definition
ADH-vasopressin
Term
SIADH: S/s
Definition
1. water retention
2. increased b/p
3. hyponateremia
4. weakness
5.muscle cramps
6. anorexia
7. nausea and diarrhea
8. irritability
9. HA
10. wt gain without edema
11. decreased LOC leading to seizures and coma
Term
SIADH: Treatment
Definition
aimed at the cause.
fluid restriction
strict I&O
Teaching important
Term
SIADH: Diagnosis
Definition
1. serum and urine electrolytes and osmolality
2. urine osmolality is much higher than that of serum, indicating SIADH.
3. Serum is dilute and urine is concentrated.
Term
Adrenal hypofunction (Addison's disease): Hormones involved:
Definition
cortisol and aldostrone
Term
Addison's disease: s/s
Definition
1. elevated BUN
2. irritablity
3. anorexia
4. wt loss
5. N&V
6. metabolic acidosis
7. unexplained abd pain
8. malaise
9. decrease o loss of body, axillary and pubic hair
Term
addison's disease: diagnosis
Definition
. Low serum and urine cortisol level
decreased fasting glucose
hyponatremia
hyperkalemia
24 hour steroid excretions test
serum ACTH levels
Term
addison's disease: treatment
Definition
replacement therapy of glucocorticoids and mineralocorticoids
Term
Acute Adrenal Crisis (addisonian Crisis): S/S
Definition
caused by sudden decrease in adrenal hormones: hypotension, tachycardia, dehydration, confusion, hyponatremia, hypecalcemia, hypoglycemia
Term
Acute Rental Crisis: Diagnosis
Definition
CBC
BUN
plasma cortisol levels
Term
addisonian Crisis: TREATMENT
Definition
Intial dose of SoluCortef IV push followed by infusion over 8 hrs, hydrocortison IM every 12 hrs. After crisis is resolved; oral glucocorticoids are tapered
Term
Cushing's Disease (adrenal hypersecretion): hormones involved
Definition
Cortisol
Term
Cushing's disease: S?S
Definition
Hallmark findings: trunk obesity, protein wasting, moon face, purple striae on abd, breasts, buttocks, or thighs; osteoporosis, hypokalemia, red face, HTN, excessive hair
Term
Cushing's disease: Diagnosis
Definition
1. physical s/s
2. 24 hr urine for free cortisol levels
3. low dose dexamethasone suppression test
4. hypokalemia
5. hypernatremia
6. hyperglycemia
7. leukocytosis
8. glycosuria
9. hypocalcemi
10. elevate plasma corisol
Term
Cushing's disease:treatment
Definition
Drug, radiation and surgery
Nizoral or metopirone
Term
Pheochromocytoma (benign turmor on the adrenal medulla: Hormones involved
Definition
epinephrine and norepinephrine
Term
Pheochromoytoma: S/S
Definition
1. HTN
2. Hypermetabolism
3. hyperglycemia
4. profuse sweating
5. diaphorisis
6. pounding HA
Term
Pheochromocytoma: Diagnosis
Definition
CT scan
Term
Pheochromocytoma: Treatment
Definition
removal of tumor,
monitor for signs of adrenal crisis
Term
Hyperthyroidism:Hormones involved:
Definition
TSH
T3
T4
Term
Hyperthyroidism: S?S
Definition
Grave's disease
wt loss
nervousness
restlessness
irritable behavior
sleep disturbances
hair loss and fatige
poor tolerance to heat
excessive perspiration
Term
hyperthyroidism: Diagnosis
Definition
TSH and T4 levels
Term
hyperthyroidism: Treatment
Definition
Drug therapy
radiation
surgery
Antithyroid drugs--thionamides, iodides (lugo's solution)
Term
hyperthyroidism: IF patient has surgery to have thyroid removed, monitor for WHAT?
Definition
bleeding behind the neck, watch for changes in voice, restlessness and KEEP A TRACH KIT AT BEDSIDE.
Monitor for tetany in case the parathyroid gland was damaged during surgery
Term
hypothyroidism: Hormones involved:
Definition
TSH
T4
Term
hypothyroidism: S/S
Definition
gradual onset
wt gain
metabolic rate slow
lethargy
forgetfullness
irritability
freqeuent HA
constipation
intolerance to cold
slow pulse
dyspnea
swelling of the lips
nonpitting edema
thick skin
thin coarse hair and hoarsenes
Term
hypothyroidism: Treatment
Definition
if untreated may lead to myxedema coma.
Hormone replacement therapy
synthroid
Cytomel for life
monitor for chest pain
Term
Hyperparathyroidism: Hormone involved
Definition
Paraythyroid hormone
Term
Hyperparathyroidism: S/S
Definition
hypercalcemia
fx's
urinary calculi
weakness
lethargy
depression
anorexia
constipation
wt loss
cardia dyshythmias
Term
hyperparathyroidism: Diagnosis
Definition
serum calcium
serum phosphate
PTH
24 hr urine calcium
CT
MRI
needle aspiration
Term
hyperparathyroidism: Treatment
Definition
high fluid intake
calcium restriction
sodium and phosphorus replacement therapy
Calcitonin
Lasix
Propranolol
Term
hypoparathyroidism: hormones involved
Definition
parathyroid hormone
Term
Hypoparathyroidism: S?S
Definition
hypocalceima with painful muscle cramps, fatigue, weakness, tingling and twitching of the face and hands, mental and emotional changes.
Term
hypoparathyroidism: Diagnosis
Definition
s/s
low serum calcium
high serum phosphate
low urine calcium
Chvostek's sign
Trousseau's sign
Term
hypoparathyroidism:Treatment
Definition
Acute is treated with parenteral PTH
Oral calcium salts and Vit D
Monitor for seizure activity when giving
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