Chapter 41 and 42 Flashcards


Set Details Share
created 4 years ago by charleejo
1,470 views
updated 4 years ago by charleejo
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:

1

hyposecretion of hormones from anterior pituitary gland; deficiency of one of the anterior pituitary hormones results in changes in metabolic or sexual function

hypopituitarism

2

in children before the closure of the epiphyses, ______ (small stature) develops

dwarfism

3

a lack of GH in adults does not affect bone length, but does affect bone

density and osteoporosis may develop

4

clinical manifestations of decreased glucocorticoids associated with hypopituitarism?

  • hypoglycemia
  • decreased cortisol levels
  • decreased ability to handle stress

5

clinical manifestations of decreased mineralocorticoids associated with hypopituitarism?

  • hyponatremia
  • hypotension
  • hyperkalemia

6

clinical manifestations of growth hormone associated with hypopituitarism?

  • decreased bone density
  • decreased muscle strength
  • increased risk of bone fractures

7

clinical manifestations of thyroid-stimulating hormone (TSH) associated with hypopituitarism?

think decreased levels of T3 and T4

  • decreased metabolic rate
  • weight gain
  • thinning of hair
  • decreased libido

8

aldosterone controls?

Na+ and water

9

lack of ACTH with a resultant decrease in glucocorticoids and mineralocorticoids is a life-threatening emergency because the pt is unable to maintain adequate fluid volume status, which may lead to circulatory collapse

panhypopituitarism

10

what do pt's VS look like with hypopituitarism?

  • hypotensive
  • tachycardia

11

what must we teach our patients about taking hormone at home?

taking hormone supplements in the morning mimics the normal release of these hormones

12

hypersecretion of hormones from anterior pituitary gland; usually related to a hypersecreting tumor

hyperpituitarism

13

in children before the closure of the epiphyses, _____ (large stature) develops

gigantism

14

an excess of GH in adults does not affect bone length because of closure of the epiphyses but does affect bone density, and ______ (thickening of bones, particularly of the hands, feet, and facial bones) may develop

acromegaly

15

clinical manifestations of increased glucocorticoids associated with hyperpituitarism?

  • hyperglycemia
  • increased cortisol levels

16

clinical manifestations of increased mineralocorticoids associated with hyperpituitarism?

  • hypernatremia
  • hypertension
  • hypokalemia

17

clinical manifestations of GH associated with hyperpituitarism?

  • increased bone density
  • coarse facial features
  • mensural irregularities

18

clinical manifestations of thyroid-stimulating hormone (TSH) associated with hyperpituitarism?

think increased T3 and T4

  • increased metabolic rate
  • weight loss
  • exopthalmos

19

vital signs with hyperpituitarism?

  • HTN
  • think FVE: SOB, peripheral edema, crackles, dyspnea
  • increased heart rate

20

review nursing interventions for a pt after transphenoidal hypophysectomy

pt 925

21

A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect to find during assessment? Select all that apply.

A. Loss of color discrimination

B. Coarse facial features

C. Enlarged distal extremities

D. Hepatomegaly

E. Moon face

A, B, C, D

22

where are your adrenal glands located?

on top of each kidney

23

the adrenal cortex secretes?

  • glucocorticoids (cortisol)
  • mineralocorticoids (aldosterone)
  • sex hormones (androgens and estrogens)

24

primary glucocorticoid and its actions include carbohydrate, fat, and protein metabolism; suppression of the immune response; and control of the body's stress response

cortisol

25

primary mineralocorticoid, and its primary actions are to promote sodium and water reabsorption and potassium excretion in the kidneys?

aldosterone

26

what happens if exogenous corticosteroids are discontinued abruptly?

Addisonian crisis (acute adrenal crisis)

27

adrenal insufficiency that may result from destruction of the adrenal glands or insufficiency or Addison's disease

adrenal cortical insufficiency

28

adrenal cortical insufficiency (Addison's crisis) is a decrease/increase in glucocorticoids and mineralocorticoids

decrease

29

patients presenting with acute adrenal insufficiency require emergency stabilization with IV fluids and glucose, along with IV administration of glucocorticoids

***

30

clinical manifestations of adrenal cortical insufficiency/Addison's crisis?

  • decrease in cortisol and aldosterone
  • bronzed hyperpigmentation R/T ^ MSH
  • weakness
  • weight loss
  • fatigue
  • nausea
  • abd pain
  • gastroenteritis
  • emotional lability
  • decrease in pubic and axillary hair
  • dehydration and hypotension

31

what is our volume like in adrenal cortical insufficiency/Addison's crisis?

FVD

  • high K+
  • low Na+ and water
  • low BS
  • low BP

32

what replacement is necessary for adrenal insufficiency?

replacement of cortisol

33

The nurse correlates which clinical manifestation with the pathophysiology of adrenal insufficiency?

A. Heat intolerance

B. Weight gain

C. Peripheral edema

D. Hypoglycemia

D. Hypoglycemia

34

A patient has been receiving doses of prednisone for treatment of RA for the past 3 months. If this medication is suddenly discontinued, for which complication is the patient at risk?

A. Hypovolemia

B. Hypernatremia

C. Hypothermia

D. Hyperglycemia

A. Hypovolemia

35

adrenal cortex disorder in which there is an excessive secretion of glucocorticoids and mineralocorticoids

adrenal cortex hyperfunction; Cushing's

36

clinical manifestations of adrenal cortex hyperfunction/Cushing's?

  • emotional disturbance
  • enlarged sells turcica
  • moon face
  • buffalo hump
  • cardiac hypertrophy (HTN)
  • osteoporosis
  • breast atrophy
  • adrenal tumor or hyperplasia
  • obesity
  • abd striae
  • thin, wrinkled skin
  • amenorrhea
  • decreased muscle mass
  • purpura
  • skin ulcers (poor wound healing)
  • decreased inflammatory and immune responses

37

clinical manifestations of adrenal cortex hyperfunction/Cushing's related to overproduction of cortisol?

decreased inflammatory and immune responses

38

what is our fluid like in adrenal cortex hyperfunction/Cushing's?

FVE

  • SOB
  • crackles
  • peripheral edema
  • dyspnea
  • decreased UOP
  • HTN
  • increased heart rate

39

safety alert

pg 938

40

what are the electrolytes and BS doing in adrenal cortex hyperfunction/Cushing's?

  • increased BS
  • increased Na+ and water
  • decreased K+

41

patients who have an adrenalectomy are at risk for?

Addison's; will need steroids

42

possible complications from adrenal cortex hyperfunction/Cushing's?

  • osteoporosis
  • adrenal crisis- w/ abrupt withdrawal of corticosteroid
  • elevated BG
  • GI bleeding
  • uncontrolled HTN
  • cardiac dysrhythmias

43

rare catecholamine secreting tumors of the adrenal medulla; secrete epi and norepi

pheochromocytoma

44

clinical manifestations of pheochromocytoma?

  • tachycardia
  • HTN
  • headaches
  • palpitations
  • hyperhydrosis
  • hypermatabolism
  • hyperglycemia

45

treatment for pheochromocytoma?

adrenalectomy is the definitive treatment

46

vital signs in pheochromocytoma?

  • extremely high BP
  • tachycardia

47

pheochromocytoma is/is not life threatening

is life threatening

48

what is important to remember about the morning of adrenalectomy?

administer glucocorticoid to avoid adrenal insufficiency

49

A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make?

A. It is caused by the lack of production of insulin by the pancreas.

B. It is caused by the lack of production of aldosterone by the adrenal gland.

C. It is caused by the overproduction of growth hormone by the pituitary gland.

D. It is caused by the overproduction of parathormone by the parathyroid gland.

B. It is caused by the lack of production of aldosterone by the adrenal gland.

50

A nurse is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should the nurse include in the teaching?

A. Limit intake of potassium-rich foods

B. Restrict sodium intake

C. Increase carbohydrate intake

D. Decrease protein intake

B. Restrict sodium intake

51

A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? (Select all that apply.)

A. Alopecia

B. Tremors

C. Moon face

D. Purple striations

E. Buffalo hump

A, C, D, E

52

A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect?

A. Hyperpigmentation

B. Intention tremors

C. Hirsutism

D. Purple striations

A. Hyperpigmentation

53

A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortiolism?

A. A client who has a butterfly rash on his face

B. Moon face

C. A client who has a positive Chvostek's sign

D. A client who has muscle hypertrophy

B. Moon face