Term
|
Definition
- pineal gland
- hypothalamus
- pituitary gland
- thyroid gland
- thymus
- pancreas
- adrenal glands
- testes
- ovaries |
|
|
Term
| pituitary gland - master gland |
|
Definition
anterior pituitary
posterior pituitary |
|
|
Term
|
Definition
|
|
Term
|
Definition
- vasopressin or antidiuretic hormone (ADH)
- oxytocin |
|
|
Term
|
Definition
- tumors
- anterior pituitary dysfunction
- diabetes insipidus |
|
|
Term
|
Definition
| o Gigantism – if onset in early life o Acromegaly – if onset in adulthood |
|
|
Term
| Anterior pituitary dysfunction |
|
Definition
| o Oversecretion of ACTH – Cushing’s syndrome o Oversecretion of GH – Acromegaly o Undersecretion of ACTH – Adrenocorticotropic hormone deficiency o Undersecretion of GH – dwarfism or achondroplasia |
|
|
Term
|
Definition
| o Deficiency of ADH or vasopressin. |
|
|
Term
| Dysfunctions of the pituitary gland txts |
|
Definition
Surgery – hypophysectomy
Radiation therapy
Hormone replacement therapy which can target:
• GH • TSH • ACTH • ADH
Bromocriptine mesylate (Parlodel) – used in conjunction with radiation
Antithyroid drugs |
|
|
Term
| A patient with diabetes insipidus will show signs of |
|
Definition
| electrolyte imbalance, Impaired urinary elimination, and deficient fluid volume |
|
|
Term
|
Definition
- An imbalance in the growth hormone (GH) causes acromegaly.
- Diabetes insipidus is caused by an imbalance in the Antidiuretic Hormone (ADH).
- An imbalance in the Adrenocorticotropic Hormone (ACTH) causes Cushing’s syndrome and
- a TSH disturbance causes thyroid dysfunction |
|
|
Term
|
Definition
- Growth hormone levels will be checked and an MRI will be done to determine the presence of a pituitary tumor.
- An ultrasound or CT scan may also be performed to determine any other organ involvement |
|
|
Term
| Two parts of the adrenal gland: |
|
Definition
| • Adrenal Medulla • Adrenal Cortex |
|
|
Term
| The adrenal cortex produces these steroid hormones: |
|
Definition
| • Glucocorticoids • Mineralcorticoids • Adrenal sex hormones |
|
|
Term
| Disorders of Adrenal Glands: |
|
Definition
| • Pheochromocytoma • Addison’s disease • Addisonian Crisis • Cushing’s Syndrome |
|
|
Term
|
Definition
| When adrenal cortex activity is insufficient to meet the body’s needs for cortisol, a condition arises |
|
|
Term
|
Definition
| The most common cause of this condition is corticosteroid therapy, which suppresses adrenal cortex function. It may also be caused by surgical removal or infection of the adrenal glands |
|
|
Term
| Clinical manifestations of Addison’s disease are |
|
Definition
- muscle weakness,
- anorexia,
- GI disturbances,
- emaciation,
- dark pigmentation of skin or mucous membranes,
- hypotension,
- hypoglycemia,
- hyponatremia, and
- hyperkalemia |
|
|
Term
|
Definition
| When adrenal cortex activity is excessive to meet the body’s needs for cortisol, a condition arises known as |
|
|
Term
| The most common causes of cushings are: |
|
Definition
| • use of corticosteroid medication • hyperplasia of adrenal cortex • pituitary tumor • malignancies |
|
|
Term
| Clinical manifestations of Cushing’s syndrome are |
|
Definition
- central obesity,
- thin extremities and a
- “buffalo hump” on the back of the neck. - There may also be muscle wasting, osteoporosis, hypernatremia, hyperglycemia or virilization of females.
- Sodium and water retention cause hypertension and heart failure
- impaired wound healing |
|
|
Term
|
Definition
| Although most cases are autoimmune in nature, tuberculosis should be considered since he is a recent immigrant |
|
|
Term
|
Definition
| The nurse will need to monitor the patient’s fluid status carefully, including weight, and encourage oral fluids. Addisonian crisis must be prevented. |
|
|
Term
|
Definition
- Pulse: 110 and slightly irregular
• Skin: Cool and moist to touch (due to diaphoresis)
- headaches
- nervousness |
|
|
Term
| dx tests for Pheochromocytoma |
|
Definition
- A 24-hour urine collection will be done;
- total plasma catecholamine levels,
- clonidine suppression test,
- imaging studies may also be performed |
|
|
Term
|
Definition
| This patient will need to have the adrenal gland removed and lifelong hormone replacement therapy may be necessary |
|
|
Term
| pt teaching for Pheochromocytoma |
|
Definition
| The RN will need to stress the need for compliance with the therapy and regular health monitoring, as the patient no longer has her adrenal glands. |
|
|
Term
|
Definition
• T3 • T4
• TSH – secreted by pituitary gland
- T3, T4, and TSH are regulated by the negative feedback response produced by the pituitary gland |
|
|
Term
|
Definition
• Hyperthyroidism
• Hypothyroidism
• Thyrotoxicosis
• Thyroid Tumors |
|
|
Term
| dx tests for thyroid disorders |
|
Definition
- blood and urine
- stimulation tests
- suppression tests
- imaging studies
- other tests |
|
|
Term
| blood and urine tests for thyroid disorders |
|
Definition
| TSH • Serum-free T4 • T3 and T4 • T4 resin uptake • Thyroid antibodies |
|
|
Term
| imaging studies tests for thyroid disorders |
|
Definition
. Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan
• Ultrasonography (Ultrasound)
• Positron emission tomography (PET) scan
• Dual energy x-ray (DEXA) scan |
|
|
Term
| other tests for thyroid disorders |
|
Definition
• Visual fields and central vision assessment
• Radioactive iodine uptake
• Fine-needle biopsy to determine if a nodule is cancerous
• Genetic screening to determine specific genes associated with endocrine disorders |
|
|
Term
|
Definition
- Brittle nails
- Cognitive changes
- dry skin
- Extreme fatigue
- Hair loss
- Weight gain
- common in women over 40 |
|
|
Term
|
Definition
- Amenorrhea
- Exophthalmos
- Flushed, moist skin
- Palpitations
- Tremor of hands
- Weight loss |
|
|
Term
| Patients with hypothyroidism will exhibit |
|
Definition
- activity intolerance,
- overweight and
- impaired skin integrity.
- They would not have evidence of a risk for aspiration or impaired verbal communication |
|
|
Term
|
Definition
| - Palpation of the thyroid gland is done, - serum levels of TSH, T3, and T4 may be ordered |
|
|
Term
| The RN will need to teach Pt with hypothyr that |
|
Definition
| she will need to take synthetic levothyroxine for the rest of her life and her levels will need regular monitoring via blood tests |
|
|
Term
|
Definition
Angela Leung, aged 58, is brought to the emergency department with
- an elevated blood pressure of 188/100,
- a pulse of 104, and
- respirations of 24.
- She is confused and disoriented
- Sodium: 135 mg per dL
- Potassium: 3.5 per mg dL
- Calcium: 12 mg per dL |
|
|
Term
| This condition may be caused by cancers or parathyroid dysfunction (besides hypercalcemia). If uncorrected, this may lead to a life-threatening hypercalcemic crisis |
|
Definition
an elevated blood pressure of 188/100,
- a pulse of 104, and
- respirations of 24.
- She is confused and disoriented
- Sodium: 135 mg per dL
- Potassium: 3.5 per mg dL
- Calcium: 12 mg per dL |
|
|
Term
| dx test for hypercalcemia |
|
Definition
| Since calcium levels are regulated by the parathyroid glands, a complete workup including assessment of hormonal levels and ultrasound or C T and M R I scans, would be indicated |
|
|
Term
| addl nursing assess for hypercal |
|
Definition
| The nurse should perform frequent neurological assessments to identify progressing dysfunction |
|
|
Term
| Parathyroid Gland Disorders |
|
Definition
- hyperparathyroidism
- hypo " |
|
|
Term
| Clinical manifestations of hyperparathyroidism |
|
Definition
| • Apathy • Fatigue • Kidney stones • Muscle weakness • Nausea & vomiting • Pancreatitis • Hypoparathyroidism |
|
|
Term
| Clinical manifestations of hypoparathyroidism |
|
Definition
• Bronchospasm • ECG changes • Hypocalcemia • Seizures • Tetany (latent or overt)
- photophobia |
|
|
Term
| Disorders of the pituitary gland include |
|
Definition
- pituitary tumors,
- anterior pituitary dysfunction that causes Cushing’s syndrome or acromegaly,
- diabetes insipidus.
- Pituitary disorders can be treated surgically or pharmacologically |
|
|
Term
|
Definition
| - located near the inferior part of the brain and consists of the anterior pituitary and the posterior pituitary. Each of these parts produces hormones, such as Thyroid-Stimulating Hormone (TSH) and Antidiuretic Hormone (ADH). |
|
|
Term
|
Definition
located on the upper portion of each kidney and consists of the adrenal medulla and the adrenal cortex.
- The adrenal gland produces epinephrine, norepinephrine, and various steroids such as glucocorticoids and adrenal sex hormones |
|
|
Term
| Disorders of the adrenal gland include |
|
Definition
Pheochromocytoma, Addison’s disease, Addisonian Crisis, and Cushing’s syndrome.
- Treatment includes pharmacological or surgical management |
|
|
Term
|
Definition
produces the T3 and T4 hormones that regulate metabolism in the body, assist in cell replication, and control normal growth and brain cell function.
-also secretes calcitonin, which helps to deposit calcium in the bones |
|
|
Term
| Disorders of the thyroid gland |
|
Definition
include hypothyroidism, hyperthyroidism, thyrotoxicosis, and thyroid tumors.
- Treatment includes pharmacological or surgical management. |
|
|
Term
|
Definition
located in the posterior of the thyroid gland and produce parathormone that regulates calcium and phosphorous.
- Disorders of the parathyroid glands include hyperparathyroidism and hypoparathyroidism |
|
|
Term
| drugs that act early in the nephron |
|
Definition
| are in a position to block the greatest amt of solute reabsorption and produce the greatest diuresis |
|
|
Term
|
Definition
- block Na and Cl reabsorption in the loop of Henle
- produces the greatest diuresis |
|
|
Term
| unlike thiazide diuretics, loop diuretics |
|
Definition
| are effective when GFR is low |
|
|
Term
|
Definition
|
|
Term
| loop diurs causing hypokalemia |
|
Definition
| a special problem in pts taking digoxin |
|
|
Term
|
Definition
- block Na and water reabsorption in the early convoluted tubule
- produce less diuresis than loops
- ineffective when GFR is low
- don't cause hearing loss |
|
|
Term
|
Definition
- blocks Na-K exchange in the distal convoluted tubule
- cause only modest diuresis
- used primarily to counteract K loss in pts taking loops or thiazides
- can cause hyperkalemia |
|
|
Term
|
Definition
- combining K-sparing diurs
- with each other
- or with K suppls
- ACE inhibitors
- ARBs
- direct renin inhibitors
- |
|
|
Term
| dehydration due to loop diurs can cause |
|
Definition
- thromboembolism
- monitor pt for s/s of (headache, chest pain, calve or pelvis pain) |
|
|
Term
|
Definition
- irregular heartbeat
- muscle weakness
- cramping
- flaccid paralysis
- leg discomfort
- extreme thirst
- confusion |
|
|
Term
|
Definition
- irregular heartbeat
- muscle weakness
- cramping
- flaccid paralysis
- leg discomfort
- extreme thirst
- confusion |
|
|
Term
| steroid hormones produced by the adrenal cortex |
|
Definition
- glucocorticoids
- mineralocorticoids
- androgens |
|
|
Term
|
Definition
influences the metabolism of carbs, proteins, and fats
- they affect skeletal muscle, the cardiovascular system, and the CNS |
|
|
Term
| synthesis and release of glucocorticoids is regulated by |
|
Definition
- a neg feedback loop involving CRH from the hypothalamus
- ACTH from the pituitary
- cortisol from the adrenal cortex |
|
|
Term
|
Definition
- the major mineralocorticoid
- acts on the kidneys to promote retention of Na and H2O and excretion of K and H
- acts directly on the heart and vessels, causing harm when its levels are high |
|
|
Term
|
Definition
| caused by glucocorticoid excess |
|
|
Term
| the principal txt of Cushing's |
|
Definition
- removal of the adrenals (if adrenal adenoma or carcinoma is the cause)
- removal of part of the pituitary (if pituitary adenoma is the cause) |
|
|
Term
|
Definition
|
|
Term
| adrenal insufficiency treated by |
|
Definition
- replacement therapy with glucocorticoids (eg, hydrocortisone)
- fludocortisone, a pure mineralocorticoid, may be added if the mineralocorticoid actions of hydrocortisone are inadequate |
|
|
Term
| Glucocorticoid replacement therapy |
|
Definition
- give entire dose in am or
- give 2/3 in am and 1/3 in the afternoon |
|
|
Term
| in pts with adrenal insufficiency |
|
Definition
- it's essential to inc glucocorticoid doses at times of stress (eg, surgery or infection)
- failure to do so can be fatal |
|
|
Term
|
Definition
| when used chronically, in high doses needed to txt nonendocrine diseases (eg, arthritis), it can cause severe adverse effects |
|
|
Term
|
Definition
| acts like ACTH, is used only for dx of adrenal insufficiency - not for txt |
|
|
Term
|
Definition
| in time of stress (eg, infection, surgery, trauma). applies to gluco dosage |
|
|
