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Viewing:

endocrine----exam 2

front 1

pituitary gland

back 1

master gland

front 2

anterior pituitary gland

back 2

  • Prolactin
  • adrenocorticotropic hormone (ACTH)
  • growth hormone (GH)
  • Thyroid stimulating hormone (TSH)
  • follicle-stimulating hormone (FSH)
  • luteinizing hormone (LH)

front 3

posterior pituitary gland

back 3

  • anti-diuretic hormone (ADH)
  • oxytocin

front 4

disorders of the pituitary gland can include what?

back 4

tumors

hypofunction

hyperfunction

damage to gland

trauma

front 5

what are pituitary tumors described as?

back 5

benign pituitary adenoma.

  • slow growing
  • unclear etiology

front 6

signs and symptoms can be local or systemic for pituitary glands

Local symptoms

back 6

  • headache
  • visual disturbances with possible blindness

front 7

signs and symptoms can be local or systemic for pituitary glands

systemic symptoms

back 7

  • vague and slow to process
  • personality changes
  • weakness
  • fatigue

front 8

pituitary gland :

diagnosis

back 8

  • complete history and physical exam
  • MRI
  • CT with contrast dye
  • labs
  • Ophthamlmologic exam

front 9

treatment for pituitary glands

back 9

  • hormone therapy
  • radiation
  • surgery-transsphenoidal hypophysectomy

front 10

Hypophysectomy

post op and nursing care

back 10

  • semi-folwers
  • monitor vital sings closely
  • through and frequent neuro checks: LOC, strength, visual changes, and mental status
  • monitor for bleeding
  • nasal drip pad will be placed: monitor the drainage-should be bloody/mucus

front 11

hyper function of the anterior pituitary gland: Acromegaly

back 11

  • over secretion of growth hormone (GH)
  • increase in bone size
  • enlargement of facial features, hands, and feet

front 12

hyper function of anterior pituitary gland: gigantism

back 12

over secretion of GH in children

front 13

hyperfunction of anterior pituitary gland: Prolactin and gonadotropin (FSH&LH) hyper function

back 13

fertility issues

front 14

S/S of acromegaly

back 14

  • change in ring size
  • change in shoe size
  • enlargement of nose, jaw, brow, hands, feet
  • muscle weakness and joint pain

front 15

diagnosis for acromegaly

back 15

lab tests-hormone levels

front 16

acromegaly treatment

back 16

  • aimed at cause
  • medications
  • hypophysectomy
  • radiation

front 17

Sheehan syndrome

back 17

rare but serious postpartum hemorrhage

front 18

what does a decrease in growth hormones cause?

back 18

  • leads to short stature
  • results in bone breakdown and increased risk of osteoporosis
  • metabolic problems

front 19

decrease in gonadotropins (FSH,LH)

back 19

  • sexual dysfunction
  • fertility problems
  • testicular failure in men
  • ovarian failure, amenorrhea in women

front 20

dwarfism

back 20

hypo secretion of GH during fetal development or childhood

  • results in limited growth- congenital or from damage to the pituitary gland

front 21

posterior pituitary gland

back 21

  • diabetes indipidus (DI)- decreased antidiuretic hormone (ADH)
  • syndrome of inappropriate antidiuretic hormone (SIADH)- increased ADH

front 22

diabetes insipidus

(DI)

ETIOLOGY AND PATH.

back 22

  • decrease production of antidiuretic hormone (ADH)
  • excretion of copious amounts of urine

front 23

diabetes insipidus (DI)

signs and symptoms

back 23

  • diuresis
  • polydipsia
  • weakness/fatigue
  • sings of deficient fluid volume
  • hypotension
  • weight loss
  • constipation
  • poor skin tugor
  • can lead to shock if untreated

front 24

diagnosis for DI

back 24

  • h&p
  • lab testing (CBC, CMP)
  • urine specific gravity- low urine osomality, low specific gravity--> urine diluted
  • plasma osmolality
  • hyperosmolitiy- decreased water volume in the blood
  • CT/MRI- check for tumor
  • water deprivation test

front 25

DI

water deprivation test

back 25

used to determine whether the patient has DI

-test measures changes in body weight, urine output, and urine composition when fluids are withheld

front 26

treatment for DI

back 26

replacement of fluid and electrolytes

hormone therapy

front 27

SIADH

etiology and path

back 27

  • opposite of DI
  • excessive amounts of ADH produced
  • fluid retention
  • can be caused by a tumor

front 28

SIADH

S/S

back 28

  • weight gain from water retention
  • edema
  • hyponatremia- can be less than 120 mEq/L
  • decreased urine output
  • high BP
  • confusion
  • seizures
  • LOS
  • muscle cramps and weakness

front 29

SIADH

Diagnosis

back 29

  • simultaneous urine and serum osmolality tests- urine high, blood low
  • CMP
  • hyponatermia
  • BUN decreased
  • creatine clearance decreased
  • CBC
  • hgb and hct decreased

front 30

SIADH

treatment

back 30

  • correct underlying cause
  • fluid restrictions (500-1000ml/day)
  • sodium chloride po
  • diuretics

front 31

the thyroid gland secretes what?

back 31

triiodothyronine (T3), thyroxine (T4), and calcitonin

front 32

goiter

back 32

  • enlarged thyroid gland
  • can be caused by iodine deficiency
  • most common cause is an increase in TSH from lack of thyroid hormone production

front 33

S/S of goiter

back 33

  • enlargement in front of neck.
  • difficulty swallowing/breathing

front 34

hyperthyroidism

E&PATH

back 34

  • overactive thyroid

front 35

graves disease

E&path

back 35

  • autoimmune disorder affecting the thyroid gland
  • causes hyperthyroidism
  • immune system attacks the thyroid and causes it to make more

front 36

graves disease

S/S

back 36

  • enlarged thyroid gland
  • bulged eyes
  • mood swings
  • heat insensitivity
  • anxiety
  • temors

front 37

hyperthyroidism

S/S

back 37

  • weight loss despite a good appetite
  • nervousness/ anxiety/tremors/agitation
  • tachycardia, palpations
  • insomnia
  • increased thirst and increased urination

front 38

hyperthyroidism-

radioactive iodine (ablation therapy)

back 38

  • given orally
  • destroys thyroid tissue
  • collects in the thyroid and destroys the gland and cells with little effect on the rest of the body
  • monitor for thyroid storm/ thyroid crisis

front 39

subtotal thyroidectomy

back 39

only a portion removed, so the remaining portion can still make hormones

front 40

total thryoidectomy

back 40

entire thyroid gland removed

thyroid malignancy

front 41

hyerpthyrpoidism

thyroidectomy pre-op care

back 41

  • thorough assessment and baseline vital signs
  • EKG, CXR, labs
  • IV access

front 42

thyroidectomy post op care

back 42

  • high fowlers portion for breathing and education of swelling
  • keep head in neutral position to relieve tension
  • do NOT hyperextend neck
  • continuous vital sings - any increase in TPR/BP should be reported immediately

front 43

thyroid storm

AKA thyrotoxic crisis or thyrotoxicosis

back 43

SEVERE hyperthyroid state

  • can result in death in as little as 2 hours
  • can occur in patients with hyperthyroidism who are expecting another stressor/illness, or after thyroid surgery

front 44

thyroid storm

S/S

back 44

  • hyperthyroid state symptoms
  • apprehension, anxiety, restlessness
  • Tachycardia
  • tachypnea
  • hypertension
  • severly high temp- up to 106 degrees
  • MONIOT VITAL SIGNS CONTINOUSLY AND CLOSELY

front 45

tREAMENT for thyroid storm

back 45

MUST BE IMMEDIATE

  • reduced temp
  • cooling blankets
  • acetaminophen
  • slow heart rate with cardiac medications
  • administer sedatives to reduce anxiety, agitation, and restlessness

front 46

hypothyroidism

S/S

back 46

  • weight gain
  • joint pain
  • slow HR
  • fertility issues
  • fatigue
  • dry skin and brittle hair
  • cold intolerance
  • constipation
  • non pitting edema

front 47

hypothyroidism treatment

back 47

replacement of thyroid hormone with levothyroxine (Synthroid)

life long therapy

front 48

myxedema coma

(hypothyroidism)

back 48

  • life threatening medical emergency
  • can occur due to abrupt withdrawal of hypothyroid treatment
  • can occur due to increased stress/illness

front 49

myxedema coma

S/S

back 49

  • bradycardia
  • hypoventilation
  • dizziness
  • resp acidosis
  • LOS
  • hypotension

front 50

thyroiditis ACUTE

back 50

caused by an infection

treat with antibiotics

front 51

thryoiditis SUBACUTE

back 51

caused by a viral infection- respiratory

treat symptoms

front 52

thyroiditis CHRONIC

back 52

autoimmune- hashimotos thyroiditis

lifelong hormone replacement- levothyroxine

front 53

thyroiditis S/S

back 53

  • enlargement of thyroid gland
  • dysphagia

front 54

thyroiditis diagnosis

back 54

  • lab testing (TSH, thyroid levels, radioactive iodine uptake testing)
  • biopsy
  • treatment goal___- reduce inflammation and prevent hypothyroidism

front 55

thyroid cancer

back 55

slow growing tumors

front 56

thyroid cancer S/S

back 56

  • nodules noted on palpation
  • fatigue
  • weight changes
  • difficulty swallowing or breathing
  • voice changes
  • fluctuating hormone levels

front 57

thyroid cancer diagnosis

back 57

  • thyroid ultrasound
  • iodine uptake studies
  • fine-needles biopsies

front 58

thyroid cancer treatment

back 58

  • thryoidectomy
  • radioactive iodine ablation therapy