What is the term used to describe the regulation of hormone concentration in the bloodstream?
What is the major structure that balances the rapid action of the nervous system with slower hormonal action?
What are the
two major hormones secreted by the posterior lobe of the pituitary gland?
- vasopressin
- oxytocin
What does vasopressin control?
the excretion of water by the kidneys
milk ejection during
lactation
What does oversecretion of adrenocorticotropic hormone (ACTH), or the growth hormone result in?
- acromegaly
- gigantism
A deficiency of ADH or vasopressin can result in what?
Diabetes insipidus is characterized by what?
- polydipsia (excessive thirst)
- large volume of dilute urine
What three hormones does the thyroid gland produce?
- thyroxine
- calcitonin
- triiodothyronine
What is the most common cause of hypothyroidism?
autoimmune thyroiditis (Hashimoto's)
True or False: primary hyperthyroidism occurs two to four times more often in women than in men.
What is the most common type of hyperthyroidism?
What are the two most common medications used to treat hyperthyroidism?
- methimazole (Topazole)
- propylthiouracil (PTU)
A positive Trousseau's or Chvostek's indicates what?
What are the
three types of steroid hormones produced by the adrenal cortex?
- glucocorticoids
- mineralcorticoids
- androgens
What is one of the most important and frequently occurring complications of hyperparathyroidism?
What is the most common cause of thyrotoxicosis in the older adult patient?
Controls excretion of water by the kidneys?
Inhibits bone resorption?
Influences metabolism that is essential for normal growth?
Supports sexual maturation?
Promotes the secretion of milk?
Stimulates the reabsorption of sodium and the elimination of potassium?
Increases the force of uterine contractions during parturition?
The anterior pituitary gland is responsible for secreting what hormones?
- adrenocorticotropic hormone (ACTH)
- follicle-stimulating hormone (FSH)
- thyroid-stimulating hormones (TSH)
- luteinizing hormone (LH)
- Prolactin
- somatotropin (GH)
Hormones are classified in what four ways?
- steroids
- proteins or peptides
- polypeptides and glycoproteins
- amines and amino
acids, and fatty acids
What deficiency would the RN suspect in a patient with obvious goiter?
Most hormones secreted from _____glands or released directly into the blood stream?
_____glands, such as sweat glands, secrete their products through ducts onto epithelial surfaces or into the gi tract?
When conducting a health history during an assessment, it is important to document what?
- the severity of these changes
- the length of time the patient has experienced these changes
- the in which these changes have affected the patients ability to carry out activities of daily living
- the effect of the changes on the patients
self perception
- family history
What is commonly referred to as the master gland?
pituitary gland (hypophysis)
True or False: urine tests are used to measure the amount of hormones or the end products of hormones excreted by the kidneys.
Basophilic tumors give rise to what?
_____% of pituitary tumors are benign?
The three principal types of pituitary tumors represent and overgrowth of?
- eosinophilic cells
- basophilic cells
- cromophobic cells
Insufficient secretion of somatotropin during childhood results in what?
The result of the total destruction of the pituitary gland, trauma, tumor, are vascular lesion removes all stimuli that are normally received by the thyroid, gonads, and the adrenal glands.
- extreme weight loss
- emaciation
- atrophy of all endocrine glands and organs
- hair loss
- impotence
- amenorrhea
- hypometabolism
- hypoglycemia
Hypo function of the pituitary gland (hypopituitarism) can result from?
- disease of the pituitary gland itself
- disease of the hypothalamus
True or False: the inability to increase the specific gravity and osmolality of the urine is characteristic of diabetes insipidus.
What are the objectives of diabetes insipidus therapy?
- replace ADH
- to ensure adequate fluid replacement
- to identify and
correct the underlying intracranial pathology
What are the two pillars of skilled nursing management of the patient with a diagnosis of DI?
- physical assessment
- patient education
What is the largest endocrine gland that is shaped like a
butterfly?
The thyroid gland has approximately _____ times the blood flow to the liver.
syndrome of inappropriate anti diuretic hormone
What is the term that refers to normal thyroid hormone production?
TSH screening should begin on all adults, _____ years of age and
every _____ years thereafter.
What is the single best screening test of thyroid function in outpatients?
measurement of serum TSH concentration
What is the most widely used lab tests?
- serum ammunoassay for TSH
- free T4
What refers to the accumulation of mucopolysaccharides in subcutaneous and other interstitial tissues?
Atrial fibrillation occurs in what percent of older adult patients with new onset hyperthyroidism?
What is a life threatening condition
manifested by cardiac dysrhythmias, fever, and neurologic impairment?
The most commonly used anti thyroid drugs in the united states are?
- methimazol (Tapazole)
- propylthiouracil (PTU)
Prior to initiating drug therapy, what base
line lab tests are performed?
- CBC with differential
- liver profile
Discontinuation of anti thyroid before therapy is complete usually results in relapse within how many months?
What is the major effect of epinephrine?
to meet a fight or flight response
Each person has how many adrenal glands?
2, one attached to the upper portion each kidney
The adrenal cortex secretes what?
The adrenal medulla secretes whats?
What tumor is usually benign and originates from chromaffin cells of the adrenal medulla?
What "five H's" are associated with pheochromocytoma?
- hypertension
- headache
- hyperhidrosis
- hypermetabolism
- hyperglycemia
What value of epinephrine and norepinephrine are considered diagnostic for pheochromocytoma?
what is the definitive treatment of pheochromocytoma?
What disease occurs when the adrenal cortex function is inadequate to meet the patients needs for cortical hormones?
What are the three tests used to diagnose Cushing syndrome?
- serum cortisol
- urinary cortisol
- Decadron suppression test
What is the "classic" picture of an adult with Cushing syndrome?
- central-type obesity
- "buffalo hump" in the neck and supraclavicular area
- a heavy trunk
- relatively thin extremities
When are serum cortisol levels usually higher?
When are serum cortisol levels usually lower?
If Cushing syndrome is caused by pituitary tumors rather than tumors of the adrenal cortex, the
treatment of choice is?
surgical removal by transphenoidal hypophysectomy
What is the treatment of choice in patients with primary adrenal hypertrophy?
nervousness, rapid pulse, heat intolerance, tremors, skin flushed, warm, soft, and moist; exophthalmos; increased appetite; weight loss; elevated systolic BP;
cardiac dysrhythmias.
What is the treatment of choice for thyroid cancer?
What are the four glands on the posterior thyroid gland?
S/S of hyperparathyroidism?
elevated serum calcium, bone decalcification, renal calculi, apathy,
fatigue, muscle weakness, nausea and vomiting, constipation, hypertension, cardiac dysrhythmias, psychological manifestations.
S/S of hypoparathyroidism?
tetany, numbness, tingling in extremities, stiffness of hands and feet, bronchospasm, laryngeal spasm, carpopedal spasm, anxiety, irritability, depression, delirium, ECG changes.
True or False: a patient in acute hypercalcemic crisis requires close monitoring for life-threatening complications and prompt treatment to reduce serum calcium levels.
S/S of adrenocortical insufficiency?
muscle weakness, anorexia, GI symptoms, fatigue, dark pigmentation of skin and
mucosa, hypotension, low blood glucose, low serum sodium, high serum potassium, apathy, emotional lability, confusion.
True or False: oversecretion of adrenocorticotropic hormone (ACTH) or the growth hormone results in Grave's disease.
False (Grave's disease results from an excessive output of thyroid hormones caused by abnormal
stimulation of the thyroid gland by circulating immunoglobulins.